B-Cell Immunophenotyping to Predict Vaccination Outcome in the Immunocompromised-A Systematic Review

Vaccination is the most effective measure to prevent infections in the general population.<br/>Its efficiency strongly depends on the function and composition of the immune system. If<br/>the immune system lacks critical components, patients will not be fully protected despite a<br/>completed vaccination schedule. Antigen-specific serum immunoglobulin levels are<br/>broadly used correlates of protection. These are the products of terminally differentiated<br/>B cells – plasma cells. Here we reviewed the literature on how aberrancies in B-cell<br/>composition and function influence immune responses to vaccinations. In a search<br/>through five major literature databases, 6,537 unique articles published from 2000 and<br/>onwards were identified. 75 articles were included along three major research lines:<br/>extremities of life, immunodeficiency and immunosuppression. Details of the protocol can<br/>be found in the International Prospective Register of Systematic Reviews [PROSPERO<br/>(registration number CRD42021226683)]. The majority of articles investigated immune<br/>responses in adults, in which vaccinations against pneumococci and influenza were<br/>strongly represented. Lack of baseline information was the most common reason of<br/>exclusion. Irrespective of study group, three parameters measured at baseline seemed to<br/>have a predictive value in assessing vaccine efficacy: (1) distribution of B-cell subsets<br/>(mostly a reduction in memory B cells), (2) presence of exhausted/activated B cells, or B<br/>cells with an aberrant phenotype, and (3) pre-existing immunological memory. In this<br/>review we showed how pre-immunization (baseline) knowledge of circulating B cells can<br/>be used to predict vaccination efficacy. We hope that this overview will contribute to<br/>optimizing vaccination strategies, especially in immunocompromised patients.

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