scholarly journals Potential Association Between Dietary Fibre and Humoral Response to the Seasonal Influenza Vaccine

2021 ◽  
Vol 12 ◽  
Author(s):  
Alissa Cait ◽  
Anna Mooney ◽  
Hazel Poyntz ◽  
Nick Shortt ◽  
Angela Jones ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Dietary Fibre ◽  
De Novo ◽  
Statistical Significance ◽  
Intestinal Bacteria ◽  
Humoral Response ◽  
Short Chain Fatty Acids ◽  
Bacterial Fermentation ◽  
Vaccine Responses

Influenza vaccination is an effective public health measure to reduce the risk of influenza illness, particularly when the vaccine is well matched to circulating strains. Notwithstanding, the efficacy of influenza vaccination varies greatly among vaccinees due to largely unknown immunological determinants, thereby dampening population-wide protection. Here, we report that dietary fibre may play a significant role in humoral vaccine responses. We found dietary fibre intake and the abundance of fibre-fermenting intestinal bacteria to be positively correlated with humoral influenza vaccine-specific immune responses in human vaccinees, albeit without reaching statistical significance. Importantly, this correlation was largely driven by first-time vaccinees; prior influenza vaccination negatively correlated with vaccine immunogenicity. In support of these observations, dietary fibre consumption significantly enhanced humoral influenza vaccine responses in mice, where the effect was mechanistically linked to short-chain fatty acids, the bacterial fermentation product of dietary fibre. Overall, these findings may bear significant importance for emerging infectious agents, such as COVID-19, and associated de novo vaccinations.

scholarly journals The Effects of Imprinting and Repeated Seasonal Influenza Vaccination on Adaptive Immunity after Influenza Vaccination

Vaccines ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 663
Author(s):  
Amy C. Sherman ◽  
Lilin Lai ◽  
Mary Bower ◽  
Muktha S. Natrajan ◽  
Christopher Huerta ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Seasonal Influenza ◽  
Geometric Mean ◽  
Fold Change ◽  
Post Vaccination ◽  
Seasonal Influenza Vaccination ◽  
Vaccine Responses ◽  
Immune Factors ◽  
Antibody Secreting Cells

(1) Background: The influenza virus continues to cause significant annual morbidity and mortality. The overall efficacy of seasonal influenza vaccination is suboptimal, which is partly due to host immune factors. The effects of imprinting and repeated seasonal influenza vaccination were investigated to assess for immune factors and mechanisms that impact influenza vaccine responses. (2) Methods: Twenty participants were enrolled into a prospective pilot study based on birth cohort and seasonal influenza immunization history. Immunologic parameters were assessed over a six-month period after the seasonal influenza vaccine was administered. (3) Results: There was no significant imprinting effect, as measured by hemagglutination inhibition (HAI) fold change, HAI geometric mean titer (GMT) for Day 29 or Day 180 post-vaccination and antigen- specific antibody-secreting cells (ASC) for Day 8 post-vaccination. Individuals who had minimal prior seasonal influenza vaccination had a higher magnitude ASC response and a higher HAI fold change post-vaccination than individuals who were repeatedly vaccinated. (4) Conclusions: Repeated seasonal influenza vaccination resulted in a decreased fold change of the immune response, although individuals in this cohort tended to have high HAI titers at baseline that persisted after vaccination. Imprinting effects were not observed in this cohort. These host immune factors should be considered in the development of universal influenza vaccines. ClinicalTrials.gov Identifier: NCT03686514.

Good but Variable Humoral Response to Trivalent Influenza Vaccination in Patients with Non-Hodgkin’s Lymphoma - Two Seasons Experience.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4685-4685
Author(s):  
Piotr Centkowski ◽  
Lidia Brydak ◽  
Magdalena Machala ◽  
Ewa Kalinka ◽  
Maria Blasinska-Morawiec ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Geometric Mean ◽  
Humoral Response ◽  
Fold Increase ◽  
Treated Group ◽  
Influenza Hemagglutinin ◽  
Protection Rate ◽  
Antibody Titers ◽  
Previously Treated

