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Antibody Response to Capsular Polysaccharide Vaccine of Streptococcal Pneumonia in Patients with Nephrotic Syndrom

Journal of the Korean Pediatric Society 1995;38(8):1107-1115.
Published online August 15, 1995.
Antibody Response to Capsular Polysaccharide Vaccine of Streptococcal Pneumonia in Patients with Nephrotic Syndrom
Ji Young Choi, Jae Ho Lee
Department of Pediatrics, Chungnam National University Tae Jeon, Korea
신증후군 질환에서의 복합 폐구균 다당질 백신에 대한 항체반응
최지영, 이재호
충남대학교 의과대학 소아과학교실
Abstract
Purpose
: Although the etiology and pathogenesis of child with nephrotic syndrome remains uncertain, it has been suggested from indirect evidence that this syndrome may represent deficiency in T-cell function and abnormal humoral immune response to antigens or immynoglobulin. Children with nephrotic syndrome are susceptible to pneumococcal infection. Now, we performed this study to evaluate pneumococcal anticapsular antibody concentration and immunologic competence
Methods
: we studied 29 patients between the ages of 4 and 14 years with nephrotic syndrome and 20 normal healthy children between the ages of 8 and 12 years. All subjects were vaccinated andthen blood samples were obtained before and four weeks after vaccination. All sera were promptly forzen and stored at -70℃. Mean pneumococcal IgG and IgM antibody were measured in serum by enzyme linked immunoassay. Antibody fold increase was defined as postvaccination mean pneumococcal antibody compared to prevaccination mean pnumococal antibody. Student's t-test, paired t-test and Anova test were used in statistical ealuation of data
Results
: 1) Children with nephrotic synrome showed that pneumococcal antibody after vaccination were significantly elevated before immunization 2) Pneumococcal IgM antibody response before and after vaccination were not different significantly between patients with nephrotic syndrome and healthy children. However, pneumococcal IgG antibody concentration of nephrotic syndrome before and after vaccination were significantly lower than control subject 3) IgG and IgM pneumococcal antibody oncentration and antibody response in nephrotic syndrome were independently of the state of proteinuria and wa snot affected by administration of steroid
Conclusion
: These results suggest that patients with nephrotic syndrome can mount and adequate antibody response to pneumococcal polysaccharides and these response may protect patients from pneumococcal infection. However long term duration of serum antibody concentration and clinical efficacy must await further evaluation.
Key Words: Nephrotic syndrome, Pneumococcal IgG and IgM antibody, Pneumococcal polysaccharides vaccination


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