Effective humoral immunity against diphtheria and tetanus in patients with systemic lupus erythematosus or myasthenia gravis

Csuka, Dorottya; Czirják, László; Hóbor, Renáta; Illés, Zsolt; Bánáti, Miklós; Rajczy, Katalin; Tordai, Attila; Füst, George

doi:10.1016/j.molimm.2013.01.012

Cited by 20 publications

(10 citation statements)

References 10 publications

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“…A previous prospective study investigating the humoral immune response to tetanus revaccination in patients with MG or Lambert-Eaton myasthenic syndrome showed that IST slightly reduced pre-and post-tetanus antibody titers, but a significant humoral response could still be evoked with a median 6-fold increase factor of the tetanus antibody titer (69). These findings corroborated those from a prior study which found no significant differences in antibody responses and immune protection against diphtheria and tetanus in patients with systemic lupus erythematosus (SLE), and MG, relative to healthy subjects (66). Another study evaluating the efficacy and safety of influenza vaccines in MG patients in 2019 reported that a post-vaccination seroprotective titer for three strains of seasonal influenza vaccine was reached in 40.4% and 51% of AChR MG subjects and healthy controls, respectively (70).…”

Section: The Efficacy Of Vaccination In Mgsupporting

confidence: 86%

“…Age of vaccination is another factor that affects vaccine efficacy (87). For example, previous studies have shown that it is somewhat difficult to induce strong immune responses in the first year of life or in older periods, particularly among individuals older than 75 years (66,68). Previous evidence has also indicated that growing older compromises protection after vaccination (66,68).…”

Section: The Efficacy Of Vaccination In Mgmentioning

confidence: 99%

“…For example, previous studies have shown that it is somewhat difficult to induce strong immune responses in the first year of life or in older periods, particularly among individuals older than 75 years (66,68). Previous evidence has also indicated that growing older compromises protection after vaccination (66,68). Moreover, vaccine doses and administrative schedules also impact protection, since immunocompromised patients often require larger doses or frequent administration (77).…”

Section: The Efficacy Of Vaccination In Mgmentioning

confidence: 99%

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To Be or Not To Be Vaccinated: That Is a Question in Myasthenia Gravis

Zhou

Yang

et al. 2021

Front. Immunol.

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Myasthenia gravis (MG) is an autoimmune disease characterized by muscle weakness and abnormal fatigability due to the antibodies against postsynaptic receptors. Despite the individual discrepancy, patients with MG share common muscle weakness, autoimmune dysfunction, and immunosuppressive treatment, which predispose them to infections that can trigger or exacerbate MG. Vaccination, as a mainstay of prophylaxis, is a major management strategy. However, the past years have seen growth in vaccine hesitancy, owing to safety and efficacy concerns. Ironically, vaccines, serving as an essential and effective means of defense, may induce similar immune cross-reactivity to what they are meant to prevent. Herein, we outline the progress in vaccination, review the current status, and postulate the clinical association among MG, vaccination, and immunosuppression. We also address safety and efficacy concerns of vaccination in MG, in relation to COVID-19. Since only a handful of studies have reported vaccination in individuals with MG, we further review the current clinical studies and guidelines in rheumatic diseases. Overall, our reviews offer a reference to guide future vaccine clinical decision-making and improve the management of MG patients.

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Section: The Efficacy Of Vaccination In Mgsupporting

confidence: 86%

Section: The Efficacy Of Vaccination In Mgmentioning

confidence: 99%

Section: The Efficacy Of Vaccination In Mgmentioning

confidence: 99%

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To Be or Not To Be Vaccinated: That Is a Question in Myasthenia Gravis

Zhou

Yang

et al. 2021

Front. Immunol.

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“…120 The humoral immune response to diphtheria and tetanus vaccinations was comparable with healthy controls in a retrospective investigation. 121 Influenza vaccination has proven to be safe in retrospective studies, and the only randomized clinical trial of the Influenza vaccine in MG patients also approved its safety. 122 Furthermore, it has been found that the risk of aggravating MG after an influenza-like illness was more than the risk associated with influenza vaccination, supporting routine influenza vaccination in MG patients.…”

Section: Vaccinationmentioning

confidence: 99%

Iranian Consensus Recommendations for Treatment of Myasthenia Gravis

et al. 2022

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Myasthenia gravis (MG) is an immune-mediated potentially treatable disease in which rapid diagnosis and proper treatment can control symptoms. Treatment should be individualized in each patient according to distribution (ocular or generalized) and severity of the weakness, antibody status, thymus pathology, patient comorbidities, and preferences. A group of Iranian neuromuscular specialists have written these recommendations to treat MG based on national conditions. Four of the authors performed an extensive literature review, including PubMed, EMBASE, and Google Scholar, from 1932 to 2020 before the central meeting to define headings and subheadings. The experts held a 2-day session where the primary drafts were discussed point by point. Primary algorithms for the management of MG patients were prepared in the panel discussion. After the panel, the discussions continued in virtual group discussions, and the prepared guideline was finalized after agreement and concordance between the panel members. Finally, a total of 71 expert recommendations were included. We attempted to develop a guideline based on Iran’s local requirements. We hope that these guidelines help healthcare professionals in proper treatment and follow-up of patients with MG.

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“…In 2013 Csuka et al reported, in a study of 279 predominantly female patients that serum concentrations of diphtheria antitoxoid IgG and tetanus antitoxoid IgG were comparable between healthy control subjects and SLE patients [58]. In a case series by Battafarano et al, around 90% of SLE patients (65 of 72) immunized with tetanus toxoid achieved a protective antibody response [13], which is very similar to the response rate among the general population [58]. EULAR recommends that SLE patients receive the tetanus toxoid vaccine per the same guidelines as the general population.…”

Section: Diphtheria Pertussis and Tetanusmentioning

confidence: 99%

Recommendations and barriers to vaccination in systemic lupus erythematosus

Garg

Mufti

Palmore

2018

Autoimmunity Reviews

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Patients with Systemic Lupus Erythematosus (SLE) pose a unique dilemma pertaining to immunization against common pathogens. SLE patients are usually not immunized with vaccines based on the fear of either precipitating infection in this immunosuppressed patient population (with live vaccines) or aggravating autoimmunity and hence lupus flares (with any vaccines). However, elevated vulnerability to infection makes patients with SLE precisely the population that needs protection from vaccine-preventable diseases. A summary of guidelines from the Centers for Disease Control and Prevention, professional societies, review articles and expert opinions regarding use of individual vaccines applicable to adults with SLE is presented in this review.

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Effective humoral immunity against diphtheria and tetanus in patients with systemic lupus erythematosus or myasthenia gravis

Cited by 20 publications

References 10 publications

To Be or Not To Be Vaccinated: That Is a Question in Myasthenia Gravis

To Be or Not To Be Vaccinated: That Is a Question in Myasthenia Gravis

Iranian Consensus Recommendations for Treatment of Myasthenia Gravis

Recommendations and barriers to vaccination in systemic lupus erythematosus

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