A prospective study of in vitro anti‐HBs producing B cells (spot‐ELISA) following primary and supplementary vaccination with a recombinant hepatitis B vaccine in insulin dependent diabetic patients and matched controls

Abstract

A prospective study of the immune response after hepatitis B vaccination was carried out in 32 insulin dependent diabetes mellitus (IDDM) patients and their age and sex matched healthy controls. A sensitive, immunoenzymatic technique was used, able to detect in vitro specific antibody production by mitogen stimulated individual B cells. In-vivo serologic response after vaccination with a standard scheme (0, 1 and 6 months) of 20 micrograms recombinant hepatitis B (HB) vaccine was significantly impaired in the IDDM patients both with respect to the number of nonresponders (25 versus 3%, P less than 0.05) and antibody titers reached (1,377 vs. 9,060 IU/L, P less than 0.05). The total number of in vitro IgM- and IgG-class immunoglobulin producing B cells as detected by the spot-ELISA, was found to be comparable in both groups. Specific IgG anti-HBs (and to a lesser extent IgM anti-HBs) showed impairment in the diabetic population as a whole. The number of IgG anti-HBs producing B cells was markedly depressed one month following vaccination, which is probably a reflection of homing of B cells outside the circulation. Responding subjects were identified early during their vaccination by the detection of in vitro anti-HBs production using the spot-ELISA. Non-responding healthy subjects and IDDM patients as a group showed a low number of IgG anti-HBs spots, suggesting a reduced specific memory B cell frequency. In 13 of 15 hypo- and nonresponders with positive IgG anti-HBs spots supplementary vaccination(s) resulted in improved anti-HBs levels.

Long term persistence of T cell memory to HBsAg after hepatitis B vaccination

“…We observed positive lymphocyte proliferative responses in 7 of the 12 subjects, although the maximal proliferation was lower than that in vaccine recipients with positive serum antiHBs. We previously reported that an immunological B cell memory to hepatitis B after a vaccination existed in healthcare personnel though serum anti-HBs titers were decreased with time or not measurable in some cases [32] . The long term efficacy of hepatitis B vaccination was also investigated in China and it was found that the protective efficacy of hepatitis B vaccination was still existed with a low risk of becoming a carrier and a low serum level of neutralizing antibody even at the time of 12 years after vaccination [9] .…”

Hepatitis B and C seroprevalence in patients with diabetes mellitus and its relationship with microvascular complications

“…Mucormycosis, malignant external otitis, emphysematous pyelonephritis and emphysematous cholecystitis diseases are known to be strongly associated with diabetes [11]. On the other hand, in the studies on hepatitis immunology in patients with DM, it was found that diabetic patients generated a significantly lower antibody response compared to healthy subjects [14–16]. While the frequency of HCV infection worldwide is around 3%, the frequency of HBV infection varies between 0.1% and 20%.…”

Long-Term Humoral and Cellular Immune Response to Hepatitis B Vaccine in High-Risk Children 18–20 Years After Neonatal Immunization

“…Several studies have attempted to detect and validate HBsAg-specific T-and B-cell reactivity in vaccinees to show the presence of T-and B-cell memory (9,18,26,27). The results, however, were contradictory, probably due to the different detection systems used and the limited sensitivity of some of the methods applied.…”