Deficiência específica de anticorpo antipolissacarídeo de pneumococo e resposta humoral a vacinas pneumocócicas: atualização em diagnóstico

A deficiencia especifica de anticorpo antipolissacarideo de pneumococo e o comprometimento da resposta IgG especifica aos antigenos polissacarideos do pneumococo e manifesta-se de maneira semelhante as outras deficiencias de imunoglobulinas, com infeccoes recorrentes do trato respiratorio. A prevalencia e variavel, entre 7 a 19%, representando no Brasil 8,7% dos casos de imunodeficiencias. O diagnostico funcional baseia-se na capacidade do organismo montar uma resposta imune constituida pela producao de anticorpos quando estimulado por antigenos polissacarideos presentes na vacina pneumococica polissacaridea pura. No estudo da resposta a vacina pneumococica polissacaridea pura e necessario testar os sorotipos nao comuns a vacina polissacaridea conjugada para determinar a resposta de anticorpos antipolissacarideos sem a interferencia de anticorpos antiproteinas advindos da vacina polissacaridea conjugada. Sao reconhecidos quatro diferentes fenotipos da doenca, denominados memoria, leve, moderada e grave. O objetivo do presente trabalho foi realizar revisao da literatura para verificar a epidemiologia, diagnostico e fenotipos da deficiencia especifica de anticorpo antipolissacarideo de pneumococo. Trata-se de revisao narrativa de artigos nos ultimos 10 anos sobre a deficiencia de anticorpo especifica para o pneumococo. Concluimos que a deficiencia especifica de anticorpo antipolissacarideo de pneumococo e frequente, com espectro laboratorial variavel.(AU) Specific anti-pneumococcal polysaccharide antibody deficiency is characterized by impairment of specific IgG response to pneumococcal polysaccharide antigens. Its clinical manifestation is similar to other immunoglobulin deficiencies, with recurrent infections of the respiratory tract. Prevalence is variable, ranging from 7 to 19%; in Brazil, it accounts for 8.7% of cases of immunodeficiencies. Diagnosis is based on the body’s functional ability to mount an immuneresponse including the production of antibodies after stimulation by polysaccharide antigens present in the pure pneumococcal polysaccharide vaccine. When studying responses to this vaccine, it is necessary to test serotypes other than those present in the pneumococcal conjugate vaccine, in order to determine the response of anti-polysaccharide antibodies not influenced by antiprotein antibodies originating from the conjugate vaccine. Four different phenotypes of the disease are known: memory, mild, moderate, and severe. The objective of the present study was to review the literature on the epidemiology, diagnosis, and phenotypes of specific antipolysaccharide antibody deficiency. This narrative review includes papers published in the past 10 years on specific anti-pneumococcal polysaccharide antibody deficiency. We conclude that the condition is common, with a variable spectrum of laboratory findings.(AU)