{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:11:14Z","timestamp":1791612674054,"version":"4.3.4"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2018,7,9]],"date-time":"2018-07-09T00:00:00Z","timestamp":1531094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The C5 complement inhibitor eculizumab is a first-line treatment in atypical haemolytic uraemic syndrome (aHUS). Therapy with eculizumab is associated with a highly increased risk for meningococcal infection. Therefore, vaccination is highly recommended before beginning treatment. Efficacy of quadrivalent meningococcal vaccines (MenACWY) in patients treated with the C5 complement inhibitor eculizumab in aHUS has not yet been determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with aHUS received one dose of a MenACWY conjugate vaccine before eculizumab treatment commenced. Bactericidal titres against meningococcal serogroups A, C, W and Y were determined using baby rabbit complement in 25 patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Full immune response to meningococcal vaccination was detected in five patients (20%), while seven patients (28%) showed no immune response in any of the tested serogroups. The remaining 13 patients showed incomplete immune response with proof of protective antibody titres for one to three serogroups without perceptible preference for any serogroup. Bactericidal titres after re-vaccination were available for 17 patients. Nine patients with incomplete immune response after first vaccinations showed protective antibody titres for all serogroups after re-vaccination. Kidney function had improved in &amp;gt;50% of patients at the time of re-vaccination compared with the time of first vaccination and immunosuppressive therapy was only applied to re-vaccinated patients following kidney transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Immunogenicity of first quadrivalent meninongococcal vaccination is insufficient in patients with aHUS. Booster response is promising, but incomplete. Therefore, establishing antibiotic prophylaxes seems pivotal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ndt\/gfy225","type":"journal-article","created":{"date-parts":[[2018,6,18]],"date-time":"2018-06-18T15:10:11Z","timestamp":1529334611000},"page":"298-303","source":"Crossref","is-referenced-by-count":21,"title":["Failure of first meningococcal vaccination in patients with atypical haemolytic uraemic syndrome treated with eculizumab"],"prefix":"10.1093","volume":"35","author":[{"given":"Anja","family":"G\u00e4ckler","sequence":"first","affiliation":[{"name":"Department of Nephrology, University Hospital Essen, University Duisburg-Essen , Essen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meike","family":"Kaulfu\u00df","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen , Essen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"Rohn","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen , Essen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Vogel","sequence":"additional","affiliation":[{"name":"Institute for Hygiene and Microbiology, National Reference Laboratory for Meningococci and Haemophilus Influenzae, University of W\u00fcrzburg , W\u00fcrzburg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heike","family":"Claus","sequence":"additional","affiliation":[{"name":"Institute for Hygiene and Microbiology, National Reference Laboratory for Meningococci and Haemophilus Influenzae, University of W\u00fcrzburg , W\u00fcrzburg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorsten","family":"Feldkamp","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein, Christian Albrechts University Kiel , Kiel,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Kribben","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Hospital Essen, University Duisburg-Essen , Essen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Witzke","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen , Essen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,7,9]]},"reference":[{"key":"2025102312510231100_gfy225-B1","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1056\/NEJMra0902814","article-title":"Atypical hemolytic-uremic syndrome","volume":"361","author":"Noris","year":"2009","journal-title":"N Engl J Med"},{"key":"2025102312510231100_gfy225-B2","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1111\/j.1600-6143.2010.03156.x","article-title":"Thrombotic microangiopathy after kidney transplantation","volume":"10","author":"Noris","year":"2010","journal-title":"Am