[go: up one dir, main page]
More Web Proxy on the site http://driver.im/ Skip to main content
NCBI home page
Infection and Immunity logoLink to Infection and Immunity
. 1997 Jan;65(1):242–247. doi: 10.1128/iai.65.1.242-247.1997

Comparison of pneumococcal polysaccharide and CRM197-conjugated pneumococcal oligosaccharide vaccines in young and elderly adults.

M A Shelly 1, H Jacoby 1, G J Riley 1, B T Graves 1, M Pichichero 1, J J Treanor 1
PMCID: PMC174582  PMID: 8975918

Abstract

Conjugation of carbohydrate antigens to protein carriers significantly improves the immune response to many carbohydrates. In order to evaluate the potential for this approach to improve the performance of pneumococcal vaccine in the elderly, we evaluated pneumococcal polysaccharide-derived oligosaccharides conjugated to cross-reacting material 197 (CRM197) (CRM-OS) in 49 older adults over 60 years of age (median age, 66 years) and compared the results to those from 50 younger adults under age 45 (median age, 27 years). Subjects were randomly assigned to receive licensed 23-valent polysaccharide vaccine (PS) which contain 25 micrograms of polysaccharide per serotype, or 5-valent CRM-OS, which contains 10 micrograms of oligosaccharide per serotype, in double-blind fashion. Both vaccines were associated with moderate local pain on administration. Antibody responses to type 14 were seen in the majority of both younger and older subjects following administration of both CRM-OS and PS, and there was no significant improvement of responses with CRM-OS in either age group. Antibody responses in young adults to the less immunogenic type 6B were seen in only 36% of subjects receiving PS and in 56% of subjects receiving CRM-OS (P = 0.15), and the geometric mean 6B titer 1 month after vaccination was higher in CRM-OS recipients (10.9 versus 3.7 micrograms/ml; P = 0.04). However, 6B responses were poor following the administration of either vaccine to elderly adults and there was no difference between results with CRM-OS and those with PS in this age group. Relatively few subjects developed measurable mucosal immunoglobulin A responses in nasal secretions following administration of either vaccine. Revaccination of CRM-OS recipients with PS at 2 months did not result in significant additional responses to 6B or 14. Though CRM-OS is possibly more immunogenic in young adults, the formulation of the pneumococcal glycoconjugate vaccine used in this study does not appear to offer an advantage to the elderly for types 6B or 14.

