Influence of Thymopentin on Antibody Response, and Monocyte and T Cell Function in Hemodialysis Patients Who Fail to Respond to Hepatitis B Vaccination

Dumann, Hubert; Meuer, Stefan; Renschin, Günter; Köhler, Hans

doi:10.1159/000185941

Cited by 17 publications

(8 citation statements)

References 14 publications

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“…Lately, there have been signals [16] that the recombining DNA vaccine is more effective in comparison with the plasma compound vaccine. As far as we know, the anti-FI BV vaccination with plasma compound vaccine, associ ated with thymopentine, does not give results worth con sidering, in accordance with others [13,14], on the other hand, we think that the treatment made up of anti-HBV vaccine and recombining DNA plus thymopentine deser ves further studies.…”

Section: Resultssupporting

confidence: 83%

“…Unfortunately, statistics show that the number of nonresponders among the patients who are on hemodialysis is very high, most probably owing to the immunological deficiency caused by uremia [I I]. I n order to overcome this situation, vaccination against HBV, includ ing immunostimulating drugs, has been proposed [6,8,14,15], The primary objective of the study was to compare some of these treatments, including an immunostimulator, such as thymopentine, with a control group treated without immunostimulators [7,9, 10, 12,14,17],…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Treatments for the Vaccination against Hepatitis B+Thymopentine

Ervo¹,

Faletti²,

Magni³

et al. 1992

Nephron

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We have studied a series of 43 patients – who were suffering from uremia, subject to hemodialysis treatment, resulting seronegative to the test for HBV and who had never been vaccinated before – considering the HBS antibody as seroconversion index. We subdivided our patients into three groups, according to the treatment employed. First group: French vaccine; 2nd group: French vaccine + thymopenthine; 3rd group: recombining DNA vaccine + thymopentine. From a statistical point of view, in the 3rd group we obtained a significant seroconversion in terms of patients, if compared with the other groups.

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Section: Resultssupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Evaluation of Treatments for the Vaccination against Hepatitis B+Thymopentine

Ervo¹,

Faletti²,

Magni³

et al. 1992

Nephron

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“…Grob et al [17,18] used interferon and thymopeptin as an adjuvant for hepa titis B vaccination in non-and low-responder popula tions. Influence of thymopentin on antibody response, monocyte and T-cell function in HD patients who fail to respond to hepatitis B vaccination was also looked into by Dumann et al [19] while Scnnedel et al [20] found that treatment with recombinant human erythropoietin in creases antibody titers after hepatitis B vaccination in dialysis patients. The route of administration is again important.…”

Section: Discussionmentioning

confidence: 99%

Responsiveness to Hepatitis B Vaccine in Immunocompromised Patients by Doubling the Dose Scheduling

1996

Nephron

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The protective efficacy of three schedules of a recombinant hepatitis B vaccine was evaluated in 42 patients undergoing dialysis at a teaching hospital. The rate of seroconversion after vaccination was highest (82.3%) among the recipients of three 20-μg doses (i.e. double the conventional dose for healthy adult) at 0, 1 and 2 months (group II). The response was satisfactory (80%) among the recipients of three 20-μg doses at 0, 1 and 6 months (group III) but was lowest with the single dose schedule of three 10-μg doses at 0, 1 and 2 months (group I). Seroconverters from all the three groups received a booster dose (each equal to his scheduled dose) at 12 months. Those who did not seroconvert from groups I and II were shifted to group III. The rate of seroconversion was higher in female (88.9%) than in male patients (66.7%) and in younger patients less than 30 years (83.3%) than in elderly patients more than 50 years. Patients undergoing peritoneal dialysis also responded much better (93.3%) than the hemodialysis patients (66.7%). In conclusion, a schedule of double the conventional dose of the vaccination for healthy adults at 0, 1, 2, and 12 months seems to give a better seroconversion and higher response to the HB vaccine, but a further large-scale study is needed to confirm this finding and also to look into the difference in response between male and female, younger and older patients and the difference in response between HD and PD patients.

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“…The uraemic environment causes defective macrophage functioning (Briggs et al 1983;Dumann et al 1990b;Jonston 1988;Meuer & Meyer zum Buschenfelde 1986). The uraemic environment causes defective macrophage functioning (Briggs et al 1983;Dumann et al 1990b;Jonston 1988;Meuer & Meyer zum Buschenfelde 1986).…”

Section: Humoral Immunitymentioning

confidence: 99%

The Use of Vaccines in Renal Failure

Johnson

Fleming

1992

Clinical Pharmacokinetics

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Renal insufficiency is characterised by impaired host defences, which are compromised further by each of the 3 modes of renal replacement--haemodialysis, continuous ambulatory peritoneal dialysis (CAPD) and renal transplantation. Reduced renal clearance of unknown toxins, possible development of nutritional deficiencies and administration of immunosuppressive medications lead to aberrant immune regulation early in the course of renal failure. This results subsequently in increased frequency and severity of infection. Vaccination plays an important role in attenuating this infection risk, but impaired cell-mediated and humoral immunity contraindicates the use of live vaccines and engenders suboptimal and short-lived antibody responses to inactivated vaccines. Reinforced vaccination schedules, increased vaccine dosage and concomitantly administered adjuvant immunomodulators have variably improved the defective antibody responses to certain vaccines. Immunisation against hepatitis B virus has resulted in a significant decrease in prevalence and incidence of this infection in haemodialysis units. Similarly, the inoculation of influenza vaccine in patients with uraemia and of polyvalent pneumococcal vaccine in special risk circumstances has been recommended because of perceived reductions in morbidity and mortality from infection with these agents. Cytomegalovirus (CMV) vaccine may attenuate CMV disease severity in recipients of renal allografts. Staphylococcus aureus vaccine, on the other hand, is ineffective in preventing peritonitis or exit site infections in patients receiving CAPD. Other killed vaccines have not been comprehensively studied, but generally have the same indications for use as in normal individuals. However, the protection that these vaccines afford may be either inadequate or transient, so that other infection control strategies should be simultaneously implemented.

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Influence of Thymopentin on Antibody Response, and Monocyte and T Cell Function in Hemodialysis Patients Who Fail to Respond to Hepatitis B Vaccination

Cited by 17 publications

References 14 publications

Evaluation of Treatments for the Vaccination against Hepatitis B+Thymopentine

Evaluation of Treatments for the Vaccination against Hepatitis B+Thymopentine

Responsiveness to Hepatitis B Vaccine in Immunocompromised Patients by Doubling the Dose Scheduling

The Use of Vaccines in Renal Failure

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