J Transplant"},{"key":"2025102312510231100_gfy225-B3","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1111\/ajt.12077","article-title":"Complement genes strongly predicht recurrence and graft outcome in adult renal transplant recipients with atypical hemolytic and uremic syndrome","volume":"13","author":"Le Quintrec","year":"2013","journal-title":"Am J Transplant"},{"key":"2025102312510231100_gfy225-B4","doi-asserted-by":"crossref","first-page":"88","DOI":"10.2215\/CJN.00050505","article-title":"Outcome of renal transplantation in patients with non-Shiga toxin-associated hemolytic uremic syndrome: prognostic significance of genetic background","volume":"1","author":"Bresin","year":"2005","journal-title":"Clin J Am Soc Nephrol"},{"key":"2025102312510231100_gfy225-B5","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.trre.2017.10.001","article-title":"De novo thrombotic microangiopathy after kidney transplantation","volume":"32","author":"Garg","year":"2018","journal-title":"Transplant Rev (Orlando)"},{"key":"2025102312510231100_gfy225-B6","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s00467-015-3076-8","article-title":"An international consensus approach to the management of atypical hemolytic uremic syndrome in children","volume":"31","author":"Loirat","year":"2016","journal-title":"Pediatr Nephrol"},{"key":"2025102312510231100_gfy225-B7","doi-asserted-by":"crossref","first-page":"e0188155","DOI":"10.1371\/journal.pone.0188155","article-title":"Long-term outcomes of the atypical hemolytic uremic syndrome after kidney transplantation treated with eculizumab as first choice","volume":"12","author":"de Andrade","year":"2017","journal-title":"PLoS One"},{"key":"2025102312510231100_gfy225-B8","doi-asserted-by":"crossref","first-page":"257","DOI":"10.3389\/fimmu.2015.00257","article-title":"Complement system part II: role in immunity","volume":"6","author":"Merle","year":"2015","journal-title":"Front Immunol"},{"key":"2025102312510231100_gfy225-B9","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1097\/QCO.0000000000000279","article-title":"Infections associated with the use of eculizumab: recommendations for prevention and prophylaxis","volume":"29","author":"Benamu","year":"2016","journal-title":"Curr Opin Infect Dis"},{"key":"2025102312510231100_gfy225-B10"},{"key":"2025102312510231100_gfy225-B11","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1016\/j.cmi.2018.02.002","article-title":"ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: an Infectious Diseases perspective (Soluble immune effector molecules [II]: agents targeting interleukins, immunoglobulins and complement factors)","volume":"24","author":"Winthrop","year":"2018","journal-title":"Clin Microbiol Infect"},{"key":"2025102312510231100_gfy225-B12","doi-asserted-by":"crossref","first-page":"2169","DOI":"10.1056\/NEJMoa1208981","article-title":"Terminal complement inhibitor eculizumab in atypical hemolytic-uremic syndrome","volume":"368","author":"Legendre","year":"2013","journal-title":"N Engl J Med"},{"key":"2025102312510231100_gfy225-B13","first-page":"333","article-title":"Empfehlungen der St\u00e4ndigen Impfkommission (STIKO) am Robert Koch-Institut","volume":"34","author":"Impfkommission","year":"2017","journal-title":"Epid Bull"},{"key":"2025102312510231100_gfy225-B14","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1111\/sji.12497","article-title":"Humoral and cellular responses to a single dose of fendrix in renal transplant recipients with non-response to previous hepatitis B vaccination","volume":"85","author":"Lindemann","year":"2017","journal-title":"Scand J Immunol"},{"key":"2025102312510231100_gfy225-B15","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1016\/j.vaccine.2016.12.032","article-title":"Response to active hepatitis B vaccination and mortality in incident dialysis patients","volume":"35","author":"Zitt","year":"2017","journal-title":"Vaccine"},{"key":"2025102312510231100_gfy225-B16","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1111\/tid.12359","article-title":"Low immunogenicity of quadrivalent meningococcal vaccines in solid organ transplant recipients","volume":"17","author":"Wyplosz","year":"2015","journal-title":"Transplant Infect Dis"},{"key":"2025102312510231100_gfy225-B17","doi-asserted-by":"crossref","first-page":"E246","DOI":"10.1111\/j.1399-3046.2011.01585.x","article-title":"Immunogenicity of meningococcus C vaccination in a patient with atypical hemolytic uremic syndrome (aHUS) on eculizumab therapy","volume":"16","author":"Zlamy","year":"2012","journal-title":"Pediatr