Vaccine immunity in patients with 22q11.2 microdeletion syndrome.

IF 4.3 2区 医学 Q2 ALLERGY
Leila Farpour, Renato Gualtieri, Tereza Kotalova, Barbara Lemaître, Julie Ducreux, Isabelle Arm-Vernez, Stephan Eliez, Geraldine Blanchard-Rohner
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Abstract

Background: Patients with microdeletion 22q11.2 syndrome (MDS) exhibit immunological defects, characterized by abnormalities in the development of the thymus, which plays a crucial role in T-cell maturation and immune response. As a result, these patients may have impaired adaptive immunity, with decreased responses to vaccination.

Methods: This was a prospective observational study. Vaccine serology (tetanus, diphtheria, Haemophilus influenzae type b for children <5 years, measles, varicella, hepatitis A and B, and SARS-CoV-2) and immune parameters were assessed in MDS patients aged between 1 and 25 years followed in Geneva between February 2022 and April 2023.

Results: 41 MDS patients were included. The median age was 13 years old. Most of them reported recurrent otitis and bronchitis up to 10 years, and a mild COVID-19 disease in the past. Immunological work-up indicated normal immunoglobulin levels and lymphocyte counts for the majority. Most patients were well vaccinated for tetanus, diphtheria, Haemophilus influenzae type b and measles, but only half were fully vaccinated for hepatitis B, and SARS-CoV-2 and only a quarter for hepatitis A. 70% of the patients had received 3 doses of pneumococcal conjugate vaccine in infancy but only a minority an additional dose. While most of them were seroprotected against tetanus, diphtheria, and Hib, a substantial number lacked seroprotection against varicella, measles, hepatitis B, and pneumococcus.

Conclusion: This study suggests that regular assessment of antibody levels for measles, hepatitis B, varicella, and pneumococcus, regardless of vaccination status should be encouraged in MDS patients, with reimmunization according to vaccine serology, to enhance vaccine immunity.

22q11.2微缺失综合征患者的疫苗免疫
背景:微缺失22q11.2综合征(microdeletion 22q11.2 syndrome, MDS)患者表现出免疫缺陷,其特征是胸腺发育异常,而胸腺在t细胞成熟和免疫应答中起着至关重要的作用。因此,这些患者的适应性免疫可能受损,对疫苗接种的反应降低。方法:前瞻性观察性研究。儿童疫苗血清学(破伤风、白喉、b型流感嗜血杆菌)结果:纳入41例MDS患者。平均年龄为13岁。他们中的大多数人报告了长达10年的复发性中耳炎和支气管炎,过去曾出现过轻微的COVID-19疾病。免疫检查显示大部分患者免疫球蛋白水平和淋巴细胞计数正常。大多数患者接种了破伤风、白喉、b型流感嗜血杆菌和麻疹疫苗,但只有一半的患者接种了乙型肝炎和SARS-CoV-2疫苗,只有四分之一的患者接种了甲型肝炎疫苗。70%的患者在婴儿期接种了三剂肺炎球菌结合疫苗,但只有少数人额外接种了一剂。虽然大多数儿童接种了破伤风、白喉和Hib疫苗,但仍有相当一部分儿童缺乏水痘、麻疹、乙型肝炎和肺炎球菌疫苗。结论:本研究提示,无论MDS患者是否接种疫苗,均应定期评估麻疹、乙型肝炎、水痘和肺炎球菌的抗体水平,并根据疫苗血清学进行再免疫,以增强疫苗免疫力。
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来源期刊
CiteScore
9.10
自引率
9.10%
发文量
200
审稿时长
4-8 weeks
期刊介绍: Pediatric Allergy and Immunology is the world''s leading journal in pediatric allergy, publishing original contributions and comprehensive reviews related to the understanding and treatment of immune deficiency and allergic inflammatory and infectious diseases in children. Other areas of interest include: development of specific and accessory immunity; the immunological interaction during pregnancy and lactation between mother and child. As Pediatric Allergy and Immunology promotes communication between scientists engaged in basic research and clinicians working with children, we publish both clinical and experimental work.
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