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

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 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.

• Authors: Magnus Gottfredsson, Ingi K Reynisson, Ragnar F Ingvarsson, Hafrun Kristjansdottir, Martina V Nardini, Jon F Sigurdsson, Rachel Schneerson, John B Robbins, Mark A Miller
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 53 Issue 9 Pg. e117-24 (Nov 2011) ISSN: 1537-6591 [Electronic] United States
• PMID: 21946191 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Bacterial
• Immunoglobulin G

Topics

• Adolescent
• Adult
• Antibodies, Bacterial (blood)
• Arthritis (epidemiology, etiology)
• Autoimmune Diseases (epidemiology, etiology)
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Humans
• Iceland (epidemiology)
• Immunoglobulin G (blood)
• Male
• Meningitis, Meningococcal (complications, epidemiology, microbiology)
• Middle Aged
• Migraine Disorders (epidemiology, etiology)
• Nervous System Diseases (epidemiology, etiology)
• Retrospective Studies
• Surveys and Questionnaires
• Young Adult