Open Access

ARTICLE

Antibody response to pneumococcal capsular polysaccharide vaccination in patients with chronic kidney disease

Majid Mahmoodi^1,2, Asghar Aghamohammadi^3,4, Nima Rezaei^3,4, Mahboob Lessan-Pezeshki⁵, Gholamreza Pourmand⁶, Mohammad-Ali Mohagheghi¹, Sina Abdollahzade⁴, Alireza Mousavi-Jarrahi¹

1 Cancer Research Center, Tehran University of Medical Sciences, Tehran, Iran
2 Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
3 Center of Excellence for Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
4 Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran
5 Baghiatollah University of Health and Medical Services, Tehran, Iran
6 Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran

* Corresponding Author: A. Aghamohammadi,

European Cytokine Network 2009, 20(2), 69-74. https://doi.org/10.1684/ecn.2009.0153

Accepted 10 April 2009;

Abstract

Patients with chronic kidney disease (CKD) or on dialysis are at greater risk of infection, which might be due to a defective immune function. While there are controversial reports on efficacy of vaccination in this group of patients, the aim of this study was to evaluate the antibody response to pneumococcal capsular polysaccharide vaccine (PPV23) in CKD patients. Sixty-six patients with CKD and 40 healthy individuals were vaccinated with PPV23. Blood samples were taken before and four weeks after vaccination. Specific antibodies against whole pneumococcal antigens were measured using an enzyme-linked immunosorbent assay (ELISA) technique. Among the 66 vaccinated patients, 14 (21%) were hypo-responsive to vaccine (group 1), while 52 had a normal specific-antibody response (group 2). Post-vaccination, anti-pneumococcal IgG titers in group 1 were significantly lower than those in group 2 (p = 0.012 for IgG post-vaccination and p = 0.020 for IgG2 post-vaccination). The fold increase or ratio increase of the anti-pneumococcal IgG titer in patients of group 1 was also significantly lower than that in group 2 or the healthy control group (p = 0.001 versus group 2 and p = 0.005 versus control group). During follow-up of both patient groups, group 1 patients developed more epi-sodes of pneumococcal infections than those patients in group 2 (p = 0.007). In conclusion, although the major-ity of patients with CKD were responders to the polysaccharide vaccine, a substantial proportion of patients failed to mount an adequate antibody response to PPV23 and remained at significant risk of pneumococcal infection. Nevertheless, this vaccination policy should be administered as it could prevent infection in responder patients.

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Keywords

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