HUMAN IMMUNITY TO THE MENINGOCOCCUS: I. THE ROLE OF HUMORAL ANTIBODIES

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ARTICLE

HUMAN IMMUNITY TO THE MENINGOCOCCUS : I. THE ROLE OF HUMORAL ANTIBODIES

Irving Goldschneider M.D.¹, Emil C. Gotschlich M.D.¹, and Malcolm S. Artenstein M.D.¹

¹ From The Department of Bacteriology, Walter Reed Army Institute of Research, Washington, D. C. 20012

Susceptibility to systemic meningococcal disease is relatedto a selective deficiency of humoral antibodies to pathogenicstrains of meningococci. In a study of the age-specific incidenceof meningococcal meningitis in the United States, it was foundthat the proportion of individuals with serum bactericidal activityto meningococci of serogroups A, B, and C was reciprocally relatedto the incidence of disease. The prevalence of bactericidalactivity was highest at birth and among adults, and lowest ininfants between 6 and 24 months of age.

Sera from 51 of 54 prospectivecases of meningococcal disease among military recruits weredeficient in antibodies to homologous and heterologous strainsof pathogenic meningococci as determined by serum bactericidalactivity and indirect immunofluorescence. Such sera, however,could support the bactericidal activity of purified human gammaglobulin (Cohn fraction II), and such individuals could respondimmunologically to infection with meningococci. The implicationis that susceptible persons are deficient in antimeningococcalantibodies because they have not received significant exposureto meningococcal antigens in the past.

The fate of individualswho lack bactericidal antibodies to pathogenic meningococciwas determined during an outbreak of group C meningitis amongmilitary recruits. The incidence of disease was found to beprimarily associated with the incidence of exposure of susceptiblesto the pathogenic strains. Whereas 81.5% of the presumed susceptiblesacquired a meningococcal strain, only 24.1% acquired an organismsimilar to the prevalent disease-producing strains. Of the exposedsusceptibles, 38.5% developed systemic meningococcal disease.

Submitted on February 19, 1969

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Vidarsson, G., van der Pol, W.-L., van den Elsen, J. M. H., Vile, H., Jansen, M., Duijs, J., Morton, H. C., Boel, E., Daha, M. R., Corthesy, B., van de Winkel, J. G. J. (2001). Activity of Human IgG and IgA Subclasses in Immune Defense Against Neisseria meningitidis Serogroup B. J. Immunol. 166: 6250-6256 [Abstract] [Full Text]
Rosenstein, N. E., Perkins, B. A., Stephens, D. S., Popovic, T., Hughes, J. M. (2001). Meningococcal Disease. NEJM 344: 1378-1388 [Full Text]
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Plested, J. S., Ferry, B. L., Coull, P. A., Makepeace, K., Lehmann, A. K., MacKinnon, F. G., Griffiths, H. G., Herbert, M. A., Richards, J. C., Moxon, E. R. (2001). Functional Opsonic Activity of Human Serum Antibodies to Inner Core Lipopolysaccharide (galE) of Serogroup B Meningococci Measured by Flow Cytometry. Infect. Immun. 69: 3203-3213 [Abstract] [Full Text]
Richmond, P., Borrow, R., Findlow, J., Martin, S., Thornton, C., Cartwright, K., Miller, E. (2001). Evaluation of De-O-Acetylated Meningococcal C Polysaccharide-Tetanus Toxoid Conjugate Vaccine in Infancy: Reactogenicity, Immunogenicity, Immunologic Priming, and Bactericidal Activity against O-Acetylated and De-O-Acetylated Serogroup C Strains. Infect. Immun. 69: 2378-2382 [Abstract] [Full Text]
Lebel, M. H., Tapiero, B. F., Saintonge, F. (2001). Immunogenicity of Bivalent AC Polysaccharide Meningococcal Vaccine in Children Aged 6 Through 24 Months. JAMA 285: 1578-1579 [Full Text]
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Borrow, R., Andrews, N., Goldblatt, D., Miller, E. (2001). Serological Basis for Use of Meningococcal Serogroup C Conjugate Vaccines in the United Kingdom: Reevaluation of Correlates of Protection. Infect. Immun. 69: 1568-1573 [Abstract] [Full Text]
De Wals, P., De Serres, G., Niyonsenga, T. (2001). Effectiveness of a Mass Immunization Campaign Against Serogroup C Meningococcal Disease in Quebec. JAMA 285: 177-181 [Abstract] [Full Text]
Muthukkumar, S., Goldstein, J., Stein, K. E. (2000). The Ability of B Cells and Dendritic Cells to Present Antigen Increases During Ontogeny. J. Immunol. 165: 4803-4813 [Abstract] [Full Text]
Sikkema, D. J., Friedman, K. E., Corsaro, B., Kimura, A., Hildreth, S. W., Madore, D. V., Quataert, S. A. (2000). Relationship between Serum Bactericidal Activity and Serogroup-Specific Immunoglobulin G Concentration for Adults, Toddlers, and Infants Immunized with Neisseria meningitidis Serogroup C Vaccines. CVI 7: 764-768 [Abstract] [Full Text]
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