Long term effects of vaccination of patients deficient in a late complement component with a tetravalent meningococcal polysaccharide vaccine.

Of 45 Russian patients with late complement component deficiency (LCCD) who experienced one to five meningococcal infections, 31 were immunised with a meningococcal A/C/W135/Y polysaccharide vaccine and were followed for 3-8 years. Total and immunoglobulin (Ig) class specific concentration of antibodies to meningococcal polysaccharides in sera of LCCD patients increased significantly 1 month after vaccination and remained elevated for 3 years. Revaccination of LCCD patients 3 years after the first dose restored the total Ig concentrations to those observed 1 year after the first vaccination.

Antibody-dependent killing of meningococci by human neutrophils in serum of late complement component-deficient patients.

Background: Thirty-one Russian patients with late complement component deficiency (LCCD) who had experienced one to five meningococcal infections were immunized with meningococcal polysaccharide vaccine (A + C + W135 + Y) and were followed for 3-8 years. We investigated the potentially protective killing effect of human neutrophils (PMNL) on serogroup A and W135 meningococci.

Methods: Meningococci were incubated in LCCD vaccine sera in the absence or presence of PMNL, and the number of live bacteria (CFU) was determined by plating onto chocolate agar.

[The bactericidal action of human neutrophils on meningococci in vitro].

32 Russian patients with late complement component deficiency (LCCD) were immunize with tetravalent meningococcal polysaccharide vaccine (A + C + W135 + Y). Their immune response and infectious morbidity rate were followed for 6 years and the partial protective efficacy of vaccination was demonstrated. As the antibody-mediated complement-induced bactericidal activity of plasma was completely absent in persons with LCCD, the bactericidal action of human neutrophils on meningococci of groups A, W135 and B was studied under the conditions of incubation with serum samples collected from persons with LCCD before and after vaccination.

[Clinical features of meningococcal infection in subjects with deficient terminal components of complement].

Aim: To evaluate clinical characteristics of meningococcal disease (MD) in individuals with terminal complement component deficiency (TCCD) who are thousands times more susceptible to MD than complement-sufficient persons.

Materials And Methods: 61 cases of MD in TCCD patients and 200 randomly selected cases of MD in complement-sufficient patients were analyzed.

Results: Meningitis without meningococcemia accounted for 17% of the MD episodes in the control group of complement-sufficient patients but none in individuals with TCCD who had meningococcemia (10%) or meningococcemia with meningitis (90%).

[The interconnection between the severity of meningococcal infection and the endotoxicity levels and patient's blood complement].

Seventy-eight patients with severe systemic meningococcal disease admitted to the Intensive Care Unit of the Second Moscow Hospital for Infectious Diseases were divided into four groups by complications of their disease: patients with refractory septic shock (RSS)--group 1; patients with early septic shock (ESS)--group 2; patients without shock but with severe mental disorders--group 3; patients without any of these complications--group 4. The LPS concentration in plasma was assessed by chromogenic method. Initial LPS levels in plasma of group 3 or group 4 patients (170 ng/l, median value and 360 ng/l, respectively) were greater than those of healthy donors (LPS < 15 ng/l).