Abstract We assessed humoral response to influenza vaccination (vacc) in two consecutive seasons 2003/2004 and 2004/2005 in 123 NHL patients. In season 03/04 50 patients (29 previously treated with chemotherapy - group A03/04 and 21 not treated - group B03/04) and 73 patients in season 04/05: 34 treated - A04/05, 39 not treated - B04/05 were vaccinated with trivalent subunit influenza vaccine. Antibody responses to influenza hemagglutinin (HI) and neuraminidase (NI) were determined in sera collected before vacc, after 1 month and after 6 months. One month after vacc geometric mean antibody titers (GMTs) of antiHI antibodies significantly increased (p<0.05) and mean fold increases (MFIs) ranged from 10.4 to 24.3 in A03/04, 10.9–11.7 in A04/05, 6.5–31.6 in B03/04 and 14.8–21 in B04/05, than fell after 6 months to 3.6–7.8 in A03/04, 3.7–4.4 in A04/05, 1.7–11.2 in B03/04 and 7.8–8.5 in B04/05. Prevacc protection rate, i.e. the number of subjects with the protective HI antibody titers >1:40, ranged from 3.4 to 10.3% in A03/04, 2.9-8.8% in A04/05, 0–4.6% in B03/04 and 0–5.1% in B04/05. After 1 month protection rates ranged from 78.1 to 87.5% in A03/04, 61.8–70.6% in A04/05, 73.3–93.3% in B03/04 and 66.7–74.4% in B04/05 and decreased after 6 months to 24.1–37.9% in A03/04, 32.4–35.3% in A04/05, 19–47.6% in B03/04 and 17.9–35.9% in B04/05. Response rates, i.e. the number of subjects with at least a 4-fold increase of antiHI antibody titers after vacc, ranged from 58.6–75.9% in A03/04, 50–67.6% in A04/05, 57.1–81% in B03/04 and 61.5–71.8% in B04/05. Six months after vacc it decreased to 17.2–34.5% in A03/04, 20.6–29.4% in A04/05, 19–38.1% in B03/04 and 15.4–33.3% in B04/05. In all patients’ groups, post-vacc antiNI GMTs were significantly higher (p<0.05) than pre-vacc. MFIs of antiNI antibodies 1 month after vacc ranged from 11 to 17.5 in A03/04, 4.1–9.4 in A04/05, 5.1–9.9 in B03/04 and 6.3–9.9 in B04/05, then fell to 2.9–6.9 in A03/04, 1.3–5.1 in A04/05, 3.4–4.9 in B03/04 and 2.8–3.6 in B04/05. In season 03/04 only hemagglutinin H1 antibody titers were significantly higher in CTR than in patients in contrast of season 04/05 when in patients the titers of H1, H3 and N1, N2, NB were significantly lower. We conclude that the response to influenza vaccine is similar in patients previously treated and not-treated with chemoterapy. It is highly immunogenic in NHL patients, but the level of specific antibodies is variable and may depend on immunogenecity of vaccine for actual season. After 6 months the antibody titers rapidly decline, thus the NHL patients may need the second dose of vaccine to maintain good protective level.

Immunogenicity of Influenza Vaccination in Patients with Non-Hodgkin Lymphoma: Final Report after Two Epidemic Seasons.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4598-4598
Author(s):  
Piotr Centkowski ◽  
Lidia B. Brydak ◽  
Magdalena Machala ◽  
Ewa Kalinka ◽  
Maria Blasinska-Morawiec ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Hodgkin Lymphoma ◽  
Geometric Mean ◽  
Humoral Response ◽  
Final Report ◽  
Healthy Controls ◽  
Serum Samples ◽  
Non Hodgkin Lymphoma ◽  
Antibody Titers

