Article    Table of Contents                    Full Text of this article Free    Figures/Tables List    Related articles in Annals  Services    Send comment/rapid response letter    Notify a friend about this article    Alert me when this article is cited    Add to Personal Archive    Download to Citation Manager    ACP Search                            Get Permissions  Google Scholar    Search for Related Content  PubMed Articles in PubMed by Author:    Fata, F. T.    Ast, A. L.    Related Articles in PubMed    PubMed Citation    PubMed

ARTICLE

Impaired Antibody Responses to Pneumococcal Polysaccharide in Elderly Patients with Low Serum Vitamin B₁₂ Levels

Farid T. Fata, MD; Barry C. Herzlich, MD; Gerald Schiffman, PhD; and Arie L. Ast, BS

1 February 1996 | Volume 124 Issue 3 | Pages 299-304

Objective: To determine whether immunocompetent elderly patients with low serum vitamin B₁₂ levels have impaired serum antibody responses to the 23-polyvalent pneumococcal polysaccharide vaccine.

Design: Controlled, prospective cohort study.

Measurements: 15 patients with low serum vitamin B₁₂ levels and 15 age- and diagnosis-matched patients with normal levels were vaccinated. Serum antibody titers to 12 pneumococcal serotypes were measured by radioimmunoassay before and 4 weeks after vaccination.

Results: The difference between the geometric mean of the vaccine antibody titers before and after vaccination for all 12 serotypes was lower (P = 0.005) in the patients with low vitamin B₁₂ levels than in the patients with normal levels. When mean corpuscular volume and age were controlled for, vitamin B₁₂ remained an independent predictor of antibody response (P = 0.005). Erythrocyte mean corpuscular volume was also an independent predictor of the increase in titer (P = 0.03).

Conclusions: Patients with low vitamin B₁₂ levels had impaired antibody responses to pneumococcal vaccine. Further study is necessary to determine whether treatment with vitamin B₁₂ can enhance specific immunoglobulin synthesis and improve the clinical efficacy of the pneumococcal vaccine in patients with low vitamin B₁₂ levels.

Author and Article Information

From Maimonides Medical Center and State University of New York Health Science Center at Brooklyn, Brooklyn, New York.
Grant Support: By a grant from the Maimonides Research and Development Foundation.
Requests for Reprints: Barry C. Herzlich, MD, Department of Medicine, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219.
Current Author Addresses: Drs. Fata and Herzlich and Mr. Ast: Maimonides Medical Center, Department of Medicine, 4802 Tenth Avenue, Brooklyn, NY 11219.

Related articles in Annals:

Editorials
Subtle Cobalamin Deficiency
Ralph Carmel

Annals 1996 124: 338-340. [Full Text]  

This article has been cited by other articles:

				R. R. Molls, N. Ahluwalia, A. M. Mastro, H. Smiciklas-Wright, and G. C. Handte Nutritional Status Predicts Primary Subclasses of T Cells and the Lymphocyte Proliferation Response in Healthy Older Women J. Nutr., November 1, 2005; 135(11): 2644 - 2650. [Abstract] [Full Text] [PDF]

				A. S. Artz, W. B. Ershler, and D. L. Longo Pneumococcal Vaccination and Revaccination of Older Adults Clin. Microbiol. Rev., April 1, 2003; 16(2): 308 - 318. [Abstract] [Full Text] [PDF]

				L. M Rogers, E. Boy, J. W Miller, R. Green, J. C. Sabel, and L. H Allen High prevalence of cobalamin deficiency in Guatemalan schoolchildren: associations with low plasma holotranscobalamin II and elevated serum methylmalonic acid and plasma homocysteine concentrations Am. J. Clinical Nutrition, February 1, 2003; 77(2): 433 - 440. [Abstract] [Full Text] [PDF]

				P. J. Carson, K. L. Nichol, J. O'Brien, P. Hilo, and E. N. Janoff Immune Function and Vaccine Responses in Healthy Advanced Elderly Patients Arch Intern Med, July 10, 2000; 160(13): 2017 - 2024. [Abstract] [Full Text] [PDF]

				J. B. Rubins, M. Alter, J. Loch, and E. N. Janoff Determination of Antibody Responses of Elderly Adults to All 23 Capsular Polysaccharides after Pneumococcal Vaccination Infect. Immun., November 1, 1999; 67(11): 5979 - 5984. [Abstract] [Full Text] [PDF]

				G. T Lewith Respiratory illness: a complementary perspective Thorax, October 1, 1998; 53(10): 898 - 904. [Full Text]