Safety and efficacy of influenza vaccination in systemic lupus erythematosus patients with quiescent disease

Holvast, Albert; Huckriede, Anke; Wilschut, Jan; Horst, G.; Vries, Jutte J.C. de; Benne, C. A.; Kallenberg, Cornelis; Bijl, Marc

doi:10.1136/ard.2005.043943

Cited by 142 publications

(126 citation statements)

References 31 publications

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“…In our patients we detected the highest post vaccination antibody titers in SLE vaccinated patients compared to RA and SjS vaccinated patients. Other papers reported a modest reduction or a similar humoral response in SLE patients, but compared to the healthy control group (Brodman et al 1978;Mercado et al 2004;Holvast et al 2006). In several controlled studies in SLE patients a similar humoral response was established after influenza immunization compared to the healthy control group and immunosuppressive therapy has no significant effect on the response to vaccination (Louie et al 1978;Lu et al 2011).…”

Section: Discussionmentioning

confidence: 92%

Influenza Vaccination in Autoimmune Rheumatic Disease Patients

Milanovic

Stojanovich

Djoković

et al. 2013

Tohoku J. Exp. Med.

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Section: Discussionmentioning

confidence: 92%

Influenza Vaccination in Autoimmune Rheumatic Disease Patients

Milanovic

Stojanovich

Djoković

et al. 2013

Tohoku J. Exp. Med.

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“…In SLE, antibody responses to influenza vaccination are diminished (6), but cell-mediated responses have not been assessed. The latter are relevant, because it has been shown that in certain groups, such as the elderly, cellmediated responses to influenza vaccination can be a marker of clinical protection, independent from antibody responses (7).…”

mentioning

confidence: 99%

Studies of cell‐mediated immune responses to influenza vaccination in systemic lupus erythematosus

Holvast¹,

Assen²,

Haan³

et al. 2009

Arthritis & Rheumatism

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Objective. Both antibody and cell-mediated responses are involved in the defense against influenza. In patients with systemic lupus erythematosus (SLE), a decreased antibody response to subunit influenza vaccine has been demonstrated, but cell-mediated responses have not yet been assessed. This study was therefore undertaken to assess cell-mediated responses to influenza vaccination in patients with SLE.Methods. Fifty-four patients with SLE and 54 healthy control subjects received subunit influenza vaccine. Peripheral blood mononuclear cells and sera were obtained before and 1 month after vaccination. Cellmediated responses to A/H1N1 and A/H3N2 vaccines were evaluated using an interferon-␥ (IFN␥) enzymelinked immunospot assay and flow cytometry. Antibody responses were measured using a hemagglutination inhibition test.Results. Prior to vaccination, patients with SLE had fewer IFN␥ spot-forming cells against A/H1N1 compared with control subjects and a lower frequency of IFN␥-positive CD8؉ T cells. After vaccination, the number of IFN␥ spot-forming cells increased in both patients and control subjects, although the number remained lower in patients. In addition, the frequencies of CD4؉ T cells producing tumor necrosis factor and interleukin-2 were lower in patients after vaccination compared with healthy control subjects. As expected for a subunit vaccine, vaccination did not induce a CD8؉ T cell response. For A/H3N2-specific responses, results were comparable. Diminished cell-mediated responses to influenza vaccination were associated with the use of prednisone and/or azathioprine. The increase in A/H1N1-specific and A/H3N2-specific antibody titers after vaccination was lower in patients compared with control subjects.Conclusion. In addition to a decreased antibody response, cell-mediated responses to influenza vaccination are diminished in patients with SLE, which may reflect the effects of the concomitant use of immunosuppressive drugs. This may render these patients more susceptible to (complicated) influenza infections.

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“…Yearly influenza vaccination is recommended for all SLE patients; however, they may experience less protection. Adequate vaccine responses to influenza A and B, occurred in 39-41% of SLE patients compared to 71-94% controls, particularly in patients with higher ANA titers, IFN-α production, and number of ACR criteria for SLE (>6) [20,21]. Vaccination may be contraindicated during disease flare, as patients are less likely to develop a protective response [4].…”

Section: Influenza Vaccinationmentioning

confidence: 99%

Prevention of Infection in Lupus Patients

Fane¹,

Sodqi²,

Chakib³

et al. 2017

J Antimicrob Agents

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Despite the many advances in the treatment of systemic lupus erythematous (SLE), infection remains one of the leading causes of morbidity and mortality of patients. The reasons for the high incidence of infection are immunosuppressive therapy and immune disturbances of lupus itself. Bacterial infections are most frequent, followed by viral and fungal infections. Vaccination is the most important tool in the prevention of infections specially influenza and Streptococcus pneumonia infections. Prophylaxis of tuberculosis and pneumocystosis are also recommended to prevent those deadly infections. In this review, we aim to give an overview of the prevention means of infections in SLE.

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Safety and efficacy of influenza vaccination in systemic lupus erythematosus patients with quiescent disease

Cited by 142 publications

References 31 publications

Influenza Vaccination in Autoimmune Rheumatic Disease Patients

Influenza Vaccination in Autoimmune Rheumatic Disease Patients

Studies of cell‐mediated immune responses to influenza vaccination in systemic lupus erythematosus

Prevention of Infection in Lupus Patients

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