Abstract
A subgroup of patients with common variable immunodeficiencies (CVIDs) responds to vaccination. The aim of this study was to try to identify predictive markers for those with a humoral immune response after influenza vaccination. Forty-eight patients with CVID (29 female and 19 male patients; mean age, 57.7years) were vaccinated with the A(H1N1) influenza vaccine Pandemrix (GlaxoSmithKline, Wavre, Belgium) and boosted after 1month. Blood samples were collected before each vaccination and 2months later. Patients with a 4-fold titer increase in results on the hemagglutinin inhibition test (≥1:40) were considered responders and compared with nonresponders for clinical, immunologic, and genetic markers. Eight (16.7%) patients responded to the vaccination. Asignificantly higher proportion of the responders, who showed a EUROclass SmB-Trnorm21norm profile (P=.03) with a post-germinal center B-cell pattern (P=.04) in blood, experienced enteropathies (P=.04) compared with nonresponders. On the other hand, bronchiectasis was found exclusively among nonresponders (n=7), as was autoimmune cytopenia (n=5). Nonresponders with a EUROclass SmB-Trnorm21low profile (P=.02) had a significantly greater prevalence of progressive antibody deficiency (P=.048) and, at diagnosis, a higher mean serum IgM level (P=.03), lower mean serum IgG1 level (P=.007), expansion of absolute counts of cytotoxic CD8+ T cells (P=.033), and increased proportion of memory CD8+ T cells (P=.044) in blood. CVID-associated HLA markers were not detected in responders (P=.03). About one fifth of the patients with CVIDs achieved protective antibody levels after A(H1N1) vaccination and selected clinical, and immunologic markers were identified thatmight predict a positive outcome of influenza vaccination. Patients with CVID should be offered vaccination also against seasonal influenza because of the potential severity of the infection and risk for bacterial complications.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