Abstract Vaccination against influenza is recommended for immunocompromised individuals. However, there is little information concerning the efficacy of vaccination in patients (pts) with non-Hodgkin lymphoma (NHL). The purpose of this study was to assess humoral response to standard intramuscular trivalent subunit influenza vaccine in pts with NHL as compared to healthy subjects. In two consecutive epidemic seasons, 2003/2004 and 2004/2005, 163 pts and 92 healthy controls were vaccinated. Antibody titers to hemagglutinin (HA) and neuraminidase (NA) were measured in serum samples collected before vaccination, and 1 and 6 months apart. Changes in the hemagglutination inhibition (HAI) and neuraminidase inhibition (NII) antibody titers were assessed by comparing geometric mean titers and mean fold increases to baseline values and by comparing changes in the HA seroconversion and seroprotection rates. Pts who received influenza vaccine during 2003/2004 season had after one month increases in the geometric mean titers by a factor of 8,64–26,60 for HI and 6,93–12,66 for NI, as compared with respective increases by a factor of 9,12–24,41 and 4,83–10,31 for the healthy controls. At one month after vaccination seroprotection and seroresponse rates were similar in the two groups, ranging from 68,42 to 84,21 % and 71,93 to 94,74 % in NHL and 66,67–82,22 % and 62,22–86,67 % in controls, respectively. After six months, seroprotection and seroresponse rates had decreased in NHL group to 31,91–38,30% and 46,81–72,34%, respectively. Pts who received influenza vaccine during 2004/2005 season had after 1 month increases in the geometric mean titers by a factor of 38,76–41,49 for HI and 26,59–30,31 for NI, as compared with respective increases by a factor of 81,19–104,32 and 52,16–54,52 for the healthy controls. Seroprotection and seroresponse rates were lower in the former group, ranging from 62,11 to 65,26 % and 74,47 to 77,66 %, respectively. After six months, these parameters had decreased to 24,72–31,46% and 57,30–59,55%, respectively. In both studied seasons, pts achieved titres of functional antibodies greater than the protective threshold, irrespective of the previous chemotherapy administration. The results of this study indicate that standard influenza vaccination induces sufficient immune responses in pts with NHL. Previous chemotherapy adminstration seems to have no impact on the efficacy of vaccination.

scholarly journals Slc5a8, a Na+-coupled high-affinity transporter for short-chain fatty acids, is a conditional tumour suppressor in colon that protects against colitis and colon cancer under low-fibre dietary conditions

2015 ◽  
Vol 469 (2) ◽  
pp. 267-278 ◽  
Author(s):  
Ashish Gurav ◽  
Sathish Sivaprakasam ◽  
Yangzom D. Bhutia ◽  
Thomas Boettger ◽  
Nagendra Singh ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Colon Cancer ◽  
Gene Family ◽  
Dietary Fibre ◽  
Short Chain Fatty Acids ◽  
Protective Function ◽  
Bacterial Fermentation ◽  
High Affinity ◽  
Solute Carrier ◽  
Dietary Fibre Content

Butyrate generated by bacterial fermentation of dietary fibre protects against colitis and colon cancer. Slc5a8 (solute carrier gene family 5a, member 8), a butyrate transporter, mediates this effect; but the transporter's protective function is linked to dietary fibre content, observable only under conditions of low fibre intake.

scholarly journals Caeca Microbial Variation in Broiler Chickens as a Result of Dietary Combinations Using Two Cereal Types, Supplementation of Crude Protein and Sodium Butyrate

2021 ◽  
Vol 11 ◽  
Author(s):  
Daniel Borda-Molina ◽  
Gábor Mátis ◽  
Máté Mackei ◽  
Zsuzsanna Neogrády ◽  
Korinna Huber ◽  
...  
Keyword(s):  
Sodium Butyrate ◽  
Bacterial Communities ◽  
Broiler Chickens ◽  
Crude Protein ◽  
Statistical Significance ◽  
Short Chain Fatty Acids ◽  
Intestinal Microbiome ◽  
Bacterial Fermentation ◽  
Dietary Crude Protein ◽  
The Family

