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Fifth percentile cutoff values for antipneumococcal polysaccharide and anti-salmonella typhi Vi IgG describe a normal polysaccharide response

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Abstract
Background: Serotype-specific antibody responses to unconjugated pneumococcal polysaccharide vaccine (PPV) evaluated by a World Health Organization (WHO)standardized enzyme-linked immunosorbent assay (ELISA) are the gold standard for diagnosis of specific polysaccharide antibody deficiency (SAD). The American Academy of Allergy, Asthma and Immunology (AAAAI) has proposed guidelines to interpret the PPV response measured by ELISA, but these are based on limited evidence. Additionally, ELISA is costly and labor-intensive. Measurement of antibody response to Salmonella typhi (S. typhi) Vi vaccine and serum allohemagglutinins (AHA) have been suggested as alternatives. However, there are no large cohort studies and cutoff values are lacking. Objective: To establish cutoff values for antipneumococcal polysaccharide antibody response, anti-S. typhi Vi antibody, and AHA. Methods: One hundred healthy subjects (10- 55 years) were vaccinated with PPV and S. typhi Vi vaccine. Blood samples were obtained prior to and 3-4 weeks after vaccination. Polysaccharide responses to 3 serotypes were measured by WHO ELISA and to 12 serotypes by an in-house bead-based multiplex assay. Anti-S. typhi Vi IgG were measured with a commercial ELISA kit. AHA were measured by agglutination method. Results: Applying AAAAI criteria, 30% of healthy subjects had a SAD. Using serotype- specific fifth percentile (p5) cutoff values for postvaccination IgG and fold increase pre-over postvaccination, only 4% of subjects had SAD. One-sided 95% prediction intervals for anti-S. typhi Vi postvaccination IgG (>= 11.2U/ml) and fold increase (>= 2) were established. Eight percent had a response to S. typhi Vi vaccine below these cutoffs. AHA titer p5 cutoffs were 1/2 for anti-B and 1/4 for anti-A. Conclusion : We establish reference cutoff values for interpretation of PPV response measured by bead-based assay, cutoff values for S. typhi Vi vaccine responses, and normal values for AHA. For the first time, the intraindividual consistency of all three methods is studied in a large cohort.
Keywords
polysaccharide antibody deficiency, specific antibody deficiency, pneumococcal polysaccharide vaccine, Salmonella typhi Vi vaccine, allohemagglutinins, RECURRENT RESPIRATORY-INFECTIONS, PRIMARY IMMUNODEFICIENCY, PNEUMOCOCCAL VACCINATION, TRACT INFECTIONS, ANTIBODIES, CHILDREN, DEFICIENCY, DIAGNOSIS, QUANTITATION, IMMUNOASSAY

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MLA
Schaballie, Heidi, et al. “Fifth Percentile Cutoff Values for Antipneumococcal Polysaccharide and Anti-Salmonella Typhi Vi IgG Describe a Normal Polysaccharide Response.” FRONTIERS IN IMMUNOLOGY, vol. 8, 2017, doi:10.3389/fimmu.2017.00546.
APA
Schaballie, H., Bosch, B., Schrijvers, R., Proesmans, M., De Boeck, K., Boon, M. N., … Meyts, I. (2017). Fifth percentile cutoff values for antipneumococcal polysaccharide and anti-salmonella typhi Vi IgG describe a normal polysaccharide response. FRONTIERS IN IMMUNOLOGY, 8. https://doi.org/10.3389/fimmu.2017.00546
Chicago author-date
Schaballie, Heidi, Barbara Bosch, Rik Schrijvers, Marijke Proesmans, Kris De Boeck, Mieke Nelly Boon, Francois Vermeulen, et al. 2017. “Fifth Percentile Cutoff Values for Antipneumococcal Polysaccharide and Anti-Salmonella Typhi Vi IgG Describe a Normal Polysaccharide Response.” FRONTIERS IN IMMUNOLOGY 8. https://doi.org/10.3389/fimmu.2017.00546.
Chicago author-date (all authors)
Schaballie, Heidi, Barbara Bosch, Rik Schrijvers, Marijke Proesmans, Kris De Boeck, Mieke Nelly Boon, Francois Vermeulen, Natalie Lorent, Doreen Dillaerts, Glynis Frans, Leen Moens, Inge Derdelinckx, Willy Peetermans, Bjorn Kantso, Charlotte Svaerke Jorgensen, Marie-Paule Emonds, Xavier Bossuyt, and Isabelle Meyts. 2017. “Fifth Percentile Cutoff Values for Antipneumococcal Polysaccharide and Anti-Salmonella Typhi Vi IgG Describe a Normal Polysaccharide Response.” FRONTIERS IN IMMUNOLOGY 8. doi:10.3389/fimmu.2017.00546.
Vancouver
1.
Schaballie H, Bosch B, Schrijvers R, Proesmans M, De Boeck K, Boon MN, et al. Fifth percentile cutoff values for antipneumococcal polysaccharide and anti-salmonella typhi Vi IgG describe a normal polysaccharide response. FRONTIERS IN IMMUNOLOGY. 2017;8.
IEEE
[1]
H. Schaballie et al., “Fifth percentile cutoff values for antipneumococcal polysaccharide and anti-salmonella typhi Vi IgG describe a normal polysaccharide response,” FRONTIERS IN IMMUNOLOGY, vol. 8, 2017.
@article{01J82GQDS6T1CE8QEGSJFH8WWS,
  abstract     = {{Background: Serotype-specific antibody responses to unconjugated pneumococcal polysaccharide vaccine (PPV) evaluated by a World Health Organization (WHO)standardized enzyme-linked immunosorbent assay (ELISA) are the gold standard for diagnosis of specific polysaccharide antibody deficiency (SAD). The American Academy of Allergy, Asthma and Immunology (AAAAI) has proposed guidelines to interpret the PPV response measured by ELISA, but these are based on limited evidence. Additionally, ELISA is costly and labor-intensive. Measurement of antibody response to Salmonella typhi (S. typhi) Vi vaccine and serum allohemagglutinins (AHA) have been suggested as alternatives. However, there are no large cohort studies and cutoff values are lacking.

