Atopic eczema is associated with delayed maturation of the antibody response to pneumococcal vaccine

Abstract

Clin Exp Immunol 2000; 122:16±19 Atopic eczema is associated with delayed maturation of the antibody response to Pneumococcal vaccine P. D. ARKWRIGHT, L. PATEL, A. MORAN*, M. R. HAENEY*, C. I. EWING & T. J. DAVID University Department of Child Health, Booth Hall Children's Hospital, and *Immunology Department, Hope Hospital, Manchester, UK (Accepted for publication 13 June 2000) SUMMARY The aim of this study was to investigate a previously undocumented observation, that children with atopic eczema under 9 years of age tended to have a poor antibody response to Pneumococcal vaccination. Thirty-five children (mean age 8´8 years, range 3±16 years) with moderate to severe atopic eczema but no history of systemic infection were studied retrospectively. Pneumococcal antibody responses after immunization with Pneumovax II were compared with a hospital control group consisting of 36 children (mean age 6´0 years, range 3±16 years) with recurrent upper respiratory tract infections. Only 17% of children with atopic eczema aged 3±8 years responded to Pneumovax. This response was significantly poorer than that of the controls (57%) (odds ratio 0´20, 95% confidence interval (CI) 0´05±0´84, P ˆ 0´03). There were no significant differences in the levels of total IgG2, the component of IgG associated with protective antibody responses to Pneumococcus between the two groups. Delay in maturation of the total IgG and IgG2 antibody response to Pneumococcus is a feature in this group of children with moderately severe atopic eczema. Keywords Pneumococcal antibodies atopic eczema IgG2 subclass deficiency polysaccharide antibodies INTRODUCTION When the history and clinical features of atopic eczema in childhood are atypical, for example, in terms of unusual severity or poor response to topical corticosteroids, underlying rare disorders of immunity, such as Omenn's, Wiskott±Aldrich, Job's and Netherton's syndromes should be considered in the differ- ential diagnosis [1]. In addition to thes

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