[CIS-PAGID] B-cell subset question

[Church, Joseph]

As a protein antigen, rabies vaccine will not give you the same information as a Pneumovax response.  Same issue with Menactra (conjugate meningococcal vaccine).  Menimune (non-conjugated meningococcal polysaccharide (4 serotype) may be helpful, but I don't know how good the commercial tests are.

Joe Church

From: pagid-bounces at list.clinimmsoc.org [mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Paige Wickner
Sent: Wednesday, May 09, 2012 2:15 PM
To: pagid at list.clinimmsoc.org
Cc: pagid at list.clinimmsoc.org
Subject: Re: [CIS-PAGID] B-cell subset question

Agree. Rabies is a low risk vaccine. I have been vaccinated- no side effects experienced.

http://www.cdc.gov/vaccines/vac-gen/side-effects.htm


On May 9, 2012, at 10:38 AM, "Sullivan, Kathleen" <sullivak at mail.med.upenn.edu<mailto:sullivak at mail.med.upenn.edu>> wrote:
rabies!  It's a tough sell but also a neoantigen and it is really not so bad.  Two of our immunologists had bat exposures and had the vaccine and it had very limited side effects.

Kate
On May 9, 2012, at 11:22 AM, Fleisher, Thomas (NIH/CC/DLM) [E] wrote:


This vaccine is not available in the US as far as I know.

Thomas A. Fleisher, M.D.
Chief, Department of Laboratory Medicine
NIH Clinical Center
301 496-5668 (T)
301 402-1612 (F)
From: Seidel Markus [mailto:markus.seidel at medunigraz.at]
Sent: Wednesday, May 09, 2012 11:13 AM
To: pagid at list.clinimmsoc.org<mailto:pagid at list.clinimmsoc.org>
Subject: Re: [CIS-PAGID] B-cell subset question

Dear Zach,
Tick-borne enc.(TBE)-vaccine may be used as (licensed) neo-antigen in order to test the B cell function under IgG substitution therapy if this sounds applicable… (see Seidel, Foerster-Waldl et al., 2010 www.ncbi.nlm.nih.gov/pubmed/20656033<http://www.ncbi.nlm.nih.gov/pubmed/20656033> )
Best regards from a TBE-infested country,
Markus Seidel

Markus G. Seidel, M.D., Assoc.Prof.
Consultant| Dept.of Pediatric Hematology-Oncology | Univ.Clinics of Pediatric and Adolescent Medicine | Auenbruggerpl. 34/2 | A-8036 Graz | Austria | T. 0043 316 385 80215| F. 0043 316 385 13450
Coordinator of the Working Group for Pediatric Immunology of the Austrian Society of Pediatrics and Adolescent Medicine


________________________________
Von: pagid-bounces at list.clinimmsoc.org<mailto:pagid-bounces at list.clinimmsoc.org> [mailto:pagid-bounces at list.clinimmsoc.org] Im Auftrag von Zachary D. Jacobs, MD
Gesendet: Mittwoch, 09. Mai 2012 16:13
An: pagid at list.clinimmsoc.org<mailto:pagid at list.clinimmsoc.org>
Betreff: Re: [CIS-PAGID] B-cell subset question

Thanks for the replies.  It is a challenging situation for me.  I inherited a large group of his patients he had on IgGRT that fit this general profile, probably around fifty.  The ones who didn’t think they ever needed to be on it were easy to trial off.  However, the majority of these patients have been on therapy for several years and are reluctant to come off.  They were told that without IVIG / SCIG they could die from an infection by someone who had been practicing for fifty years, and then they hear from me, just out of training, that they may not need it and so they can become skeptical.  Generally, I have tried to establish a rapport with the patients and a good doctor / patient relationship before broaching the subject of trialing off.  I have found that if I order B-cell subsets, even with the lack of published clinical utility for the test, if the memory B-cells are normal in number then the patient has something to grasp and feels better about trialing off therapy.  I then perform repeat antibody studies when they have been off for six months.

Any advice on how to better deal with the situation would be much appreciated.

Zach

On Tue, May 8, 2012 at 5:50 PM, Cunningham-Rundles, Charlotte <charlotte.cunningham-rundles at mssm.edu<mailto:charlotte.cunningham-rundles at mssm.edu>> wrote:
In my view the memory B cell phenotype can't be used in substitution of a complete antibody workup ( off Ig of course) .
 I would not use the CD38+IgM or any other combination to assess antibody production either .

Nice if we had a way around that but this is not it.


Charlotte

Charlotte Cunningham-Rundles, MD, PhD
Departments of Medicine and Pediatrics
The David S Gottesman Professor
The Immunology Institute
Mount Sinai School of Medicine
1425 Madison Avenue
New York, NY 10029
Phone: 212 659 9268<tel:212%20659%209268>
Fax: 212 987 5593<tel:212%20987%205593>
Email: Charlotte.Cunningham-Rundles at mssm.edu<http://Charlotte.Cunningham-Rundles@mssm.edu>



________________________________
From: "Zachary D. Jacobs, MD" <zjacobs.md at gmail.com<http://zjacobs.md@gmail.com>>
Reply-To: PAGID <pagid at list.clinimmsoc.org<http://pagid@list.clinimmsoc.org>>
Date:


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