Opsonic and Antibody Responses to Pneumococcal Polysaccharide in Rheumatoid Arthritis Patients Receiving Golimumab Plus Methotrexate.
Opsonic and Antibody Responses to Pneumococcal Polysaccharide in Rheumatoid Arthritis Patients Receiving Golimumab Plus Methotrexate.
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DOI：
10.1097/md.0000000000002184
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发表时间：
2015-12
期刊：
影响因子：
1.6
通讯作者：
Oishi K
中科院分区：
文献类型：
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作者：
Migita K;Akeda Y;Akazawa M;Tohma S;Hirano F;Ideguchi H;Matsumura R;Suematsu E;Miyamura T;Mori S;Fukui T;Izumi Y;Iwanaga N;Jiuchi Y;Kozuru H;Tsutani H;Saisyo K;Yamanaka T;Ohshima S;Mori N;Matsumori A;Kitagawa K;Takahi K;Ozawa T;Hamada N;Nakajima K;Nagai H;Tamura N;Suenaga Y;Kawabata M;Matsui T;Furukawa H;Kawakami K;Oishi K
对于接受免疫抑制治疗的类风湿关节炎（RA）患者，推荐接种肺炎链球菌疫苗。本研究的目的是评估接受甲氨蝶呤（MTX）单独或与肿瘤坏死因子抑制剂golimumab （GOM）联合治疗的RA患者对23价肺炎球菌多糖疫苗（PPSV23）的体液反应。114例RA患者接受PPSV23治疗，分为3组：RA对照组（n = 35）、单独使用MTX组（n = 55）和GOM + MTX组（n = 24）。接种前和接种后4 - 6周，采用酶联免疫吸附法测定抗肺炎球菌血清型6B和23F的抗体浓度，采用多路调理噬细胞杀伤法测定抗体的功能，报告为调理指数（OI）。接种PPSV23疫苗后，各处理组血清IgG浓度和oi均显著升高。在GOM + MTX组中，IgG反应低于单独使用MTX组或对照组，而OI反应与其他两组相似。此外，GOM + MTX组IgG和OI反应存在差异。各治疗组均未见严重不良反应。OI反应表明抗体功能比抗体数量更重要。所有三组之间这些测量值的相似性表明，接受MTX + GOM的RA患者仍然受益于接种PPSV23疫苗，即使他们产生的IgG较少。这些结果可以帮助临床医生更好地安排和评估风湿性关节炎患者的肺炎球菌疫苗接种。
Vaccination against Streptococcus pneumoniae is recommended for rheumatoid arthritis (RA) patients receiving immunosuppressive treatments. The objective of this study was to evaluate the humoral response to 23-valent pneumococcal polysaccharide vaccination (PPSV23) in RA patients receiving methotrexate (MTX) alone or in combination with a tumor necrosis factor inhibitor, golimumab (GOM). PPSV23 was given to 114 RA patients, who were classified into three groups: RA control (n = 35), MTX alone (n = 55), and GOM + MTX (n = 24). Before and 4 to 6 weeks after vaccination, concentrations of antibodies against pneumococcal serotypes 6B and 23F were measured using an enzyme-linked immunosorbent assay and antibody functionality was determined using a multiplexed opsonophagocytic killing assay, reported as the opsonization index (OI). The IgG concentrations and OIs were both significantly increased in all treatment groups in response to PPSV23 vaccination. In the GOM + MTX group, the IgG responses were lower than those in the MTX alone or control groups, whereas the OI responses were similar to those in the other 2 groups. Furthermore, discrepancies between the IgG and OI responses were found in GOM + MTX group. No severe adverse effect was observed in any treatment groups. OI responses indicate that antibody functionality rather than antibody quantity is important. The similarity of these measurements between all 3 groups suggests that RA patients receiving MTX + GOM still benefit from receiving the PPSV23 vaccination, even though they produce less IgG in response to it. These results can help clinicians to better schedule and evaluate pneumococcal vaccination for RA patients.