Defective antigen presentation by monocytes in ESRD patients not responding to hepatitis B vaccination: impaired HBsAg internalization and expression of ICAM‐1 and HLA‐DR/Ia molecules

Abstract

This study was undertaken to evaluate the monocyte function of uraemic non-responders to hepatitis B vaccination. Therefore, some parameters concerning antigen processing by monocytes (Mo) as antigen presenting cells (APC) were analysed. It was found that in uraemic non-responders, (1) the internalization of HBsAg by monocytes was significantly decreasjed—HBsAg complexed with specific IgG or as immune complex isolated from patients is better internalized compared with free HBsAg; (2) during antigen presentation the expression of adhesion (ICAM-1) and accessory (HLA-DR/Ia) molecules was significantly decreased in uraemic patients, especially in non-responders; and (3) impaired internalization of HBsAg as well as a decrease in ICAM-1 and HLA-DR/Ia expression, correlated well with the blunted proliferation of CD4+ T cells stimulated by autologous monocytes induced by HBsAg.

Response to Hepatitis A and B Vaccination in Pediatric Patients With Celiac Disease

“…Approximately 4% to 10% of healthy individuals do not develop an adequate immune response against the hepatitis B vaccine after the primary vaccination series (18,19), and as reported in previous studies, nonresponsiveness was higher in patients with certain chronic illnesses such as chronic liver disease, uremia, inflammatory bowel disease, and CD (8–14,20–23).…”