The intestinal microbiome can influence the efficiency and the health status of its host’s digestive system. Indigestible non-starch polysaccharides (NSP) serve as substrates for bacterial fermentation, resulting in short-chain fatty acids like butyrate. In broiler’s nutrition, dietary crude protein (CP) and butyrate’s presence is of particular interest for its impact on intestinal health and growth performance. In this study, we evaluated the effect on the microbial ecology of the ceca of dietary supplementations, varying the cereal type (maize and wheat), adequate levels of CP and supplementation of sodium butyrate on broiler chickens with 21 days. The overall structure of bacterial communities was statistically affected by cereal type, CP, and sodium butyrate (p = 0.001). Wheat in the diet promoted the presence of Lactobacillaceae, Bifidobacteriaceae and Bacteroides xylanisolvens, which can degrade complex carbohydrates. Maize positively affected the abundance of Bacteroides vulgatus. The addition of CP promoted the family Rikenellaceae, while sodium butyrate as feed supplement was positively related to the family Lachnospiraceae. Functional predictions showed an effect of the cereal type and a statistical significance across all supplementations and their corresponding interactions. The composition of diets affected the overall structure of broilers’ intestinal microbiota. The source of NSP as a substrate for bacterial fermentation had a stronger stimulus on bacterial communities than CP content or supplementation of butyrate.

Stem Cell Source Dependent Differences in Reconstituting Peripheral T Follicular Helper Cells Following Hematopoietic Cell Transplantation, Their Association with Chronic Gvhd and Role in Response to Influenza Vaccination

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3919-3919
Author(s):  
David A. Knorr ◽  
Ryan W Nelson ◽  
Ryan Shanley ◽  
Nicole Karras ◽  
Jeffrey S. Miller ◽  
...  
Keyword(s):  
T Cells ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
B Cell ◽  
Cd4 T Cells ◽  
Advisory Committees ◽  
Vaccine Responses ◽  
Tfh Cells ◽  
Stem Cell Source ◽  
Follicular Helper

Abstract Allogeneic hematopoietic cell transplant (allo-HCT) results in profound immunodeficiency where patients remain susceptible to life-threatening infections for months to years. Although vaccination provides protection against viruses such as influenza, there is limited mechanistic evidence regarding the immune cell subsets directly involved. To better understand vaccination responses in allo-HCT recipients, a more specific analysis of the generation of influenza specific T cells is needed. Recently, it has been shown that a particular subset of CD4 T cells, T follicular helper (TFH) cells, play an important role in humoral responses to vaccination in humans. TFH cells express the receptor CXCR5, allowing them to traffic to secondary lymphoid tissues and provide help to B cells. We recently showed that TFH cells are also important in murine chronic graft-vs-host disease (cGVHD, Flynn and Blazar, Blood 2014), a process characterized by pathogenic B cell activity and chronic antibody deposition. Importantly, TFH cells and germinal centers were required for cGVHD and bronchiolitis obliterans in mice. Depletion of TFH effector cytokines (IL-21) or co-stimulatory ligands (ICOS and CD154) blocked germinal center formation and cGVHD. To date, no study has examined the recovery of TFH cells after allo-HCT and their association with vaccine specific responses or cGVHD. Here we investigated the reconstitution of peripheral T follicular helper cells (pTFH, CD3+CD4+CXCR5+ cells) in patients undergoing UCB (n=14) or matched sibling PBSC transplantation (n=12). Notably, UCB recipients had lower percentages of pTFH cells at day 60 following transplant compared to PBSC MRDs (2.0% ± 0.2 vs 8.6% ± 1.0, p<0.001). This finding is likely explained by the graft content of pTFH cells which is higher in MRD donors.UCB grafts contain no CXCR5+ CD4 T cells. Conversely, the pTFH cells in UCB recipients recovered to a higher level than PBSC MRD recipients at >1 year following transplant (13.84% ± 1.4 vs 9.7% ± 1.0 SEM, p=0.019). Comparing the trajectory of pTFH recovery, MRD recipients remain stable over time whereas UCB donors show a progressive rise (Figure 1). Also, in both UCB and MRD transplants, pTFH cells are mainly composed of central memory cells (CD27+/CD45RO+; 82.17% ± 2.588 vs 87.44% ± 1.664, p=0.1664), demonstrating that circulating pTFH cells are antigen experienced. Strikingly, when patients with any cGVHD (n=8) from both groups were combined and analyzed at 1 year, there were significantly lower percentages of pTFH cells compared to those without cGVHD (n=18) (6.9% ± 1.2 vs. 13.8% ± 1.3, p=0.004) (Figure 2). Lastly, we have previously demonstrated that donor source (MRD PBSC vs UCB) and time from transplant (<1 yr and >1 yr post-allo-HCT) were associated with influenza vaccine responses. To study the role of pTFH cells in response to influenza vaccination, we analyzed samples of patients on a randomized controlled trial receiving 1 versus 2 doses of influenza vaccine following transplant from matched related or UCB donors. Blood samples were drawn pre-vaccination, then at 4 weeks patients were randomized to receive another dose of vaccine or not. Samples from each group were also collected at 8 weeks. We then evaluated polyfunctional, influenza-specific pTFH cells (expressing CD3, CD4, CXCR5, CD154) producing one, two, three or four cytokines (eg IFNy, TNFa, IL-17 and IL-2) in response to influenza peptide. Notably, these antigen-specific pTFH cells expanded with varying responses to 1 or 2 doses of influenza vaccine in vivo. These data provide biologic evidence of an increasing frequency of antigen-specific CD4 T cells following a second dose of vaccine. In combination with our data showing a correlation between absolute B cell numbers and vaccine responders (4x Ab response p=0.03, ELIspot IFNy response p<0.01), these data also support the hypothesis that vaccine responses post-HCT are multi-factorial (eg need T cell help and a functional B cell compartment). These studies are the first to evaluate the recovery of pTFH cells following allo-HCT. Our data demonstrate significant differences in the proportion of pTFH cells following allo-HCT based on stem cell source and the presence of cGVHD. They also show that antigen specific pTFH cells can be detected after influenza vaccination and provide additional evidence for some of the differences in vaccine responses. Figure 1 Figure 1. Figure 2 Figure 2. Disclosures Miller: Coronado: Speakers Bureau; BioSciences: Membership on an entity's Board of Directors or advisory committees; SAB: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau.

