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Corrigendum: Specific Antibody Deficiency: Controversies in Diagnosis and Management

机译:更正:特定抗体缺陷:诊断和管理中的争议

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Error in Table and Table Legend In the original article there were mistakes in Table 3 regarding the numbers of protective titers (> and < were used instead of ≥ and ≤), and units of protective titers were described in mg/mL instead of μg/mL. Specific antibody deficiency phenotypes are correctly described as in Table 3 below. In addition, the acknowledgment of the original source of the data in the footnote has been amended to include that the article was reprinted from J Allergy Clin Immunol , 130, Copyright (2012). The correct footnote appears below. Table 3 Summary of deficient response phenotypes to the 23-valent pneumococcal polysaccharide vaccine (PPSV23), with permission from Ref. ( 35 ) * . Phenotype ~(a) Response to PPSV23, age >6?years Response to PPSV23, age <6?years Notes Severe ≤2 protective titers (≥1.3?μg/mL) ≤2 protective titers (≥1.3?μg/mL) Protective titers present are low Moderate <70% of serotypes are protective (≥1.3?μg/mL) <50% of serotypes are protective (≥1.3?μg/mL) Protective titers present to ≥3 serotypes Mild Failure to generate protective titers to multiple serotypes or failure of a twofold increase in 70% of serotypes Failure to generate protective titers to multiple serotypes or failure of a twofold increase in 50% of serotypes Twofold increases assume a pre-vaccination titer of <4.4–10.3?μg/mL, depending on the pneumococcal serotype Memory Loss of response within 6?months Loss of response within 6?months Adequate initial response to ≥50% of serotypes in children 6?years of age ~(a)All phenotypes assume a history of infection . *Reprinted from J Allergy Clin Immunol, 130, Orange J, Ballow M, Stiehm ER, et al. Use and interpretation of diagnostic vaccination in primary immunodeficiency: A working group report of the Basic and Clinical Immunology Interest Section of the American Academy of Allergy, Asthma & Immunology, S1-24, Copyright (2012), with permission from Elsevier . Text Corrections In the original article, there were errors in the text where the erroneous parameters from Table 3 were described. A serotype-specific protective level of 1.3?mg/mL in response to pneumococcal vaccination was discussed; the correct level is 1.3?μg/mL. This correction has been made to the section on Diagnostic Thresholds and Controversies in Response to Polysaccharide Vaccines in the Diagnosis of SAD, paragraph one. In the same paragraph, ‘of’ has been changed to ‘and’ in the third sentence: ‘Specific antibody deficiency (SAD) is normally diagnosed by determining the ability to generate protective titers in response to pneumococcal vaccines ( 12 ); however, it is important to note that the definition of a protective titer is not uniform and may vary depending on the nature of the vaccine ( 12 , 34 , 35 ). A serotype-specific level of 1.3?μg/mL has been considered protective with respect to invasive disease following polysaccharide immunization ( 35 , 36 ), and other studies have shown that levels of 0.35?