Functional antibody response to pneumococcal (PNE) and Haemophilus influenzae type B (HiB) vaccination in bronchiectasis (BE): data from the EMBARC registry.

<bold>Introduction:</bold> Assessment of immunodeficiency in patients with BE includes assessment of the ability to make co-ordinated B and T cell responses to polysaccharide antigens, assessed by testing PNE and/or HiB vaccination response. We evaluated the frequency of testing for antibody responses and the characteristics of patients with abnormal responses in EMBARC. <bold>Methods:</bold> The EMBARC registry enrolled patients from 28 European Countries with CT confirmed BE, followed-up for up to 5 years. <bold>Results:</bold> 3904 patients (23.0%) had functional antibody testing performed. Testing was most commonly performed in the UK (37.6%) and Northern and Western Europe (15%) and rarely performed in Southern Europe (7.2%) and Central and Eastern Europe (0.8%). We found 661 patients (16.9% of those tested) with an abnormal functional antibody response. These patients had similar characteristics to those with normal responses in terms of age, sex and disease severity but they were more likely to experience severe exacerbations (RR 1.26, p=0.024) at follow-up. After adjustment for age, sex, Pseudomonas infection, lung function and region, abnormal functional antibody responses remained associated with severe exacerbations (RR 1.39, p=0.002). No association was found with mild exacerbations (RR 1.10 95%CI 0.96-1.25p-=0.19) or survival (HR 0.86 95%CI 0.59-1.25,p=0.42). Only 48 patients had a formal diagnosis of specific polysaccharide antibody deficiency. <bold>Conclusion:</bold> Functional antibody testing is infrequently used as part of assessment of BE patients in Europe. Patients with abnormal functional antibody responses are at higher risk of severe exacerbations.

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Published
2024-09-14
DOI
https://doi.org/10.1183/13993003.congress-2024.pa2392
Primary Topic
Neonatal Respiratory Health Research
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article
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article

Functional antibody response to pneumococcal (PNE) and Haemophilus influenzae type B (HiB) vaccination in bronchiectasis (BE): data from the EMBARC registry.

Francesco Blasi, Josje Altenburg, Michal Shteinberg, Michael R. Loebinger et al.
Neonatal Respiratory Health Research
article

Functional antibody response to pneumococcal (PNE) and Haemophilus influenzae type B (HiB) vaccination in bronchiectasis (BE): data from the EMBARC registry.

Francesco Blasi, Josje Altenburg, Michal Shteinberg, Michael R. Loebinger, Charles Haworth, Letizia Traversi, Felix C. Ringshausen, Eva Polverino, Katerina Dimakou, Rosario Menéndez, Pieter Goeminne, James Duncan Chalmers, Tobias Welte, Montserrat Vendrell, Pierre Regis-Burgel, Anthony De Soyza, Stefano Aliberti, Antoni Torres
article en

Abstract

<bold>Introduction:</bold> Assessment of immunodeficiency in patients with BE includes assessment of the ability to make co-ordinated B and T cell responses to polysaccharide antigens, assessed by testing PNE and/or HiB vaccination response. We evaluated the frequency of testing for antibody responses and the characteristics of patients with abnormal responses in EMBARC. <bold>Methods:</bold> The EMBARC registry enrolled patients from 28 European Countries with CT confirmed BE, followed-up for up to 5 years. <bold>Results:</bold> 3904 patients (23.0%) had functional antibody testing performed. Testing was most commonly performed in the UK (37.6%) and Northern and Western Europe (15%) and rarely performed in Southern Europe (7.2%) and Central and Eastern Europe (0.8%). We found 661 patients (16.9% of those tested) with an abnormal functional antibody response. These patients had similar characteristics to those with normal responses in terms of age, sex and disease severity but they were more likely to experience severe exacerbations (RR 1.26, p=0.024) at follow-up. After adjustment for age, sex, Pseudomonas infection, lung function and region, abnormal functional antibody responses remained associated with severe exacerbations (RR 1.39, p=0.002). No association was found with mild exacerbations (RR 1.10 95%CI 0.96-1.25p-=0.19) or survival (HR 0.86 95%CI 0.59-1.25,p=0.42). Only 48 patients had a formal diagnosis of specific polysaccharide antibody deficiency. <bold>Conclusion:</bold> Functional antibody testing is infrequently used as part of assessment of BE patients in Europe. Patients with abnormal functional antibody responses are at higher risk of severe exacerbations.

Hebron University (PS), Humanitas University (IT), University of Dundee (GB), Université Paris Cité (FR), Dundee and Angus College (GB), Royal Papworth Hospital (GB), Harefield Hospital (GB), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Medizinische Hochschule Hannover (DE), Hôpital Cochin (FR), Carmel Medical Center (IL), Hospital Clínic de Barcelona (ES), Vlaamse Vereniging voor Obstetrie en Gynaecolo (BE), Vall d'Hebron Hospital Universitari (ES), German Center for Lung Research (DE), NIHR Newcastle Biomedical Research Centre (GB), Hospital Universitari de Girona Doctor Josep Trueta (ES), IRCCS Humanitas Research Hospital (IT), Instituto de Investigación Sanitaria La Fe (ES), Sotiria General Hospital (GR), Universitat de Barcelona (ES), University of Amsterdam (NL)
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Neonatal Respiratory Health Research
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