Medical College of Wisconsin
CTSICores SearchResearch InformaticsREDCap

The Use of Salmonella Typhim Vaccine to Diagnose Antibody Deficiency. J Clin Immunol 2017 Jul;37(5):427-433

Date

06/08/2017

Pubmed ID

28589420

DOI

10.1007/s10875-017-0406-6

Scopus ID

2-s2.0-85020280654   17 Citations

Abstract

PURPOSE: The specific antibody response to the unconjugated 23-valent pneumococcal polysaccharide vaccine is one of the most common tests used to assess for possible humoral immunodeficiency. The results can be difficult to interpret because most people have been immunized with one or more of the pneumococcal vaccines and there is controversy regarding what constitutes a normal response. To circumvent this problem, we developed an ELISA to measure IgG-specific antibodies to the Salmonella Vi Typhim (S. Typhim) vaccine, a pure polysaccharide vaccine, which is a neoantigen for the vast majority of people in the USA.

METHODS: We compared the pre- and post-vaccination serum titers to the Vi Typhim vaccine in healthy controls (nA =A 22), patients previously diagnosed with a primary immunodeficiency (nA =A 30), and patients referred for possible humoral immune deficiency (nA =A 29). We also determined if the S. Typhim vaccine could be used to assess specific antibody responses in people on antibody replacement therapy.

RESULTS: Following immunization with the S. Typhim vaccine, we found that a 2-fold increase in titers is 100% sensitive and specific in detecting known humoral immune deficiencies as determined by ROC curve analysis. This cut-off value was successfully applied to possible immune deficiency patients (nA =A 29), resulting in the diagnosis of seven subjects with humoral immunodeficiency. The use of immunoglobulin replacement therapy did not affect the median response ratios compared to subjects not receiving gammaglobulin.

CONCLUSION: This study suggests that measurement of the specific antibody response to the S. Typhim vaccine may have advantages over pneumococcal vaccination in the evaluation of the humoral immune response.

Author List

Bausch-Jurken MT, Verbsky JW, Gonzaga KA, Elms NP, Hintermeyer MK, Gauld SB, Routes JM

Author

James Verbsky MD, PhD Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Agammaglobulinemia
Aged
Antibodies, Bacterial
Area Under Curve
Case-Control Studies
Enzyme-Linked Immunosorbent Assay
Female
Humans
Immunoglobulin G
Immunologic Deficiency Syndromes
Male
Middle Aged
Polysaccharides, Bacterial
ROC Curve
Typhoid-Paratyphoid Vaccines
Vaccination
Young Adult