μg/mL were deemed to provide protection against invasive pneumococcal infections following immunization with a conjugate pneumococcal vaccine ( 37 ). However, these studies are based on small cohorts and protective levels in response to pneumococcal vaccination and should be interpreted with caution ( 38 ). Furthermore, the level of specific antibody necessary to provide protection against infection in spaces such as the sinuses and middle ear has not been established.’ Patients with a moderate SAD phenotype were described in the original article as those who ‘produce protective titers to more than three serotypes’; the correct number is ‘three or more serotypes’. These corrections have been made to the section on Considerations for Severity of Deficiency in Response to Pneumococcal Polysaccharide Challenge, paragraph one: ‘Although controversies exist regarding the definition of a protective titer, guidelines from a working group report were developed using the best evidence currently available to describe the diagnosis of mild, moderate, severe, and memory phenotypes of deficient response, based on response to PPSV23 (Table 3 ) ( 35 ). Patients with a mild phenotype have multiple serotypes to which they did not generate protective titers or were unable to increase titers twofold. Patients with a moderate phenotype produce protective titers to three or more serotypes but to <50% of serotypes for those under 6?years of age or <70% of serotypes for those over 6?years of age. A severe phenotype is described as producing protective titers against two or fewer serotypes, and those protective titers generated tend to be low. Patients with a memory phenotype of deficient responses initially mount an adequate response to vaccination but do not sustain the response beyond 6?months. It is important to note that pure polysaccharide vaccines invoke a T-cell-independent response and as such do not generate a long-lived memory B-cell response (although they can boost them if the patient has previously rec
机译:表和表例中的错误在原始文章中,表3中存在关于保护滴度的错误(使用>和<代替≥和≤),并且保护滴度的单位以mg / mL代替μg/毫升正确的抗体缺陷表型在下表3中有正确描述。此外,对脚注中数据原始来源的确认也已进行了修订,以包括该文章转载自《 Allergy Clin Immunol》第130期,版权(2012)。正确的脚注出现在下面。表3经参考文献3许可,对23价肺炎球菌多糖疫苗(PPSV23)的应答不足表型汇总。 (35)*。表型〜(a)对PPSV23的反应,年龄> 6?years对PPSV23的反应,年龄<6?years注意严重≤2保护滴度(≥1.3?μg/ mL)≤2保护滴度(≥1.3?μg/ mL)滴度低中等<70%的血清型具有保护性(≥1.3?μg/ mL)<50%的血清型具有保护性(≥1.3?μg/ mL)≥3种血清型具有保护性滴度轻微无法产生多种保护性滴度血清型或70%血清型增加两倍失败无法对多种血清型产生保护效价或50%血清型增加两倍失败疫苗接种前效价<4.4–10.3?μg/ mL,取决于肺炎球菌血清型的记忆在6个月内丧失反应能力在6个月内丧失反应能力对6岁以下儿童的≥50%血清型有足够的初始反应〜(a)所有表型均具有感染史。 *转载自《变态反应临床免疫学杂志》 130,Orange J,Ballow M,Stiehm ER等。诊断性疫苗接种在原发性免疫缺陷中的使用和解释:经Elsevier许可,美国过敏,哮喘和免疫学研究院基础和临床免疫学兴趣小组的工作组报告,S1-24,版权所有(2012)。文本更正在原始文章中,描述表3中错误参数的文本中存在错误。讨论了针对肺炎球菌疫苗接种的血清型特异性保护水平为1.3?mg / mL;正确的水平是1.3?μg/ mL。对“ SAD诊断中对多糖疫苗的诊断阈值和争议”的第一节进行了更正。在同一段中,“ of”已改为“ and”,在第三句中:“通常通过确定对肺炎球菌疫苗产生保护性滴度的能力来诊断特定抗体缺乏症(SAD)(12);”但是,必须注意的是,保护滴度的定义并不统一,并且可能会根据疫苗的性质而有所不同(12、34、35)。在多糖免疫后,血清型特异性水平1.3?μg/ mL被认为对侵袭性疾病具有保护作用(35、36),其他研究表明,0.35μg/ mL的血清型被认为可提供针对侵袭性肺炎球菌的保护作用用结合的肺炎球菌疫苗免疫后感染(37)。然而,这些研究基于对肺炎球菌疫苗接种的小队列研究和保护水平,应谨慎解释(38)。此外,尚未确定在鼻窦和中耳等空间提供保护以防止感染所需的特异性抗体水平。“中度SAD表型患者在原始文章中描述为“产生超过三种血清型正确的数字是“三个或更多血清型”。对“应对肺炎球菌多糖挑战的严重程度不足的考虑”部分的第一部分进行了这些更正:“尽管在保护滴度的定义方面存在争议,但工作组报告的指导原则是根据目前可获得的最佳证据制定的基于对PPSV23的反应,描述对反应不足的轻度,中度,重度和记忆表型的诊断(表3)(35)。具有轻度表型的患者具有多种血清型,无法产生保护性滴度或无法将其滴度提高两倍。中度表型的患者对三种或更多种血清型产生保护性滴度,但对于6岁以下的人而言,其血清滴度<50%,对于6岁以上的人<70%。严重的表型被描述为产生针对两种或更多种血清型的保护性滴度,并且所产生的那些保护性滴度往往较低。记忆表型反应不足的患者最初对疫苗接种有足够的反应,但不能维持反应超过6个月。重要的是要注意,纯多糖疫苗会引起非T细胞依赖性反应,因此不会产生长效的记忆B细胞反应(尽管如果患者先前接受

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