tetano
Editor, Senior Moderator
nfluenza vaccination responses in human systemic lupus erythematosus: impact of clinical and demographic features
1. Sherry R. Crowe PhD1,
2. Joan T. Merrill MD1,
3. Evan S. Vista MD1,
4. Amy B. Dedeke MD1,
5. David M. Thompson PhD2,
6. Scott Stewart MS1,
7. Joel M. Guthridge PhD1,
8. Timothy B. Niewold MD3,
9. Beverly S. Franek BS3,
10. Gillian M. Air PhD2,
11. Linda F. Thompson PhD1,2,
12. Judith A. James MD, PhD1,2,*,?
DOI: 10.1002/art.30388
Copyright ? 2011 by the American College of Rheumatology
Issue
Cover image for Vol. 63 Issue 5
Arthritis & Rheumatism
Accepted Article (Accepted, unedited articles published online for future issues)
Additional Information
Author Information
1. 1
Oklahoma Medical Research Foundation, 825 NE 13th Street, Oklahoma City, OK 73104
2. 2
University of Oklahoma Health Sciences Center, 1100 N. Lindsay, Oklahoma City, OK 73104
3. 3
Gwen Knapp Center for Lupus and Immunology Research, University of Chicago, 5841 S Maryland Avenue, Chicago, IL 60637
Email: Judith A. James MD, PhD (jamesj@omrf.org)
*Correspondence: Judith A. James MD, PhD, Arthritis and Clinical Immunology Program, 825 NE 13th Street, Oklahoma City, OK 73104
1. ?
Ph: (405) 271- 4987; Fax: (405) 271-7063
Publication History
1. Accepted manuscript online: 19 MAY 2011 10:47AM EST
2. Manuscript Accepted: 31 MAR 2011
3. Manuscript Revised: 14 JAN 2011
4. Manuscript Received: 12 APR 2010
Funded by
* National Institutes of Health. Grant Numbers: HHSN266200500026C, AR058554, RR015577, AI082714, AR053483
* Kirkland Foundation Scholar
* Lou C. Kerr Chair in Biomedical Research
Abstract
Objective:
Vaccination against common pathogens, such as influenza, is recommended for SLE patients to decrease infections and improve health. However, most vaccination response reports are limited to evaluation of SLE patients with quiescent disease. This study focuses on understanding the clinical, serological, therapeutic, and demographic factors which influence the response to influenza vaccination in patients with a range of disease activities.
Methods:
Blood specimens and disease activity information were collected from seventy-two SLE patients at baseline and 2, 6 and 12 weeks after influenza vaccination. Influenza-specific antibody responses were assessed for antibody concentration (Bmax), relative affinity (Ka), and hemagglutination inhibition (HAI). Using a cumulative score, the subjects were evenly divided into high and low responders. Autoantibody levels were evaluated at each time-point by immunofluorescence and standard ELISAs.
Results:
Low responders to the vaccine were more likely to have hematologic criteria (p=0.009), exhibit more ACR criteria (p=0.05), and be on concurrent prednisone treatment (p=0.04). Interestingly, European American patients were more likely to be low responders than African Americans (p = 0.03). Following vaccination, low responders were more likely to experience disease flares (p=0.01) and to have increased ANA titers (p = 0.04). Baseline serum interferon alpha activity was significantly higher in patients that experienced a flare after vaccination compared to a matched group of patients that did not flare (p= 0.04).
Conclusions:
Ancestral background, prednisone treatment, hematological criteria and evidence of increased disease flares were associated with low antibody responses to influenza vaccination in SLE patients.
http://onlinelibrary.wiley.com/doi/10.1002/art.30388/abstract
1. Sherry R. Crowe PhD1,
2. Joan T. Merrill MD1,
3. Evan S. Vista MD1,
4. Amy B. Dedeke MD1,
5. David M. Thompson PhD2,
6. Scott Stewart MS1,
7. Joel M. Guthridge PhD1,
8. Timothy B. Niewold MD3,
9. Beverly S. Franek BS3,
10. Gillian M. Air PhD2,
11. Linda F. Thompson PhD1,2,
12. Judith A. James MD, PhD1,2,*,?
DOI: 10.1002/art.30388
Copyright ? 2011 by the American College of Rheumatology
Issue
Cover image for Vol. 63 Issue 5
Arthritis & Rheumatism
Accepted Article (Accepted, unedited articles published online for future issues)
Additional Information
Author Information
1. 1
Oklahoma Medical Research Foundation, 825 NE 13th Street, Oklahoma City, OK 73104
2. 2
University of Oklahoma Health Sciences Center, 1100 N. Lindsay, Oklahoma City, OK 73104
3. 3
Gwen Knapp Center for Lupus and Immunology Research, University of Chicago, 5841 S Maryland Avenue, Chicago, IL 60637
Email: Judith A. James MD, PhD (jamesj@omrf.org)
*Correspondence: Judith A. James MD, PhD, Arthritis and Clinical Immunology Program, 825 NE 13th Street, Oklahoma City, OK 73104
1. ?
Ph: (405) 271- 4987; Fax: (405) 271-7063
Publication History
1. Accepted manuscript online: 19 MAY 2011 10:47AM EST
2. Manuscript Accepted: 31 MAR 2011
3. Manuscript Revised: 14 JAN 2011
4. Manuscript Received: 12 APR 2010
Funded by
* National Institutes of Health. Grant Numbers: HHSN266200500026C, AR058554, RR015577, AI082714, AR053483
* Kirkland Foundation Scholar
* Lou C. Kerr Chair in Biomedical Research
Abstract
Objective:
Vaccination against common pathogens, such as influenza, is recommended for SLE patients to decrease infections and improve health. However, most vaccination response reports are limited to evaluation of SLE patients with quiescent disease. This study focuses on understanding the clinical, serological, therapeutic, and demographic factors which influence the response to influenza vaccination in patients with a range of disease activities.
Methods:
Blood specimens and disease activity information were collected from seventy-two SLE patients at baseline and 2, 6 and 12 weeks after influenza vaccination. Influenza-specific antibody responses were assessed for antibody concentration (Bmax), relative affinity (Ka), and hemagglutination inhibition (HAI). Using a cumulative score, the subjects were evenly divided into high and low responders. Autoantibody levels were evaluated at each time-point by immunofluorescence and standard ELISAs.
Results:
Low responders to the vaccine were more likely to have hematologic criteria (p=0.009), exhibit more ACR criteria (p=0.05), and be on concurrent prednisone treatment (p=0.04). Interestingly, European American patients were more likely to be low responders than African Americans (p = 0.03). Following vaccination, low responders were more likely to experience disease flares (p=0.01) and to have increased ANA titers (p = 0.04). Baseline serum interferon alpha activity was significantly higher in patients that experienced a flare after vaccination compared to a matched group of patients that did not flare (p= 0.04).
Conclusions:
Ancestral background, prednisone treatment, hematological criteria and evidence of increased disease flares were associated with low antibody responses to influenza vaccination in SLE patients.
http://onlinelibrary.wiley.com/doi/10.1002/art.30388/abstract