Transplant"},{"key":"2025102312510231100_gfy225-B18","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1128\/iai.40.1.257-264.1983","article-title":"Importance of complement source in bactericidal activity of human antibody and murine monoclonal antibody to meningococcal group B polysaccharide","volume":"40","author":"Zollinger","year":"1983","journal-title":"Infect Immun"},{"key":"2025102312510231100_gfy225-B19"},{"key":"2025102312510231100_gfy225-B20"},{"key":"2025102312510231100_gfy225-B21","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1007\/s00277-017-2924-y","article-title":"Serologic response to meningococcal vaccination in patients with paroxysmal nocturnal hemoglobinuria (PNH) chronically treated with the terminal complement inhibitor eculizumab","volume":"96","author":"Alashkar","year":"2017","journal-title":"Ann Hematol"},{"key":"2025102312510231100_gfy225-B22","first-page":"1","article-title":"Prevention and control of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACPI","volume":"62","author":"Cohn","year":"2013","journal-title":"MMWR Recomm Rep"},{"key":"2025102312510231100_gfy225-B23","doi-asserted-by":"crossref","first-page":"141","DOI":"10.2174\/1389201033489900","article-title":"Recombinant hepatitis B vaccination in renal failure patients","volume":"4","author":"Vlassopoulos","year":"2003","journal-title":"Curr Pharm Biotechnol"},{"key":"2025102312510231100_gfy225-B24","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1136\/bmj.39563.545255.AE","article-title":"Seroprotection against serogroup C meningococcal disease in adolescents in the United Kingdom: observational study","volume":"336","author":"Snape","year":"2008","journal-title":"BMJ"},{"key":"2025102312510231100_gfy225-B25","doi-asserted-by":"crossref","first-page":"817","DOI":"10.3389\/fimmu.2017.00817","article-title":"Novel intervention in the aging population: a primary meningococcal vaccine inducing protective IgM responses in middle-aged adults","volume":"8","author":"van der Heiden","year":"2017","journal-title":"Front Immunol"},{"key":"2025102312510231100_gfy225-B26","doi-asserted-by":"crossref","first-page":"2222","DOI":"10.1016\/j.vaccine.2005.01.051","article-title":"Meningococcal surrogates of protection\u2013serum bactericidal antibody activity","volume":"23","author":"Borrow","year":"2005","journal-title":"Vaccine"},{"key":"2025102312510231100_gfy225-B27","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1099\/jmm.0.45529-0","article-title":"Neisseria meningitidis: an overview of the carriage state","volume":"53","author":"Yazdankhah","year":"2004","journal-title":"J Med Microbiol"},{"key":"2025102312510231100_gfy225-B28","doi-asserted-by":"crossref","first-page":"2481","DOI":"10.1111\/ajt.14426","article-title":"High risk for invasive meningococcal disease among patients receiving eculizumab (Soliris) despite receipt of meningococcal vaccine","volume":"17","author":"McNamara","year":"2017","journal-title":"Am J Transplant"},{"key":"2025102312510231100_gfy225-B29","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1182\/blood-2017-05-781450","article-title":"Eculizumab treatment and impaired opsonophagocytic killing of meningococci by whole blood from immunized adults","volume":"130","author":"Konar","year":"2017","journal-title":"Blood"},{"key":"2025102312510231100_gfy225-B30","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.kint.2016.10.005","article-title":"Atypical hemolytic uremic syndrome and C3 glomerulopathy: conclusions from a \u201cKidney Disease: Improving Global Outcomes\u201d (KDIGO) Controversies Conference","volume":"91","author":"Goodship","year":"2017","journal-title":"Kidney Int"}],"container-title":["Nephrology Dialysis Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/35\/2\/298\/32360535\/gfy225.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/35\/2\/298\/32360535\/gfy225.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T16:52:21Z","timestamp":1761238341000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ndt\/article\/35\/2\/298\/5050868"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,9]]},"references-count":30,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2018,7,9]]},"published-print":{"date-parts":[[2020,2,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ndt\/gfy225","relation":{},"ISSN":["0931-0509","1460-2385"],"issn-type":[{"value":"0931-0509","type":"print"},{"value":"1460-2385","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,2]]},"published":{"date-parts":[[2018,7,9]]}}}