Publication date: Available online 23 January 2019
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Ricardo U. Sorensen, David Edgar
Abstract
Specific antibody deficiency (SAD) is defined as the inability to mount an antibody response to purified S. pneumoniae capsular polysaccharide antigens in presence of normal immunoglobulin concentrations and normal antibody responses to protein antigens. In this review we discuss the difficulties in using presently available testing methods to adequately define SAD. The fact that there are different forms of specific antibody deficiencies to pneumococcal surface polysaccharides is detailed. The diagnostic and therapeutic implications of recognizing that in addition to SAD, there are other forms of specific antibody deficiency in the response to S. pneumoniae polysaccharides is described in detail. The conclusion of this review is that assessment of immunity and therapeutic actions to deal with specific antibody deficiencies need to be based on clinical evidence rather than solely on arbitrarily defined antibody responses.
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