Recombinant interferon-α2b improves immune response to hepatitis B vaccination in haemodialysis patients: Results of a randomised clinical trial

Miquilena-Colina, María E.; Lozano-Rodríguez, Tamara; García-Pozo, Leonor; Saez, Alicia; Rizza, Paola; Capone, Imerio; Rapicetta, Maria; Chionne, Paola; Capobianchi, Maria Rosaria; Selleri, Marina; Castilletti, Concetta; Belardelli, Filippo; Iacono, Oreste Lo; García‐Monzón, Carmelo

doi:10.1016/j.vaccine.2009.07.014

Cited by 34 publications

(17 citation statements)

References 34 publications

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“…In a similar study, intramuscular injection of flu vaccine Vaxigrip ad-mixed with IFN-α markedly increased the serum levels of all four classes of flu-specific IgGs (IgG, IgG1, IgG2a, and IgA) in a dose-dependent manner in mice [323]. Coadministration of interferon-2b (Intron A) with hepatis B vaccine (Egerix B) by IM initiated earlier and higher seroprotection with improved Th1 response in haemodialysis patients [324]. Plasmid encoding IFN- can also be an effective adjuvant for protein antigens [325].…”

Section: Interferonsmentioning

confidence: 84%

Selection of Adjuvants for Enhanced Vaccine Potency

Wang¹,

Singh²

2011

WJV

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Section: Interferonsmentioning

confidence: 84%

Selection of Adjuvants for Enhanced Vaccine Potency

Wang¹,

Singh²

2011

WJV

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show abstract

“…The mechanisms underlying the impaired response to vaccination towards hepatitis B virus in dialysis patients are incompletely understood. Various approaches have been made to improve vaccination response‐ the intramuscular administration of multiple or double doses [25], the co‐administration of adjuvants (such as zinc supplements, HB‐AS04 [26] and HB‐AS02 [27]) or immune modulators such as (interferon [28], interleukin, thymopentin [29], granulocyte‐macrophage colony‐stimulating factor [30] and levamisole [31]). Also, it has been recommended to start vaccination in the early stages of chronic kidney disease [32].…”

Section: Discussionmentioning

confidence: 99%

Intradermal vs intramuscular vaccine against hepatitis B infection in dialysis patients: a meta-analysis of randomized trials

Fabrizi

Dixit

Martin

2010

Journal of Viral Hepatitis

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Chronic dialysis patients are at risk of contracting hepatitis B virus infection and have a diminished immune response to hepatitis B virus vaccine. Recent reports support intradermal administration of hepatitis B virus vaccine in patients on regular dialysis but the efficacy and safety of this approach remain unclear. We conducted a meta-analysis of randomized, controlled clinical trials to compare seroprotection achieved by intradermal vs intramuscular hepatitis B vaccine, in patients on maintenance dialysis. Meta-analysis of data from 718 adults (14 trials) on long-term dialysis demonstrated that intramuscular hepatitis B vaccination was less likely to achieve seroprotection than intradermal vaccination, the pooled odds ratio was 0.454 (95% CI, 0.3; 0.67), P = 0.001. The test of study heterogeneity was not significant. This difference did not persist during follow-up (6-60 months after completing vaccine schedule), the pooled odds ratio being 0.718 (95% CI, 0.36; 1.47), NS. Some evidence of significant heterogeneity including publication bias was present but stratified analysis in various subgroups showed that this issue did not meaningfully change our results. Intradermal hepatitis B vaccine was safe and well tolerated. We conclude that intradermal hepatitis B vaccine induces a superior response rate compared to intramuscular route at completion of vaccine cycle, despite a lower vaccine dose. No significant advantage was found over longer follow-up. It remains unclear whether the higher seroprotection rate achieved with intradermal route translates into a lower frequency of de novo hepatitis B among patients on maintenance dialysis.

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“…IFN-α is a type-1 IFN and a physiological danger signal [11, 12] can upregulate expression of MHC class-I molecules and costimulatory molecules on DCs, activate innate immunity, modulate DCs, promote Th1 response, help clonal expansion/survival and memory differentiation of T-lymphocytes [9–13], and has been shown to be an effective vaccine adjuvant in animal models [14] and clinical trials [15, 16]. The immunological consequences of tumor cell death induced by individual chemotherapy agents [17] and the subsequent differentiation of DCs and T-lymphocytes in the ensuing 2-week span are of pivotal importance in influencing the development toward the distinct immune responses (Th1, Th2, Th17, or tolerance).…”

Section: Introductionmentioning

confidence: 99%

Exploiting antitumor immunity to overcome relapse and improve remission duration

Chen

Choi

et al. 2011

Cancer Immunol Immunother

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Cancer survivors often relapse due to evolving drug-resistant clones and repopulating tumor stem cells. Our preclinical study demonstrated that terminal cancer patient’s lymphocytes can be converted from tolerant bystanders in vivo into effective cytotoxic T-lymphocytes in vitro killing patient’s own tumor cells containing drug-resistant clones and tumor stem cells. We designed a clinical trial combining peginterferon α-2b with imatinib for treatment of stage III/IV gastrointestinal stromal tumor (GIST) with the rational that peginterferon α-2b serves as danger signals to promote antitumor immunity while imatinib’s effective tumor killing undermines tumor-induced tolerance and supply tumor-specific antigens in vivo without leukopenia, thus allowing for proper dendritic cell and cytotoxic T-lymphocyte differentiation toward Th1 response. Interim analysis of eight patients demonstrated significant induction of IFN-γ-producing-CD8+, -CD4+, -NK cell, and IFN-γ-producing-tumor-infiltrating-lymphocytes, signifying significant Th1 response and NK cell activation. After a median follow-up of 3.6 years, complete response (CR) + partial response (PR) = 100%, overall survival = 100%, one patient died of unrelated illness while in remission, six of seven evaluable patients are either in continuing PR/CR (5 patients) or have progression-free survival (PFS, 1 patient) exceeding the upper limit of the 95% confidence level of the genotype-specific-PFS of the phase III imatinib-monotherapy (CALGB150105/SWOGS0033), demonstrating highly promising clinical outcomes. The current trial is closed in preparation for a larger future trial. We conclude that combination of targeted therapy and immunotherapy is safe and induced significant Th1 response and NK cell activation and demonstrated highly promising clinical efficacy in GIST, thus warranting development in other tumor types.

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Recombinant interferon-α2b improves immune response to hepatitis B vaccination in haemodialysis patients: Results of a randomised clinical trial

Cited by 34 publications

References 34 publications

Selection of Adjuvants for Enhanced Vaccine Potency

Selection of Adjuvants for Enhanced Vaccine Potency

Intradermal vs intramuscular vaccine against hepatitis B infection in dialysis patients: a meta-analysis of randomized trials

Exploiting antitumor immunity to overcome relapse and improve remission duration

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