tetano
Editor, Senior Moderator
Clin Exp Immunol. 2014 Jun 2. doi: 10.1111/cei.12390. [Epub ahead of print]
Rituximab impairs IgM and IgG (subclass) responses after influenza vaccination in rheumatoid arthritis patients.
Westra J1, van Assen S, Wilting KR, Land J, Horst G, de Haan A, Bijl M.
Author information
Abstract
OBJECTIVE:
Rituximab (RTX) treatment in rheumatoid arthritis (RA) patients severely hampers humoral response after influenza vaccination as determined by Haemagglutination Inhibition Assay (HI). It is not known whether HI reflects both IgM and IgG (subclass) influenza response, and whether IgM antibodies contribute to the low rate of influenza infection seen in RA patients.
METHODS:
20 RA patients on methotrexate (MTX), 23 on RTX and 28 healthy controls (HC) received trivalent influenza subunit vaccination. Before, and 28 day after vaccination H1N1 and H3N2 specific antibodies were measured by HI and by IgM and IgG (subclass) ELISA. BAFF (B cell activating factor) levels were determined in serum samples before vaccination.
RESULTS:
Vaccination induced a significant increase of IgM and IgG (IgG1 and IgG3) antibodies against both strains in the HC and MTX group (all P < 0.01) but not in the RTX group. HI significantly correlated in all cases with IgG (IgG1) but not with IgM. In RTX late patients (RTX treatment 6-10 months before vaccination) IgG (IgG1 and IgG3) response to vaccination was restored, but not IgM response. BAFF levels were significantly increased in RA-RTX patients and correlated to total IgG levels.
CONCLUSION:
Haemagglutination inhibition assay, used as gold standard, detects primarily IgG (IgG1) responses. IgM and IgG influenza specific antibodies increase after vaccination in HC and RA patients except in patients on RTX treatment. BAFF levels are increased in both early and late RTX treated patients, but do not correlate to influenza specific antibody response.
This article is protected by copyright. All rights reserved.
KEYWORDS:
BAFF; IgG antibodies; IgM antibodies; Rheumatoid arthritis; influenza; rituximab
PMID:
24889761
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/24889761
Rituximab impairs IgM and IgG (subclass) responses after influenza vaccination in rheumatoid arthritis patients.
Westra J1, van Assen S, Wilting KR, Land J, Horst G, de Haan A, Bijl M.
Author information
Abstract
OBJECTIVE:
Rituximab (RTX) treatment in rheumatoid arthritis (RA) patients severely hampers humoral response after influenza vaccination as determined by Haemagglutination Inhibition Assay (HI). It is not known whether HI reflects both IgM and IgG (subclass) influenza response, and whether IgM antibodies contribute to the low rate of influenza infection seen in RA patients.
METHODS:
20 RA patients on methotrexate (MTX), 23 on RTX and 28 healthy controls (HC) received trivalent influenza subunit vaccination. Before, and 28 day after vaccination H1N1 and H3N2 specific antibodies were measured by HI and by IgM and IgG (subclass) ELISA. BAFF (B cell activating factor) levels were determined in serum samples before vaccination.
RESULTS:
Vaccination induced a significant increase of IgM and IgG (IgG1 and IgG3) antibodies against both strains in the HC and MTX group (all P < 0.01) but not in the RTX group. HI significantly correlated in all cases with IgG (IgG1) but not with IgM. In RTX late patients (RTX treatment 6-10 months before vaccination) IgG (IgG1 and IgG3) response to vaccination was restored, but not IgM response. BAFF levels were significantly increased in RA-RTX patients and correlated to total IgG levels.
CONCLUSION:
Haemagglutination inhibition assay, used as gold standard, detects primarily IgG (IgG1) responses. IgM and IgG influenza specific antibodies increase after vaccination in HC and RA patients except in patients on RTX treatment. BAFF levels are increased in both early and late RTX treated patients, but do not correlate to influenza specific antibody response.
This article is protected by copyright. All rights reserved.
KEYWORDS:
BAFF; IgG antibodies; IgM antibodies; Rheumatoid arthritis; influenza; rituximab
PMID:
24889761
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/24889761