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Int J Cardiol Congenit Heart Dis . T Cell Response to Influenza Vaccination Remains Intact in Adults with Congenital Heart Disease Who Underwent Ea

tetano

Editor, Senior Moderator
Int J Cardiol Congenit Heart Dis


. 2022 Jun;8:100359.
doi: 10.1016/j.ijcchd.2022.100359. Epub 2022 Mar 25.
T Cell Response to Influenza Vaccination Remains Intact in Adults with Congenital Heart Disease Who Underwent Early Thymectomy


David M Leone[SUP] 1 [/SUP], Hong-Jai Park[SUP] 2 [/SUP], Serhan Unlu[SUP] 2 [/SUP], Michelle Gurvitz[SUP] 3 [/SUP], Insoo Kang[SUP] 2 [/SUP], Robert W Elder[SUP] 1 4 [/SUP]



Affiliations

Abstract

Introduction: T cells developed in the thymus play a key role in vaccine immunity. Thymectomy occurs during infant congenital heart surgery and results in an altered T cell distribution. We investigated if adults with congenital heart disease (ACHD) who underwent early thymectomy have a diminished response to influenza vaccination.
Methods: Blood samples from ACHD with early thymectomy ≤ 1 year of age (ACHD-ET; n = 12), no thymectomy (ACHD-NT; n = 8), and healthy controls (HC; n = 14) were collected prior to and 4 weeks after influenza vaccination. Flow cytometric analysis of T cell subsets and vaccine-specific cytokine expressing CD4[SUP]+[/SUP] T cells as well as hemagglutination inhibition (HI) assays were completed.
Results: The mean age of the cohort was 34 ± 10.6 years and similar in all groups. The mean frequencies of naïve CD4[SUP]+[/SUP] and CD8[SUP]+[/SUP] T cells were lower in ACHD-ET than in HC (32.7% vs. 46.5%, p = 0.027 and 37.2% vs. 57.4%, p = 0.032, respectively). There was a rise in the frequency of memory CD4[SUP]+[/SUP] and CD8[SUP]+[/SUP] T cells in the ACHD-ET group. The ACHD-NT had no statistical difference from either group. The frequencies of influenza-specific memory CD4[SUP]+[/SUP] T cells expressing IFN-γ and TNF-α were increased after vaccination across all groups (p < 0.05).
Conclusions: ACHD-ET have fewer naïve T cells, suggesting immunosenescence. Despite this, they show an adequate T Cell response to vaccination in young adulthood. Our findings support routine vaccination is effective in this population, but research into older ACHD is necessary.

Keywords: Adult Congenital Heart Disease; Immunosenescence; Influenza Vaccination; T Cells; Thymectomy.
 
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