scholarly journals A Systematic Review and Metaanalysis of Antirheumatic Drugs and Vaccine Immunogenicity in Rheumatoid Arthritis

2018 ◽  
Vol 45 (6) ◽  
pp. 733-744 ◽  
Author(s):  
Sujith Subesinghe ◽  
Katie Bechman ◽  
Andrew I. Rutherford ◽  
David Goldblatt ◽  
James B. Galloway
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Influenza Vaccine ◽  
Pneumococcal Vaccine ◽  
Drug Exposure ◽  
Humoral Response ◽  
Vaccine Response ◽  
Antirheumatic Drugs ◽  
Vaccine Responses ◽  
Vaccine Immunogenicity

Objective.Vaccination is a key strategy to reduce infection risk in patients with rheumatoid arthritis (RA) and is advocated in internationally recognized rheumatology society guidelines. The aim was to evaluate to the effect of antirheumatic drugs on influenza and pneumococcal vaccine immunogenicity.Methods.We conducted a systematic literature review and metaanalysis comparing the humoral response to influenza (pandemic and seasonal trivalent subunit vaccines) and pneumococcal (23-valent pneumococcal polysaccharide vaccine, 7- and 13-valent pneumococcal conjugated vaccines) vaccination in adult patients with RA treated with antirheumatic drugs. Vaccine immunogenicity was assessed by seroprotection rates measured 3 to 6 weeks postimmunization. Risk ratios (RR) and 95% CI were pooled.Results.Nine studies were included in the metaanalysis (7 studies investigating antirheumatic drug exposures and influenza humoral response, 2 studies investigating pneumococcal vaccine response). Influenza vaccine responses to all subunit strains (H1N1, H3N2, B strain) were preserved with methotrexate (MTX) and tumor necrosis factor inhibitor (TNFi) drug exposure. MTX but not TNFi drug exposure was associated with reduced 6B and 23F serotype pneumococcal vaccine response (RR 0.42, 95% CI 0.28–0.63 vs RR 0.98, 95% CI 0.58–1.67); however, limited data were available to draw any firm conclusions. Combination of MTX with tocilizumab or tofacitinib was associated with reduced pneumococcal and influenza vaccine responses.Conclusion.Antirheumatic drugs may limit humoral responses to vaccination as evidenced by pneumococcal responses with MTX exposure; however, they are safe and should not preclude immunization against vaccine-preventable disease. Vaccination should be considered in all patients with RA and encouraged as part of routine care. (Systematic review registration number: PROSPERO 2016: CRD42016048093.)

