Antibody and cell-mediated immune response to whole virion and split virion influenza vaccine in patients with inflammatory bowel disease on maintenance immunosuppressive and biological therapy

作者：Balint Anita; Farkas Klaudia; Eva Pallagi Kunstar; Terhes Gabriella; Urban Edit; Szucs Monika; Nyari Tibor; Bata Zsuzsanna; Nagy Ferenc; Szepes Zoltan; Miheller Pal; Lorinczy Katalin; Lakatos Peter Laszlo; Lovasz Barbara; Szamosi Tamas; Kulcsar Andrea; Berenyi Anna; Toerocsik Dalma; Daroczi Timea; Sarodi Zoltan; Wittmann Tibor; Molnar Tamas^*

来源：Scandinavian Journal of Gastroenterology, 2015, 50(2): 174-181.

DOI：10.3109/00365521.2014.928902

• anti-TNF therapy
• cellular immune response
• immunosuppression
• inflammatory bowel diseases
• influenza
• vaccination

Objective. Influenza vaccination is recommended for inflammatory bowel disease (IBD) patients on immunosuppressive therapy. The objective was to evaluate the antibody and cell-mediated immune response to the split and whole virion influenza vaccine in patients with IBD treated with anti-TNF-alpha and immunosuppressive therapy. Patients and methods. One hundred and fifty-six immunocompromised IBD patients were vaccinated. Fifty-three patients (control group) refused vaccination. Split virion vaccine and whole virion vaccine were used. Serum samples were obtained for pre- and postimmunization antibody titers to influenza vaccine (A/California/7/2009 [H1N1], A/Victoria/361/2011 [H3N2], B/Wisconsin/1/2010-like B/Hubei-Wujiagang/158/2009). Cell-mediated response was evaluated using an interferon (INF)-gamma, interleukine (IL)-2 and tumor necrosis factor (TNF)-alpha ELISA. Results. Postimmunization titers of both influenza subtypes increased significantly after the administration of split virion vaccines compared to the controls and to those who received whole virion vaccine. The antibody titers of Influenza B also increased significantly in patients immunized with split vaccine and treated with anti-TNF-alpha therapy. After influenza vaccination, the level of serum IL-2 significantly decreased. No serious side effects developed occurred after influenza vaccination, and the influenza-like symptoms did not differ significantly between vaccinated versus control patients. The relapse of the disease was observed in only 10% of the patients and was more common in vaccinated than in control subjects. Conclusion. Split virion vaccines seem to be more effective than whole virion vaccines. Measuring the antibody responses is worthwhile in patients treated with immunosuppressants to determine the efficacy of influenza vaccination.

• 出版日期2015-2