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Mycoplasma pneumoniae carriage evades induction of protective mucosal antibodies

Ruben Cornelis Anthonie de Groot, Silvia Cristina Estevão, Patrick Michael Meyer Sauteur, Aditya Perkasa, Theo Hoogenboezem, Emiel Benny Margriet Spuesens, Lilly Maria Verhagen, Anna Maria Christiane van Rossum, Wendy Wilhelmina Josephina Unger
European Respiratory Journal 2021; DOI: 10.1183/13993003.00129-2021
Ruben Cornelis Anthonie de Groot
1Department of Pediatrics, Laboratory of Pediatrics, Erasmus MC University Medical Centre Rotterdam – Sophia Children”s Hospital, Rotterdam, The Netherlands
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  • ORCID record for Ruben Cornelis Anthonie de Groot
Silvia Cristina Estevão
1Department of Pediatrics, Laboratory of Pediatrics, Erasmus MC University Medical Centre Rotterdam – Sophia Children”s Hospital, Rotterdam, The Netherlands
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Patrick Michael Meyer Sauteur
2Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Zurich, Switzerland
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Aditya Perkasa
1Department of Pediatrics, Laboratory of Pediatrics, Erasmus MC University Medical Centre Rotterdam – Sophia Children”s Hospital, Rotterdam, The Netherlands
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Theo Hoogenboezem
3Department of Pediatrics, Van Weel Bethesda Hospital, Dirksland, The Netherlands
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Emiel Benny Margriet Spuesens
1Department of Pediatrics, Laboratory of Pediatrics, Erasmus MC University Medical Centre Rotterdam – Sophia Children”s Hospital, Rotterdam, The Netherlands
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Lilly Maria Verhagen
4Department of Pediatrics, Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
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Anna Maria Christiane van Rossum
5Department of Pediatrics, Division of Paediatric Infectious Diseases and Immunology, Erasmus MC University Medical Centre Rotterdam–Sophia Children's Hospital, Rotterdam, The Netherlands
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Wendy Wilhelmina Josephina Unger
1Department of Pediatrics, Laboratory of Pediatrics, Erasmus MC University Medical Centre Rotterdam – Sophia Children”s Hospital, Rotterdam, The Netherlands
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  • For correspondence: w.unger@erasmusmc.nl
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Abstract

Mycoplasma pneumoniae is the most common bacterial cause of pneumonia in children hospitalised for community-acquired pneumonia. Prevention of infection by vaccines may be an important strategy in the presence of emerging macrolide resistant M. pneumoniae. However, knowledge of immune responses to M. pneumoniae is limited, complicating vaccine design. We therefore studied the antibody response during M. pneumoniae infection and asymptomatic carriage.

In a nested case-control study (n=80) of M. pneumoniae carriers and matched controls we observed that carriage by M. pneumoniae does not lead to a rise in either mucosal or systemic M. pneumoniae-specific antibodies, even after months of persistent carriage. We replicated this finding in a second cohort (n=69) and also found that during M. pneumoniae community-acquired pneumonia, mucosal levels of M. pneumoniae-specific IgA and IgG did increase significantly. In vitro adhesion assays revealed that high levels of M. pneumoniae-specific antibodies in nasal secretions of paediatric patients prevented the adhesion of M. pneumoniae to respiratory epithelial cells.

In conclusion, our study demonstrates that M. pneumoniae-specific mucosal antibodies protect against bacterial adhesion to respiratory epithelial cells and are induced only during M. pneumoniae infection and not during asymptomatic carriage. This is strikingly different from carriage with bacteria such as Streptococcus pneumoniae where mucosal antibodies are induced by bacterial carriage.

Footnotes

This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.

Conflict of interest: Ruben Cornelis

Conflict of interest: Dr. de Groot has nothing to disclose.

Conflict of interest: Silvia Cristina

Conflict of interest: Dr. Estevão has nothing to disclose.

Conflict of interest: Dr. Meyer Sauteur has nothing to disclose.

Conflict of interest: Dr. Perkasa has nothing to disclose.

Conflict of interest: Dr. Hoogenboezem has nothing to disclose.

Conflict of interest: Dr. Spuesens has nothing to disclose.

Conflict of interest: Dr. Verhagen has nothing to disclose.

Conflict of interest: Dr. van Rossum has nothing to disclose.

Conflict of interest: Dr. Unger has nothing to disclose.

This is a PDF-only article. Please click on the PDF link above to read it.

  • Received January 14, 2021.
  • Accepted August 5, 2021.
  • Copyright ©The authors 2021. For reproduction rights and permissions contact permissions{at}ersnet.org
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Mycoplasma pneumoniae carriage evades induction of protective mucosal antibodies
Ruben Cornelis Anthonie de Groot, Silvia Cristina Estevão, Patrick Michael Meyer Sauteur, Aditya Perkasa, Theo Hoogenboezem, Emiel Benny Margriet Spuesens, Lilly Maria Verhagen, Anna Maria Christiane van Rossum, Wendy Wilhelmina Josephina Unger
European Respiratory Journal Jan 2021, 2100129; DOI: 10.1183/13993003.00129-2021

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Mycoplasma pneumoniae carriage evades induction of protective mucosal antibodies
Ruben Cornelis Anthonie de Groot, Silvia Cristina Estevão, Patrick Michael Meyer Sauteur, Aditya Perkasa, Theo Hoogenboezem, Emiel Benny Margriet Spuesens, Lilly Maria Verhagen, Anna Maria Christiane van Rossum, Wendy Wilhelmina Josephina Unger
European Respiratory Journal Jan 2021, 2100129; DOI: 10.1183/13993003.00129-2021
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