tetano
Editor, Senior Moderator
J Infect Dis. 2019 Sep 24. pii: jiz471. doi: 10.1093/infdis/jiz471. [Epub ahead of print]
[h=1]Cell-Mediated Immune Responses after Influenza Vaccination of Solid Organ Transplant Recipients: a Secondary Outcomes Analysis of a Randomized Controlled Trial.[/h] L'Huillier AG[SUP]1[/SUP], Ferreira VH[SUP]1[/SUP], Hirzel C[SUP]1[/SUP], Natori Y[SUP]2[/SUP], Slomovic J[SUP]1[/SUP], Ku T[SUP]1[/SUP], Hoschler K[SUP]3[/SUP], Ierullo M[SUP]1[/SUP], Selzner N[SUP]1[/SUP], Schiff J[SUP]1[/SUP], Singer LG[SUP]1[/SUP], Humar A[SUP]1[/SUP], Kumar D[SUP]1[/SUP].
[h=3]Author information[/h] 1 Multi-Organ Transplant Program, University Health Network, Toronto, Canada. 2 Division of Infectious Disease, Department of Medicine, University of Miami Miller School of Medicine and Miami Transplant Institute, Miami, Florida, USA. 3 Public Health England, London, United Kingdom.
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Despite annual immunization, solid organ transplant (SOT) patients remain at increased risk for severe influenza infection because of suboptimal vaccine immunogenicity. We aimed to compare the CD4+ and CD8+ T-cell responses of the high-dose (HD) and the standard-dose (SD) trivalent inactivated vaccine.
[h=4]METHODS:[/h] We collected peripheral blood mononuclear cells pre- and post-immunization from 60 patients enrolled in a randomized trial of HD vs. SD vaccine (30 HD; 30 SD) during the 2016-2017 influenza season.
[h=4]RESULTS:[/h] The HD vaccine elicited significantly greater monofunctional and polyfunctional CD4+ and CD8+ T-cell responses against influenza A/H1N1, A/H3N2 and B. For example, median vaccine-elicited influenza-specific polyfunctional CD4+ T-cells were higher in recipients of the HD than SD vaccine after stimulation with influenza A/H1N1 (1193 vs 0 per 106 CD4+ T-cells [p=0.003]), A/H3N2 (1154 vs 51 [p=0.008]) and B (1102 vs 0 [p=0.001]). Similarly, vaccine-elicited influenza-specific polyfunctional CD8+ T-cells were higher in recipients of the HD than SD vaccine after stimulation with influenza B (367 vs 0 [p=0.002]).
[h=4]CONCLUSION:[/h] Our study provides novel evidence that HD vaccine elicits greater cellular responses compared to the SD vaccine in SOT recipients, which provides support to preferentially consider use of HD vaccination in the SOT setting.
? The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
[h=4]KEYWORDS:[/h] cell-mediated immunity; flow cytometry; immunogenicity; transplantation; vaccine
PMID: 31550354 DOI: 10.1093/infdis/jiz471
[h=1]Cell-Mediated Immune Responses after Influenza Vaccination of Solid Organ Transplant Recipients: a Secondary Outcomes Analysis of a Randomized Controlled Trial.[/h] L'Huillier AG[SUP]1[/SUP], Ferreira VH[SUP]1[/SUP], Hirzel C[SUP]1[/SUP], Natori Y[SUP]2[/SUP], Slomovic J[SUP]1[/SUP], Ku T[SUP]1[/SUP], Hoschler K[SUP]3[/SUP], Ierullo M[SUP]1[/SUP], Selzner N[SUP]1[/SUP], Schiff J[SUP]1[/SUP], Singer LG[SUP]1[/SUP], Humar A[SUP]1[/SUP], Kumar D[SUP]1[/SUP].
[h=3]Author information[/h] 1 Multi-Organ Transplant Program, University Health Network, Toronto, Canada. 2 Division of Infectious Disease, Department of Medicine, University of Miami Miller School of Medicine and Miami Transplant Institute, Miami, Florida, USA. 3 Public Health England, London, United Kingdom.
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Despite annual immunization, solid organ transplant (SOT) patients remain at increased risk for severe influenza infection because of suboptimal vaccine immunogenicity. We aimed to compare the CD4+ and CD8+ T-cell responses of the high-dose (HD) and the standard-dose (SD) trivalent inactivated vaccine.
[h=4]METHODS:[/h] We collected peripheral blood mononuclear cells pre- and post-immunization from 60 patients enrolled in a randomized trial of HD vs. SD vaccine (30 HD; 30 SD) during the 2016-2017 influenza season.
[h=4]RESULTS:[/h] The HD vaccine elicited significantly greater monofunctional and polyfunctional CD4+ and CD8+ T-cell responses against influenza A/H1N1, A/H3N2 and B. For example, median vaccine-elicited influenza-specific polyfunctional CD4+ T-cells were higher in recipients of the HD than SD vaccine after stimulation with influenza A/H1N1 (1193 vs 0 per 106 CD4+ T-cells [p=0.003]), A/H3N2 (1154 vs 51 [p=0.008]) and B (1102 vs 0 [p=0.001]). Similarly, vaccine-elicited influenza-specific polyfunctional CD8+ T-cells were higher in recipients of the HD than SD vaccine after stimulation with influenza B (367 vs 0 [p=0.002]).
[h=4]CONCLUSION:[/h] Our study provides novel evidence that HD vaccine elicits greater cellular responses compared to the SD vaccine in SOT recipients, which provides support to preferentially consider use of HD vaccination in the SOT setting.
? The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
[h=4]KEYWORDS:[/h] cell-mediated immunity; flow cytometry; immunogenicity; transplantation; vaccine
PMID: 31550354 DOI: 10.1093/infdis/jiz471