Full Text

The Full Text of this article is available as a PDF (201.5 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aaberge I. S., Michaelsen T. E., Heier H. E. IgG subclass antibody responses to pneumococcal polysaccharide vaccine in splenectomized, otherwise normal, individuals. Scand J Immunol. 1990 Jun;31(6):711–716. doi: 10.1111/j.1365-3083.1990.tb02822.x. [DOI] [PubMed] [Google Scholar]
  2. AlonsoDeVelasco E., Verheul A. F., Verhoef J., Snippe H. Streptococcus pneumoniae: virulence factors, pathogenesis, and vaccines. Microbiol Rev. 1995 Dec;59(4):591–603. doi: 10.1128/mr.59.4.591-603.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Anderson P., Pichichero M. E., Insel R. A. Immunogens consisting of oligosaccharides from the capsule of Haemophilus influenzae type b coupled to diphtheria toxoid or the toxin protein CRM197. J Clin Invest. 1985 Jul;76(1):52–59. doi: 10.1172/JCI111976. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Austrian R., Douglas R. M., Schiffman G., Coetzee A. M., Koornhof H. J., Hayden-Smith S., Reid R. D. Prevention of pneumococcal pneumonia by vaccination. Trans Assoc Am Physicians. 1976;89:184–194. [PubMed] [Google Scholar]
  5. Bardardottir E., Jonsson S., Jonsdottir I., Sigfusson A., Valdimarsson H. IgG subclass response and opsonization of Streptococcus pneumoniae after vaccination of healthy adults. J Infect Dis. 1990 Aug;162(2):482–488. doi: 10.1093/infdis/162.2.482. [DOI] [PubMed] [Google Scholar]
  6. Borgoño J. M., McLean A. A., Vella P. P., Woodhour A. F., Canepa I., Davidson W. L., Hilleman M. R. Vaccination and revaccination with polyvalent pneumococcal polysaccharide vaccines in adults and infants. Proc Soc Exp Biol Med. 1978 Jan;157(1):148–154. doi: 10.3181/00379727-157-40010. [DOI] [PubMed] [Google Scholar]
  7. Carlson A. J., Davidson W. L., McLean A. A., Vella P. P., Weibel R. E., Woodhour A. F., Hilleman M. R. Pneumococcal vaccine: dose, revaccination, and coadministration with influenza vaccine. Proc Soc Exp Biol Med. 1979 Sep;161(4):558–563. doi: 10.3181/00379727-161-40596. [DOI] [PubMed] [Google Scholar]
  8. Eskola J., Takala A. K., Kela E., Pekkanen E., Kalliokoski R., Leinonen M. Epidemiology of invasive pneumococcal infections in children in Finland. JAMA. 1992 Dec 16;268(23):3323–3327. [PubMed] [Google Scholar]
  9. Farr B. M., Johnston B. L., Cobb D. K., Fisch M. J., Germanson T. P., Adal K. A., Anglim A. M. Preventing pneumococcal bacteremia in patients at risk. Results of a matched case-control study. Arch Intern Med. 1995 Nov 27;155(21):2336–2340. [PubMed] [Google Scholar]
  10. Fattal-German M., Taillandier J., Mathieu D., Bizzini B. Pneumococcal vaccination of elderly individuals. Vaccine. 1991 Aug;9(8):542–544. doi: 10.1016/0264-410x(91)90239-3. [DOI] [PubMed] [Google Scholar]
  11. Fedson D. S., Shapiro E. D., LaForce F. M., Mufson M. A., Musher D. M., Spika J. S., Breiman R. F., Broome C. V. Pneumococcal vaccine after 15 years of use. Another view. Arch Intern Med. 1994 Nov 28;154(22):2531–2535. [PubMed] [Google Scholar]
  12. Fiebach N., Beckett W. Prevention of respiratory infections in adults. Influenza and pneumococcal vaccines. Arch Intern Med. 1994 Nov 28;154(22):2545–2557. [PubMed] [Google Scholar]
  13. Hilleman M. R., Carlson A. J., Jr, McLean A. A., Vella P. P., Weibel R. E., Woodhour A. F. Streptococcus pneumoniae polysaccharide vaccine: age and dose responses, safety, persistence of antibody, revaccination, and simultaneous administration of pneumococcal and influenza vaccines. Rev Infect Dis. 1981 Mar-Apr;3 (Suppl):S31–S42. doi: 10.1093/clinids/3.supplement_1.s31. [DOI] [PubMed] [Google Scholar]
  14. Kaniuk A. S., Lortan J. E., Monteil M. A. Specific IgG subclass antibody levels and phagocytosis of serotype 14 pneumococcus following immunization. Scand J Immunol Suppl. 1992;11:96–98. doi: 10.1111/j.1365-3083.1992.tb01628.x. [DOI] [PubMed] [Google Scholar]
  15. Konradsen H., Henrichsen J. Antibody response to pneumococcal vaccination in the elderly. Zentralbl Bakteriol. 1991 Apr;275(1):94–99. doi: 10.1016/s0934-8840(11)80772-3. [DOI] [PubMed] [Google Scholar]
  16. Lue C., Tarkowski A., Mestecky J. Systemic immunization with pneumococcal polysaccharide vaccine induces a predominant IgA2 response of peripheral blood lymphocytes and increases of both serum and secretory anti-pneumococcal antibodies. J Immunol. 1988 Jun 1;140(11):3793–3800. [PubMed] [Google Scholar]
