tetano
Editor, Senior Moderator
Vaccine. 2013 Jul 8. pii: S0264-410X(13)00886-4. doi: 10.1016/j.vaccine.2013.06.076. [Epub ahead of print]
Serial influenza-vaccination reveals impaired maintenance of specific T-cell memory in patients with end-stage renal failure.
Sester U, Schmidt T, Kuhlmann MK, G?rtner BC, Uhlmann-Schiffler H, Sester M.
Source
Department of Internal Medicine IV, Saarland University, Homburg, Germany.
Abstract
To investigate correlates for the well-known impaired response of haemodialysis-patients to a variety of recommended vaccinations, the induction of antigen-specific cellular and humoral immunity was characterised after influenza-vaccination in two following seasons where the identical vaccine-composition was used. Influenza-specific T-cells were flow-cytometrically characterised from whole blood of 24 healthy controls and 26 haemodialysis-patients by proliferation-assays, induction of IFN-γ and TNF-α, and maturation markers. Antibody-titres were quantified using ELISA and hemagglutination-inhibition test. Influenza-specific CD4 T-cells were recently activated CD45RO+/CD27+ Th1-cells. Specific T-cell frequencies significantly increased 1-2 weeks after the first vaccination in both controls (mean increase by 0.50?0.64%, max: 3.01%) and haemodialysis-patients (by 0.55?0.71%, max: 3.44%). Thereafter, T-cell levels continuously decreased to pre-vaccination levels within approximately 7 weeks, whereas antibody-titres were more stable over time. By 6 months, haemodialysis-patients had significantly lower precursor-frequencies of proliferating influenza-specific memory T-cells (p=0.006). In the following season, memory-maintainance in immunocompetent individuals led to a significantly less pronounced increase in cellular immunity after re-vaccination (by only 0.12?0.09%, p=0.003), whereas the vaccine induced a strong increase in a second group of vaccination-na?ve controls. Of note, haemodialysis-patients responded like vaccination-na?ve individuals, as they showed a strong increase in cellular immunity after re-vaccination that was as pronounced as in the year before. In conclusion, the less pronounced T-cell increase after re-vaccination in controls may indicate maintainance of sufficient immunological memory. In contrast, the more rapid loss of proliferating cells in haemodialysis-patients may represent a sign of relative immunodeficiency and contribute to an increased incidence of recurrent infectious complications.
Copyright ? 2013. Published by Elsevier Ltd.
KEYWORDS:
Chronic renal failure, Clinical immunology, Immunisation, Influenza, SEB, Staphylococcus aureus enterotoxin B, T-cells, Vaccination
PMID:
23845814
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/23845814
Serial influenza-vaccination reveals impaired maintenance of specific T-cell memory in patients with end-stage renal failure.
Sester U, Schmidt T, Kuhlmann MK, G?rtner BC, Uhlmann-Schiffler H, Sester M.
Source
Department of Internal Medicine IV, Saarland University, Homburg, Germany.
Abstract
To investigate correlates for the well-known impaired response of haemodialysis-patients to a variety of recommended vaccinations, the induction of antigen-specific cellular and humoral immunity was characterised after influenza-vaccination in two following seasons where the identical vaccine-composition was used. Influenza-specific T-cells were flow-cytometrically characterised from whole blood of 24 healthy controls and 26 haemodialysis-patients by proliferation-assays, induction of IFN-γ and TNF-α, and maturation markers. Antibody-titres were quantified using ELISA and hemagglutination-inhibition test. Influenza-specific CD4 T-cells were recently activated CD45RO+/CD27+ Th1-cells. Specific T-cell frequencies significantly increased 1-2 weeks after the first vaccination in both controls (mean increase by 0.50?0.64%, max: 3.01%) and haemodialysis-patients (by 0.55?0.71%, max: 3.44%). Thereafter, T-cell levels continuously decreased to pre-vaccination levels within approximately 7 weeks, whereas antibody-titres were more stable over time. By 6 months, haemodialysis-patients had significantly lower precursor-frequencies of proliferating influenza-specific memory T-cells (p=0.006). In the following season, memory-maintainance in immunocompetent individuals led to a significantly less pronounced increase in cellular immunity after re-vaccination (by only 0.12?0.09%, p=0.003), whereas the vaccine induced a strong increase in a second group of vaccination-na?ve controls. Of note, haemodialysis-patients responded like vaccination-na?ve individuals, as they showed a strong increase in cellular immunity after re-vaccination that was as pronounced as in the year before. In conclusion, the less pronounced T-cell increase after re-vaccination in controls may indicate maintainance of sufficient immunological memory. In contrast, the more rapid loss of proliferating cells in haemodialysis-patients may represent a sign of relative immunodeficiency and contribute to an increased incidence of recurrent infectious complications.
Copyright ? 2013. Published by Elsevier Ltd.
KEYWORDS:
Chronic renal failure, Clinical immunology, Immunisation, Influenza, SEB, Staphylococcus aureus enterotoxin B, T-cells, Vaccination
PMID:
23845814
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/23845814