Evaluation of Humoral Response to Trivalent Influenza Vaccination in Patients with Non-Hodgkin Lymphoma Previously Treated or Untreated with Chemotherapy.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4537-4537
Author(s):  
Piotr Centkowski ◽  
Lidia Brydak ◽  
Magdalena Machala ◽  
Ewa Kalinka ◽  
Maria Blasinska-Morawiec ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Hodgkin Lymphoma ◽  
Humoral Response ◽  
Control Group ◽  
Non Hodgkin Lymphoma ◽  
Antibody Titers ◽  
Group A ◽  
Previously Treated ◽  
Group B

Abstract The aim of this study was to assess humoral response to influenza vaccination in 47 patients with non-Hodgkin lymphoma (NHL) in comparison with 45 healthy individuals (age 12–76 years, median 41 years; 13 males and 32 females). Patients (age 36–82, median 60 years; 24 males and 23 females) consisted of two groups, previously treated with chemotherapy (group A, n=32) or untreated (group B, n=15). In autumn 2003, all subjects were vaccinated with influenza vaccine ([Isquo]influvac’, Solvay Pharmaceuticals B.V.). Antibody responses to influenza hemagglutinin and neuraminidase were determined in sera collected before and 1 month after vaccination by hemagglutination and neuraminidase inhibition tests. Statistical analysis was performed using the Mann-Whitney unpaired and Wilcoxon paired tests. After vaccination geometric mean antibody titers (GMTs) of antihemagglutinin (HI) antibodies significantly increased (p<0.05) and mean fold increases (MFIs) from 10.3 to 26.7 in group A, 5.9 to 48.9 in group B and from 9.1 to 24.4 in the controls. Pre-vaccination protection rate, i.e. the number of subjects with the protective HI antibody titers >1:40, ranged from 0% to 9.4% in group A, 0% to 13.3% in group B and from 2.2% to 20% in the controls. After vaccination protection rates increased and ranged from 78.1% to 87.5%, 73.3% to 93.3% and 66.7% to 82.2%, respectively. Response rates, i.e. the number of subjects with at least 4-fold increase of HI antibody titers after vaccination, ranged from 59.4% to 84.4%, 73.3% to 86.7% and from 51.1% to 66.7%, respectively. In both study groups and in the controls, post-vaccination antineuraminidase (NI) antibody titers were higher (p<0.05) than pre-vaccination titers. MFIs of NI antibody levels ranged from 9.8 to 17.3 in group A, 6.5 to 10.9 in group B and 4.8 to 10.3 in the controls. After vaccination, only hemagglutinin H1 antibody titers were (p<0.05) higher in the controls than in the study group A and B. In the other cases, there were no statistically significant differences between groups or there were higher values in patients with NHL than in the control group. The results of this study indicate that influenza vaccine is immunogenic in patients with NHL and stimulates production of HI and NI antibodies in the titers comparable to healthy subjects.

scholarly journals Vaccine Responses in Patients with Rheumatoid Arthritis Treated with Certolizumab Pegol: Results from a Single-blind Randomized Phase IV Trial

2014 ◽  
Vol 41 (4) ◽  
pp. 648-657 ◽  
Author(s):  
Alan J. Kivitz ◽  
Joy Schechtman ◽  
Michele Texter ◽  
Andreas Fichtner ◽  
Marc de Longueville ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Immune Response ◽  
Influenza Vaccination ◽  
Certolizumab Pegol ◽  
Humoral Response ◽  
Humoral Immune ◽  
Vaccine Responses ◽  
Link Type ◽  
Percentage Points ◽  
Single Blind