  17. Mestecky J. The common mucosal immune system and current strategies for induction of immune responses in external secretions. J Clin Immunol. 1987 Jul;7(4):265–276. doi: 10.1007/BF00915547. [DOI] [PubMed] [Google Scholar]
  18. Molrine D. C., George S., Tarbell N., Mauch P., Diller L., Neuberg D., Shamberger R. C., Anderson E. L., Phillips N. R., Kinsella K. Antibody responses to polysaccharide and polysaccharide-conjugate vaccines after treatment of Hodgkin disease. Ann Intern Med. 1995 Dec 1;123(11):828–834. doi: 10.7326/0003-4819-123-11-199512010-00003. [DOI] [PubMed] [Google Scholar]
  19. Musher D. M., Luchi M. J., Watson D. A., Hamilton R., Baughn R. E. Pneumococcal polysaccharide vaccine in young adults and older bronchitics: determination of IgG responses by ELISA and the effect of adsorption of serum with non-type-specific cell wall polysaccharide. J Infect Dis. 1990 Apr;161(4):728–735. doi: 10.1093/infdis/161.4.728. [DOI] [PubMed] [Google Scholar]
  20. Plouffe J. F., Breiman R. F., Facklam R. R. Bacteremia with Streptococcus pneumoniae. Implications for therapy and prevention. Franklin County Pneumonia Study Group. JAMA. 1996 Jan 17;275(3):194–198. doi: 10.1001/jama.275.3.194. [DOI] [PubMed] [Google Scholar]
  21. Powers D. C., Anderson E. L., Lottenbach K., Mink C. M. Reactogenicity and immunogenicity of a protein-conjugated pneumococcal oligosaccharide vaccine in older adults. J Infect Dis. 1996 Apr;173(4):1014–1018. doi: 10.1093/infdis/173.4.1014. [DOI] [PubMed] [Google Scholar]
  22. Pönkä A., Leinonen M. Adverse reactions to polyvalent pneumococcal vaccine. Scand J Infect Dis. 1982;14(1):67–71. doi: 10.3109/inf.1982.14.issue-1.13. [DOI] [PubMed] [Google Scholar]
  23. Quataert S. A., Kirch C. S., Wiedl L. J., Phipps D. C., Strohmeyer S., Cimino C. O., Skuse J., Madore D. V. Assignment of weight-based antibody units to a human antipneumococcal standard reference serum, lot 89-S. Clin Diagn Lab Immunol. 1995 Sep;2(5):590–597. doi: 10.1128/cdli.2.5.590-597.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Riley I. D., Tarr P. I., Andrews M., Pfeiffer M., Howard R., Challands P., Jennison G. Immunisation with a polyvalent pneumococcal vaccine. Reduction of adult respiratory mortality in a New Guinea Highlands community. Lancet. 1977 Jun 25;1(8026):1338–1341. doi: 10.1016/s0140-6736(77)92552-1. [DOI] [PubMed] [Google Scholar]
  25. Robbins J. B., Schneerson R. Polysaccharide-protein conjugates: a new generation of vaccines. J Infect Dis. 1990 May;161(5):821–832. doi: 10.1093/infdis/161.5.821. [DOI] [PubMed] [Google Scholar]
  26. Sankilampi U., Honkanen P. O., Bloigu A., Herva E., Leinonen M. Antibody response to pneumococcal capsular polysaccharide vaccine in the elderly. J Infect Dis. 1996 Feb;173(2):387–393. doi: 10.1093/infdis/173.2.387. [DOI] [PubMed] [Google Scholar]
  27. Sarvas H., Rautonen N., Sipinen S., Mäkelä O. IgG subclasses of pneumococcal antibodies--effect of allotype G2m(n). Scand J Immunol. 1989 Feb;29(2):229–237. doi: 10.1111/j.1365-3083.1989.tb01120.x. [DOI] [PubMed] [Google Scholar]
  28. Shapiro E. D., Berg A. T., Austrian R., Schroeder D., Parcells V., Margolis A., Adair R. K., Clemens J. D. The protective efficacy of polyvalent pneumococcal polysaccharide vaccine. N Engl J Med. 1991 Nov 21;325(21):1453–1460. doi: 10.1056/NEJM199111213252101. [DOI] [PubMed] [Google Scholar]
  29. Siber G. R. Pneumococcal disease: prospects for a new generation of vaccines. Science. 1994 Sep 2;265(5177):1385–1387. doi: 10.1126/science.8073278. [DOI] [PubMed] [Google Scholar]
  30. Smit P., Oberholzer D., Hayden-Smith S., Koornhof H. J., Hilleman M. R. Protective efficacy of pneumococcal polysaccharide vaccines. JAMA. 1977 Dec 12;238(24):2613–2616. [PubMed] [Google Scholar]
  31. Treanor J. J., Betts R. F., Smith G. E., Anderson E. L., Hackett C. S., Wilkinson B. E., Belshe R. B., Powers D. C. Evaluation of a recombinant hemagglutinin expressed in insect cells as an influenza vaccine in young and elderly adults. J Infect Dis. 1996 Jun;173(6):1467–1470. doi: 10.1093/infdis/173.6.1467. [DOI] [PubMed] [Google Scholar]

Articles from Infection and Immunity are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES