Assessing humoral immunity in daily practice: A retrospective study in a pediatric tertiary center

IF 4.5 3区医学 Q2 IMMUNOLOGY

Clinical immunology Pub Date : 2024-11-07 DOI:10.1016/j.clim.2024.110395

Isabel Fernandez , Hélène Decaluwe , Jean-Jacques DeBruycker , Elie Haddad , Fabien Touzot

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Abstract

The evaluation of humoral immunity is usually performed through the assessment of serum immunoglobulin levels, vaccine titer responses, and B-cell enumeration and phenotyping. We performed a retrospective study assessing humoral immunity in 469 pediatric patients referred at the Sainte-Justine University Hospital Center. Almost half of the patients had at least one abnormal humoral immunological parameter at their evaluation, with low vaccine response titer to protein antigen being the most frequent. Fifteen patients (3.2 %) had a proven monogenic IEI, and 21 patients (4.5 %) required Ig replacement. Besides the infectious burden, hypoIgG remains the only parameter associated with Ig replacement therapy after the age of 6 years. Low antibody titers against conjugate vaccines had low sensitivity and positive predictive values for starting Ig replacement. Our study highlights the challenge of evaluating the humoral function in the pediatric population with suspected IEI with significant age and sex-dependent variability between parameters.

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在日常工作中评估体液免疫：儿科三级中心的回顾性研究。

体液免疫评估通常是通过评估血清免疫球蛋白水平、疫苗滴度反应以及 B 细胞计数和表型来进行的。我们进行了一项回顾性研究，对圣茹斯廷大学医院中心转诊的 469 名儿科患者进行了体液免疫评估。近一半的患者在评估时至少有一项体液免疫参数异常，其中最常见的是对蛋白抗原的疫苗反应滴度低。有 15 名患者（3.2%）被证实患有单基因 IEI，21 名患者（4.5%）需要更换 Ig。除了感染负担外，IgG过低仍然是 6 岁以后与 Ig 替代治疗相关的唯一参数。针对结合疫苗的低抗体滴度对开始 Ig 置换的敏感性和阳性预测值较低。我们的研究强调了在疑似 IEI 的儿科人群中评估体液功能的挑战性，因为不同参数之间存在显著的年龄和性别差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical immunology 医学-免疫学

CiteScore

12.30

自引率

1.20%

发文量

212

审稿时长

34 days

期刊介绍： Clinical Immunology publishes original research delving into the molecular and cellular foundations of immunological diseases. Additionally, the journal includes reviews covering timely subjects in basic immunology, along with case reports and letters to the editor.