Objective.To evaluate the humoral immune response to pneumococcal and influenza vaccination in adults with rheumatoid arthritis (RA) receiving certolizumab pegol (CZP).Methods.In this 6-week, single-blind, placebo-controlled trial with optional 6-month open-label extension (NCT00993668), patients were stratified by concomitant methotrexate (MTX) use and randomized to receive CZP 400 mg (loading dose; according to CZP label) or placebo at weeks 0, 2, and 4. Pneumococcal (polysaccharide 23) and influenza vaccines were administered at Week 2. Satisfactory humoral immune response, defined as ≥ 2-fold titer increase in ≥ 3 of 6 pneumococcal antigens and ≥ 4-fold titer increase in ≥ 2 of 3 influenza antigens, were assessed independently 4 weeks after vaccination.Results.Following pneumococcal vaccination, 62.5% of placebo patients and 54.5% of CZP patients without effective titers at baseline achieved a humoral response (difference in proportions was −8.0 percentage points; 95% CI −22.5 to 6.6%). Following influenza vaccination, 61.4% of placebo and 53.5% of CZP patients without effective titers at baseline achieved a humoral response (difference in proportions: −8.0 percentage points; 95% CI −22.9 to 7.0%). In all patients, including those with effective titers at baseline, 58.2% of placebo and 53.3% of CZP patients developed satisfactory pneumococcal titers, and 54.1% of placebo and 50.5% of CZP patients developed satisfactory influenza antibody titers. Vaccine responses to pneumococcal and influenza antigens were reduced similarly in both treatment groups with concomitant MTX use.Conclusion.Humoral immune responses to pneumococcal and influenza vaccination are not impaired when given during the loading phase of CZP treatment in patients with RA. (ClinicalTrials.govNCT00993668).

scholarly journals Predictors of seasonal influenza vaccination in chronic asthma

2013 ◽  
Vol 8 ◽  
Author(s):  
Rachelle Asciak ◽  
Martin Balzan ◽  
Jesmar Buttigieg
Keyword(s):  
Side Effects ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Statistical Significance ◽  
Treatment Compliance ◽  
Female Gender ◽  
Vaccination Rate ◽  
Chronic Asthma ◽  
Asthma Exacerbations ◽  
One Year

Background: Guidelines advise annual influenza vaccination in chronic asthma. The aim of this study was to determine uptake of the influenza vaccine in a group of patients (n = 146) with moderate to severe chronic asthma and establish the main predictors of vaccination. Method: Patients attending a hospital asthma clinic were asked to complete a questionnaire in February 2012 (n = 146). These same patients were contacted a year later via telephone (n = 109 responded), and they were asked to complete the same questionnaire. Results: Vaccination rate was 50.3% in winter 2011/12, and 57.8% in 2012/13. Using binary logistic regression, the predictors for vaccination in 2012 were patient advice (Odds ratio [OR] 15.37 p = 0.001), female gender (OR 2.75, p = 0.028), past side effects (OR 0.21, p = 0.001) and comorbidity (OR 0.39, p = 0.013). Stepwise regression resulted in age as predictor (T value = 3.99, p = 0.001). On analyzing the responses from the second questionnaire at one year after attendance to asthma clinic, predictors changed to compliance to medication (OR 9.52, p= 0.001) and previous exacerbations (OR 4.19, p = 0.026). Out of the 56 patients vaccinated in 2011/12, 33 reported asthma exacerbations before 2012, and 29 reported asthma exacerbations after receiving the influenza vaccine. Out of the 46 unvaccinated patients in 2012, 27 had asthma exacerbations before 2012 and 19 patients had exacerbations in 2013. Patients vaccinated in 2011/12 needed 0.59 courses of steroid/patient/year, and 1.23 visits for nebulizer/ patient/year while non-vaccinated patients needed 0.18 courses of steroids/patient/year (p = 0.048), and 0.65 visits for nebulized/patient/year (p = 0.012). Patients’ subjective statements broadly confirmed the predictors. 16/69 (23.1%) received the vaccine in winter 2012/13 despite reporting previous side effects. Conclusions: Advice to patient, female gender and patients’ age predicted vaccination, while past side effects to the influenza vaccine, and presence of comorbidities predicted non vaccination. Symptomatic asthma patients are more likely to be vaccinated. One year after the first contact, treatment compliance and previous asthma exacerbations gained statistical significance as predictors of vaccination.

Sign in / Sign up

Export Citation Format

Share Document