Peripheral blood dendritic cells and GM-CSF as an adjuvantfor hepatitis B vaccination in hemodialysis patients

Verkade, Martijn A.; Wetering, Jacqueline van de; Klepper, Mariska; Vaessen, L. M. B.; Weimar, Willem; Betjes, Michiel G. H.

doi:10.1111/j.1523-1755.2004.00781.x

Cited by 70 publications

(61 citation statements)

References 30 publications

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“…The prematurely aged T cell system of ESRD patients is associated with a reduced vaccination response (11)(12)(13)(14) and an increased susceptibility to infection (15). The latter is a major cause of mortality in ESRD patients, in addition to cardiovascular disease (15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Uremia-Associated Premature Aging of T Cells Does Not Predict Infectious Complications After Renal Transplantation

Dedeoğlu

Meijers

Klepper

et al. 2016

American Journal of Transplantation

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Patients with end-stage renal disease have prematurely aged T cell systems. We tested whether T cell aging parameters were associated with the risk of infections after renal transplantation (RTx). We studied 188 patients over 1 year. Peripheral T cells were analyzed before and at 3 and 6 mo after RTx for frequency of recent thymic emigrants, relative telomere length and differentiation status. These parameters were related to the occurrence of opportunistic and serious infections. Overall, 84 patients developed an infection. In this group, 50 developed an opportunistic infection and 53 developed a serious infection. T cell aging parameters assessed before RTx were not associated with infection risk. The memory T cells showed a decrease within the first 3 mo in both groups (p < 0.001). The CD4 + memory T cells increased between 3 and 6 mo within the infection group (p = 0.015). The number of CD8 + memory T cells increased in both groups (p < 0.001) but reached baseline levels only in the infection group. In the infection group, the CD8 + CD28null T cell percentage increased between 3 and 6 mo (p = 0.024), tending to be higher than at baseline (p = 0.061). These differences in post-RTx dynamics resulted from infections. Parameters of uremia-associated premature aging of peripheral T cells do not predict posttransplant infections.

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Section: Introductionmentioning

confidence: 99%

Uremia-Associated Premature Aging of T Cells Does Not Predict Infectious Complications After Renal Transplantation

Dedeoğlu

Meijers

Klepper

et al. 2016

American Journal of Transplantation

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“…An aged T cell system is associated with an impaired immune response and contributes to a decreased vaccination response, greater susceptibility to infections and virus-associated cancers (9)(10)(11)(12)(13). CD4 þ CD28null T cells are highly cytotoxic and associated with an increased risk of atherosclerotic event (14,15), while the presence of highly differentiated CD8 þ T cells impairs renal graft function on the long term (16).…”

Section: Introductionmentioning

confidence: 99%

Primary Cytomegalovirus Infection Significantly Impacts Circulating T Cells in Kidney Transplant Recipients

Meijers

Litjens

Hesselink

et al. 2015

American Journal of Transplantation

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Cytomegalovirus (CMV) infection profoundly affects the T cell compartment and is associated with alterations in T cell aging parameters and generation of cytotoxic CD4þ CD28null T cells. Hence, the effect of a primary CMV infection post-kidney transplantation (KT) on the peripheral T cell compartment was examined. As aging parameters, we determined the T cell differentiation status, T cell receptor excision circle (TREC) content, CD31þ na€ ıve T cell numbers and relative telomere length (RTL) pre-KT and 12 months post-KT. CMV-seronegative KT recipients, receiving a kidney from a CMV-seropositive donor (Dþ/RÀ) were compared to Dþ/Rþ KT recipients. Eleven out of the 22 Dþ/RÀ KT recipients had CMV viremia post-KT. They developed CMV-specific CD4 þ and CD8 þ T cells and their T cell compartment shifted towards a more differentiated memory phenotype with expansion of CD4 þ CD28null and CD8 þ CD28null cells. One year post-KT, the CD8 þ T cell count was almost doubled compared to nonviremic Dþ/RÀ and Dþ/Rþ KT recipients. In addition, the RTL of the CD8 þ T cell was significantly lower and both the TREC content and CD31 þ na€ ıve T cell numbers significantly decreased. Moreover, primary CMV infection was associated with a negative impact on glomerular filtration rate. In conclusion, primary CMV infection has a substantial impact on the number and phenotype of peripheral T cells and may negatively affect renal allograft function.

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“…The dermal dendritic cell in the skin was speculated as one of the most potent antigen-presenting cell leading to primary immune response. [10] However, in a recent study, there was no difference between those two routes of administration. [11] In this study, after two 40 μg intramuscular (IM) vaccination protocols (0, 1, 2, and 6 months), patients who were unresponsive to hepatitis B vaccination were collected from three HD centers.…”

Section: Introductionmentioning

confidence: 90%

“…[1,10,12,13] However, cost-effectiveness has been another problem that needed to be addressed. Vaccination for hepatitis B at early stages of chronic kidney disease was found to reach seroprotective ranges more successfully in a previous study.…”

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confidence: 99%

Low Dose Intradermal Vaccination Is Superior to High Dose Intramuscular Vaccination for Hepatitis B in Unresponsive Hemodialysis Patients

et al. 2007

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After two intramuscular (IM) vaccination protocols (40 μg at 0, 1, 2, and 6 months), patients who were unresponsive to hepatitis B vaccination were collected from three HD centers. The aim of this study was to compare the effectiveness of intradermal (ID) and repeated IM vaccination protocols. Thirty-three of 639 HD patients were found to be unresponsive. Patients were randomly assigned into two groups: one to receive 80 μg ID and the other 160 μg IM vaccination protocol. Both ID (p=0.000) and IM (p=0.03) groups disclosed statistically significant seroconversion rates six months after the last vaccination dose. The seroconversion rate was 94.1% in the ID and 50% in the IM groups-showing a significant improvement in the ID group (p=0.011). A low-dose ID is superior to standard IM vaccination protocol and also more cost-effective in unresponsive HD patients.

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Peripheral blood dendritic cells and GM-CSF as an adjuvantfor hepatitis B vaccination in hemodialysis patients

Abstract: GM-CSF is an effective adjuvant for hepatitis B vaccination in primary nonresponding hemodialysis patients, but paradoxically decreases the antigen presenting capacity of peripheral blood mononuclear cells and the number of circulating dendritic cells.

Cited by 70 publications

References 30 publications

Uremia-Associated Premature Aging of T Cells Does Not Predict Infectious Complications After Renal Transplantation

Uremia-Associated Premature Aging of T Cells Does Not Predict Infectious Complications After Renal Transplantation

Primary Cytomegalovirus Infection Significantly Impacts Circulating T Cells in Kidney Transplant Recipients

Low Dose Intradermal Vaccination Is Superior to High Dose Intramuscular Vaccination for Hepatitis B in Unresponsive Hemodialysis Patients

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