Specific Antibody Deficiencies in Clinical Practice

• Published in: The journal of allergy and clinical immunology in practice (Cambridge, MA) Vol. 7; no. 3; pp. 801 - 808
• Main Authors: Sorensen, Ricardo U., Edgar, David
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-03-2019; Elsevier Limited
• Subjects: Antibody assessment; Antibody response; Antigens; Antipolysaccharide antibodies; Capsular polysaccharides; Clinical presentation; Global test; Immunoglobulins; Laboratories; Management; Multiplex assays; Opsonophagocytosis; Proteins; Specific antibody deficiency; Specific antibody deficiency (SAD); Streptococcus infections; Streptococcus pneumoniae; Vaccines; WHO ELISA; Specific antibody deficiency; OPA; PCV; WHO ELISA; Global test; Antibody assessment; PPV-23; Management; Opsonophagocytosis; Multiplex assays; Antipolysaccharide antibodies; Clinical presentation; SAD; Specific antibody deficiency (SAD); ELISA; WHO
• ISSN: 2213-2198; 2213-2201
• DOI: 10.1016/j.jaip.2019.01.024

Specific antibody deficiency (SAD) is defined as the inability to mount an antibody response to purified Streptococcus pneumoniae capsular polysaccharide antigens in the presence of normal immunoglobulin concentrations and normal antibody responses to protein antigens. In this review, we discuss the difficulties in using presently available testing methods to adequately define SAD. The fact that there are different forms of SADs to pneumococcal surface polysaccharides is detailed. The diagnostic and therapeutic implications of recognizing that, in addition to SAD, there are other forms of SAD in the response to S. pneumoniae polysaccharides are described in detail. The conclusion of this review is that assessment of immunity and therapeutic actions to deal with SADs need to be based on clinical evidence rather than solely on arbitrarily defined antibody responses.