tetano
Editor, Senior Moderator
J Allergy Clin Immunol. 2018 Apr 17. pii: S0091-6749(18)30560-8. doi: 10.1016/j.jaci.2018.02.052. [Epub ahead of print]
[h=1]Predictive markers for humoral influenza vaccine response in patients with common variable immunodeficiency (CVID).[/h] Gardulf A[SUP]1[/SUP], Abolhassani H[SUP]2[/SUP], Gustafson R[SUP]3[/SUP], Eriksson LE[SUP]4[/SUP], Hammarstr?m L[SUP]5[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] A subgroup of patients with common variable immunodeficiencies (CVID) responds to vaccination. The aim of the study was to try to identify predictive markers for those who developed a humoral immune response after influenza vaccination.
[h=4]METHODS:[/h] 48 patients with CVID (29 females, 19 males, mean age 59.4 years) were vaccinated with the A(H1N1) influenza vaccine Pandemrix[SUP]?[/SUP] and boosted after one month. Blood samples were collected prior to each vaccination and two months later. Patients with a 4-fold titer increase of the hemagglutinin inhibition test (≥ 1:40) were considered responders and compared to non-responders for clinical, immunological and genetic markers.
[h=4]RESULTS:[/h] Eight (16.7%) patients responded to the vaccination. A significantly higher proportion of the responders, who showed a Euroclass SmB[SUP]-[/SUP]Tr[SUP]norm[/SUP]21[SUP]norm[/SUP] profile (p=0.03) with a post-germinal center B cell pattern (p=0.04) in blood, suffered from enteropathies (p=0.04) as compared to non-responders. Bronchiectasis on the other hand, was exclusively found among non-responders (n=7), as was autoimmune cytopenia (n=5). Non-responders with a Euroclass SmB[SUP]-[/SUP]21[SUP]low[/SUP]Tr[SUP]norm[/SUP] profile (p=0.02), had a significantly higher prevalence of progressive antibody deficiency (p=0.048) and, at diagnosis, a higher mean serum IgM level (p=0.03), a lower mean serum IgG1 level (p=0.007), an expansion of absolute counts of cytotoxic CD8[SUP]+[/SUP] T-cells (p=0.033) and an increased proportion of memory CD8[SUP]+[/SUP] T-cells (p=0.044) in blood. CVID associated HLA markers were not detected in non-responders (p=0.03).
[h=4]CONCLUSION:[/h] About one-fifth of the CVID patients achieved protective antibody levels after A(H1N1) vaccination and selected clinical and immunological markers were identified that may predict a positive outcome of influenza vaccination.
Copyright ? 2018. Published by Elsevier Inc.
[h=4]KEYWORDS:[/h] A(H1N1); CVID; Common variable immunodeficiency; Pandemrix; immune response; influenza; pandemic influenza; specific antibody deficiency; vaccination
PMID: 29678747 DOI: 10.1016/j.jaci.2018.02.052
[h=1]Predictive markers for humoral influenza vaccine response in patients with common variable immunodeficiency (CVID).[/h] Gardulf A[SUP]1[/SUP], Abolhassani H[SUP]2[/SUP], Gustafson R[SUP]3[/SUP], Eriksson LE[SUP]4[/SUP], Hammarstr?m L[SUP]5[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] A subgroup of patients with common variable immunodeficiencies (CVID) responds to vaccination. The aim of the study was to try to identify predictive markers for those who developed a humoral immune response after influenza vaccination.
[h=4]METHODS:[/h] 48 patients with CVID (29 females, 19 males, mean age 59.4 years) were vaccinated with the A(H1N1) influenza vaccine Pandemrix[SUP]?[/SUP] and boosted after one month. Blood samples were collected prior to each vaccination and two months later. Patients with a 4-fold titer increase of the hemagglutinin inhibition test (≥ 1:40) were considered responders and compared to non-responders for clinical, immunological and genetic markers.
[h=4]RESULTS:[/h] Eight (16.7%) patients responded to the vaccination. A significantly higher proportion of the responders, who showed a Euroclass SmB[SUP]-[/SUP]Tr[SUP]norm[/SUP]21[SUP]norm[/SUP] profile (p=0.03) with a post-germinal center B cell pattern (p=0.04) in blood, suffered from enteropathies (p=0.04) as compared to non-responders. Bronchiectasis on the other hand, was exclusively found among non-responders (n=7), as was autoimmune cytopenia (n=5). Non-responders with a Euroclass SmB[SUP]-[/SUP]21[SUP]low[/SUP]Tr[SUP]norm[/SUP] profile (p=0.02), had a significantly higher prevalence of progressive antibody deficiency (p=0.048) and, at diagnosis, a higher mean serum IgM level (p=0.03), a lower mean serum IgG1 level (p=0.007), an expansion of absolute counts of cytotoxic CD8[SUP]+[/SUP] T-cells (p=0.033) and an increased proportion of memory CD8[SUP]+[/SUP] T-cells (p=0.044) in blood. CVID associated HLA markers were not detected in non-responders (p=0.03).
[h=4]CONCLUSION:[/h] About one-fifth of the CVID patients achieved protective antibody levels after A(H1N1) vaccination and selected clinical and immunological markers were identified that may predict a positive outcome of influenza vaccination.
Copyright ? 2018. Published by Elsevier Inc.
[h=4]KEYWORDS:[/h] A(H1N1); CVID; Common variable immunodeficiency; Pandemrix; immune response; influenza; pandemic influenza; specific antibody deficiency; vaccination
PMID: 29678747 DOI: 10.1016/j.jaci.2018.02.052