Renal transplant recipients between 65-75 years of age, on stable immunosuppression. who previously (>1 year prior) received the 23 valent pneumococcal polysaccharide vaccine (pneumovax23). Cause or renal failure was either DMII or HTN.

Persons with DMII or hypertension but normal renal function between ages 65-75 years of age

Healthy persons between the ages 65-75 who previously (>1 year prior) received the 23 valent pneumococcal polysaccharide vaccine (pneumovax23)

Persons between the ages 65-75 with DMII or hypertension but normal renal function who previously (>1 year prior) received the 23 valent pneumococcal polysaccharide vaccine (pneumovax23)

Healthy persons between the ages 35-45 who previously (>1 year prior) received the 23 valent pneumococcal polysaccharide vaccine (pneumovax23) or are willing to receive PPV23 and 1 year later Prevnar 13.

Renal Transplantation

Aging

FDA approved pneumococcal polysaccharide vaccine containing capsular polysaccharide of 23 different pneumococcal serotypes. Only group 5 will potentially receive this as an intervention.

23 valent pneumococcal polysaccharide vaccine

FDA approved pneumococcal polysaccharide vaccine containing capsular polysaccharide of 13 different pneumococcal serotypes conjugated to CRM197. Only group 5 will receive this as an intervention. In all other groups Prevnar 13 will be given as standard of care.

13 valent conjugated pneumococcal vaccine

Peripheral blood samples (30-60 mL) will be collected at day 0 (pre-immune), day 7, and day 30 (4 weeks post-PPV23) for groups 1-4 and at days 366, 373 and 396 for group 5. In addition, day 5, and 10 blood samples will be obtained from a limited (n=10) number of elderly RT participants to determine the optimal time point for circulation of PPS-specific B cells. Yearly blood samples will be obtained thereafter for serum antibody and OPA analyses to test longevity of antibody and OPA responses. Samples obtained from days 0, 30 and yearly samples will be used for antibody titers and opsonophagocytic assays. Samples from day 0 (day of vaccination with PCV13) and day 7 will be used for flow cytometric analysis.

Peripheral blood sample

Ralph H. Johnson VA Medical Center, Charleston, SC

Medical University of South Carolina

Pneumococcal Conjugate Vaccine in Aging Renal Transplant

Immune Response to Pneumococcal Vaccination in Aging Renal Transplant Recipients

Measure the anti-pneumococcal polysaccharide IgG antibody response against streptococcus pneumonia serotypes 14, 19A and 23F in serum by ELISA at days 0, 30, 365 and 720

Measure the serum opsonophagocytic activity against streptococcus pneumonia serotypes 14, 19A and 23F on days 0, 30, 365 and 720 by opsonophagocytic assay.

number of polysaccharide specific B cells, and absolute number of IgM memory B cells/mL induced by vaccination with PCV13

Measure the relative gene expression of 56 genes important in antibody production and cell survival per single cell of polysaccharide-specific and non-specific B cells as measured by QTR PCR.

VA Office of Research and Development

Immune response to immunization with Prevnar in elderly aging renal transplant compared to comparison groups: healthy young, healthy elderly, healthy elderly hypertension (HTN) and young renal transplants.

cooking with Biomass Briquettes and Rocket Stove

Pneumococcal Carriage

Particulate Matter

Biomass briquettes are made from dried peanut shells. Rocket stoves were designed to efficiently burn the briquettes

Biomass Briquettes and Rocket stove

Medical Research Council Unit

Indoor Air Pollution (IAP) Carriage Study

Use of Biomass Briquettes: Its Effect on Indoor Air Pollution and on Pneumococcal Nasopharyngeal Carriage. A Randomized Clinical Trial

1. Integrated PM2.5 concentrations (48 hour measurements in each kitchen) Integrated PM2.5 concentrations will be measured using gravimetric Casella and SKC pumps, cyclones, and Teflon filters. The pumps will run one minute on, 5 minutes off, for 48 continuous hours in each of the participating cookhouses. These integrated measurements will allow us to compare the emissions from briquettes and firewood.
The measurements will take place at a random time during the 16 week invention period

To measure the prevalence of pneumococcal carriage in both study arms. These surveys will occur at the start of the study (before the intervention) to capture the baseline measurement, and at the end of the study (after the 16 weeks of intervention), to see whether reduced exposure to PMs affects pneumococcal carriage in the mothers and babies

pneumococcal infections/nicotina

Pneumococcal Conjugate Vaccine in Aging Renal Transplant

Indoor Air Pollution (IAP) Carriage Study

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