Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Comparative long-term adverse effects elicited by invasive group B and C meningococcal infections

Gottfredsson, Magnus ; Reynisson, Ingi K ; Ingvarsson, Ragnar F LU orcid ; Kristjansdottir, Hafrun ; Nardini, Martina V ; Sigurdsson, Jon F ; Schneerson, Rachel ; Robbins, John B and Miller, Mark A (2011) In Clinical Infectious Diseases 53(9). p.24-117
Abstract

BACKGROUND: Given the identity between Neisseria meningitidis serogroup B (MenB) capsular polysaccharide (polysialic acid; PSA) and PSA found on neural cell adhesion molecules, it has been proposed that infection with MenB or vaccination with PSA may be associated with subsequent autoimmune or neurological disease.

METHODS: We conducted 2 studies. The first was a retrospective nationwide study of invasive meningococcal disease (IMD) in Iceland (with 541 subjects) during the period 1975-2004, and we cross referenced this cohort with databases with respect to subsequent diagnosis of autoimmune disorders. A follow-up study involving 120 survivors of IMD was performed. The study included 70 patients with a history of MenB and 50... (More)

BACKGROUND: Given the identity between Neisseria meningitidis serogroup B (MenB) capsular polysaccharide (polysialic acid; PSA) and PSA found on neural cell adhesion molecules, it has been proposed that infection with MenB or vaccination with PSA may be associated with subsequent autoimmune or neurological disease.

METHODS: We conducted 2 studies. The first was a retrospective nationwide study of invasive meningococcal disease (IMD) in Iceland (with 541 subjects) during the period 1975-2004, and we cross referenced this cohort with databases with respect to subsequent diagnosis of autoimmune disorders. A follow-up study involving 120 survivors of IMD was performed. The study included 70 patients with a history of MenB and 50 patients with N. meningitidis serogroup C (MenC) infection, who served as control subjects. Participants answered standardized questionnaires (Beck's Depression Inventory [BDI] II, Depression Anxiety Stress Scales [DASS], and Patient Health Questionnaire [PHQ]), and serum levels of immunoglobulin (Ig) G against MenB and MenC capsular polysaccharides were measured.

RESULTS: The nationwide cohort had 9166 patient-years of follow up. No evidence of increased autoimmunity was found to be associated with MenB, compared with MenC. In the follow-up study, patients were evaluated 16.6 years after the infection, representing 2022 patient-years of observation. Comparable rates of most complications were recorded, but MenC infections were associated with arthritis (P = .008) and migraine headaches (P = .01) more frequently than were MenB infections. No difference was observed with respect to scores on BDI-II, DASS, or PHQ. IgG anti-MenB and anti-MenC capsular polysaccharide levels were not related to patient complaints.

CONCLUSIONS: This study does not support the hypothesis that MenB infection may predispose to autoimmunity. MenC infections are associated with a higher prevalence of arthritis and migraine headaches. No evidence of antibody-associated pathology was detected at long-term follow-up.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adolescent, Adult, Antibodies, Bacterial, Arthritis, Autoimmune Diseases, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Iceland, Immunoglobulin G, Male, Meningitis, Meningococcal, Middle Aged, Migraine Disorders, Nervous System Diseases, Retrospective Studies, Surveys and Questionnaires, Young Adult, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't
in
Clinical Infectious Diseases
volume
53
issue
9
pages
24 - 117
publisher
Oxford University Press
external identifiers
  • pmid:21946191
  • scopus:80054086305
ISSN
1537-6591
DOI
10.1093/cid/cir500
language
English
LU publication?
no
id
afedfabc-24ac-4c32-a850-7551cec6aaff
date added to LUP
2018-04-26 09:55:56
date last changed
2024-03-01 18:14:19
@article{afedfabc-24ac-4c32-a850-7551cec6aaff,
  abstract     = {{<p>BACKGROUND: Given the identity between Neisseria meningitidis serogroup B (MenB) capsular polysaccharide (polysialic acid; PSA) and PSA found on neural cell adhesion molecules, it has been proposed that infection with MenB or vaccination with PSA may be associated with subsequent autoimmune or neurological disease.</p><p>METHODS: We conducted 2 studies. The first was a retrospective nationwide study of invasive meningococcal disease (IMD) in Iceland (with 541 subjects) during the period 1975-2004, and we cross referenced this cohort with databases with respect to subsequent diagnosis of autoimmune disorders. A follow-up study involving 120 survivors of IMD was performed. The study included 70 patients with a history of MenB and 50 patients with N. meningitidis serogroup C (MenC) infection, who served as control subjects. Participants answered standardized questionnaires (Beck's Depression Inventory [BDI] II, Depression Anxiety Stress Scales [DASS], and Patient Health Questionnaire [PHQ]), and serum levels of immunoglobulin (Ig) G against MenB and MenC capsular polysaccharides were measured.</p><p>RESULTS: The nationwide cohort had 9166 patient-years of follow up. No evidence of increased autoimmunity was found to be associated with MenB, compared with MenC. In the follow-up study, patients were evaluated 16.6 years after the infection, representing 2022 patient-years of observation. Comparable rates of most complications were recorded, but MenC infections were associated with arthritis (P = .008) and migraine headaches (P = .01) more frequently than were MenB infections. No difference was observed with respect to scores on BDI-II, DASS, or PHQ. IgG anti-MenB and anti-MenC capsular polysaccharide levels were not related to patient complaints.</p><p>CONCLUSIONS: This study does not support the hypothesis that MenB infection may predispose to autoimmunity. MenC infections are associated with a higher prevalence of arthritis and migraine headaches. No evidence of antibody-associated pathology was detected at long-term follow-up.</p>}},
  author       = {{Gottfredsson, Magnus and Reynisson, Ingi K and Ingvarsson, Ragnar F and Kristjansdottir, Hafrun and Nardini, Martina V and Sigurdsson, Jon F and Schneerson, Rachel and Robbins, John B and Miller, Mark A}},
  issn         = {{1537-6591}},
  keywords     = {{Adolescent; Adult; Antibodies, Bacterial; Arthritis; Autoimmune Diseases; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Iceland; Immunoglobulin G; Male; Meningitis, Meningococcal; Middle Aged; Migraine Disorders; Nervous System Diseases; Retrospective Studies; Surveys and Questionnaires; Young Adult; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{24--117}},
  publisher    = {{Oxford University Press}},
  series       = {{Clinical Infectious Diseases}},
  title        = {{Comparative long-term adverse effects elicited by invasive group B and C meningococcal infections}},
  url          = {{http://dx.doi.org/10.1093/cid/cir500}},
  doi          = {{10.1093/cid/cir500}},
  volume       = {{53}},
  year         = {{2011}},
}