 Objective: To establish cutoff values for antipneumococcal polysaccharide antibody response, anti-S. typhi Vi antibody, and AHA.

 Methods: One hundred healthy subjects (10- 55 years) were vaccinated with PPV and S. typhi Vi vaccine. Blood samples were obtained prior to and 3-4 weeks after vaccination. Polysaccharide responses to 3 serotypes were measured by WHO ELISA and to 12 serotypes by an in-house bead-based multiplex assay. Anti-S. typhi Vi IgG were measured with a commercial ELISA kit. AHA were measured by agglutination method.

 Results: Applying AAAAI criteria, 30% of healthy subjects had a SAD. Using serotype- specific fifth percentile (p5) cutoff values for postvaccination IgG and fold increase pre-over postvaccination, only 4% of subjects had SAD. One-sided 95% prediction intervals for anti-S. typhi Vi postvaccination IgG (>= 11.2U/ml) and fold increase (>= 2) were established. Eight percent had a response to S. typhi Vi vaccine below these cutoffs. AHA titer p5 cutoffs were 1/2 for anti-B and 1/4 for anti-A.

 Conclusion : We establish reference cutoff values for interpretation of PPV response measured by bead-based assay, cutoff values for S. typhi Vi vaccine responses, and normal values for AHA. For the first time, the intraindividual consistency of all three methods is studied in a large cohort.}},
  articleno    = {{546}},
  author       = {{Schaballie, Heidi and  Bosch, Barbara and  Schrijvers, Rik and  Proesmans, Marijke and  De Boeck, Kris and  Boon, Mieke Nelly and  Vermeulen, Francois and  Lorent, Natalie and  Dillaerts, Doreen and  Frans, Glynis and  Moens, Leen and  Derdelinckx, Inge and  Peetermans, Willy and  Kantso, Bjorn and  Jorgensen, Charlotte Svaerke and  Emonds, Marie-Paule and  Bossuyt, Xavier and  Meyts, Isabelle}},
  issn         = {{1664-3224}},
  journal      = {{FRONTIERS IN IMMUNOLOGY}},
  keywords     = {{polysaccharide antibody deficiency,specific antibody deficiency,pneumococcal polysaccharide vaccine,Salmonella typhi Vi vaccine,allohemagglutinins,RECURRENT RESPIRATORY-INFECTIONS,PRIMARY IMMUNODEFICIENCY,PNEUMOCOCCAL VACCINATION,TRACT INFECTIONS,ANTIBODIES,CHILDREN,DEFICIENCY,DIAGNOSIS,QUANTITATION,IMMUNOASSAY}},
  language     = {{eng}},
  pages        = {{9}},
  title        = {{Fifth percentile cutoff values for antipneumococcal polysaccharide and anti-salmonella typhi Vi IgG describe a normal polysaccharide response}},
  url          = {{http://doi.org/10.3389/fimmu.2017.00546}},
  volume       = {{8}},
  year         = {{2017}},
}

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