The humoral immune response to the inactivated influenza A (H1N1) 2009 monovalent vaccine in patients with Type 2 diabetes mellitus in Korea

Nam, Ji Sun; Kim, A. R.; Yoon, Jae-Cheol; Byun, Young Ho; Kim, S. A.; Kim, K. R.; Cho, S.; Seong, Baik Lin; Ahn, Chul Woo; Lee, Jae Myun

doi:10.1111/j.1464-5491.2011.03255.x

Cited by 18 publications

(22 citation statements)

References 7 publications

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“…23 A third study showed that diabetic patients in the older age range or with longer disease duration showed a lower sero-conversion proportion with A(H1N1)pdm09 vaccine. 24 Such results are broadly consistent with our findings that immunity was sufficient as a whole, but older age, decreased BMI and increased HbA1c level were associated with poor immunogenicity. The reason for these minor differences is unclear, but differences in the severities of DM and the comorbidities or genetic characteristics of the population may have been involved.…”

Section: Discussionsupporting

confidence: 82%

Immunogenicity of influenza A(H1N1)pdm09 vaccine in patients with diabetes mellitus

Egawa

Ohfuji

Fukushima

et al. 2014

Human Vaccines & Immunotherapeutics

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Section: Discussionsupporting

confidence: 82%

Immunogenicity of influenza A(H1N1)pdm09 vaccine in patients with diabetes mellitus

Egawa

Ohfuji

Fukushima

et al. 2014

Human Vaccines & Immunotherapeutics

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“…To determine if the susceptibility of individuals with diabetes is the result of lower titers or a poor protective ability of generated antibodies to capsular polysaccharide and/or protein antigens, we measured both titers and protective antibody functions. Our observation that diabetes was associated with poor antibody responses to PspA was consistent with observations made by Nam et al indicating that baseline positive rates of cross-reactive antibodies against pandemic influenza virus in patients with diabetes were lower than those in age-and sex-matched nondiabetes controls (35). Additionally, Fabrizi et al reported a lower seroprotection rate elicited by the hepatitis B vaccine in diabetics (both influenza virus and hepatitis B virus are protein antigens) (13).…”

Section: Discussionsupporting

confidence: 81%

Impaired Function of Antibodies to Pneumococcal Surface Protein A but Not to Capsular Polysaccharide in Mexican American Adults with Type 2 Diabetes Mellitus

Mathews¹,

Brown

Martinez³

et al. 2012

Clin Vaccine Immunol

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ABSTRACTThe goal of the study was to determine baseline protective titers of antibodies toStreptococcus pneumoniaesurface protein A (PspA) and capsular polysaccharide in individuals with and individuals without type 2 diabetes mellitus. A total of 561 individuals (131 individuals with diabetes and 491 without) were screened for antibodies to PspA using a standard enzyme-linked immunosorbent assay (ELISA). A subset of participants with antibodies to PspA were retested using a WHO ELISA to determine titers of antibodies to capsular polysaccharide (CPS) (serotypes 4, 6B, 9V, 14, 18C, 19A, 19F, and 23F). Functional activity of antibodies was measured by assessing their ability to enhance complement (C3) deposition on pneumococci and promote killing of opsonized pneumococci. Titers of antibodies to protein antigens (PspA) were significantly lower in individuals with diabetes than controls without diabetes (P= 0.01), and antibodies showed a significantly reduced complement deposition ability (P= 0.02). Both antibody titers and complement deposition were negatively associated with hyperglycemia. Conversely, titers of antibodies to capsular polysaccharides were either comparable between the two groups or were significantly higher in individuals with diabetes, as was observed for CPS 14 (P= 0.05). The plasma specimens from individuals with diabetes also demonstrated a higher opsonophagocytic index against CPS serotype 14. Although we demonstrate comparable protective titers of antibodies to CPS in individuals with and individuals without diabetes, those with diabetes had lower PspA titers and poor opsonic activity strongly associated with hyperglycemia. These results suggest a link between diabetes and impairment of antibody response.

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“…To our knowledge, only seven studies have been published regarding the immunogenicity of influenza vaccination among diabetic patients (6)(7)(8)(9)(10)(11)(12). Of them, six studies concluded that the immune response was similar between diabetic individuals and healthy controls.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have shown that diabetic individuals have an immune response to influenza vaccination similar to that of healthy controls, while a few studies have reported suboptimal responses in diabetic subjects (6)(7)(8)(9)(10)(11)(12). Immunogenicity should be maintained throughout the entire seasonal epidemic; therefore, an evaluation of longterm immunogenicity is essential before the current conventional vaccination program can be recommended.…”

mentioning

confidence: 99%

Long-Term Immunogenicity and Safety of a Conventional Influenza Vaccine in Patients with Type 2 Diabetes

Seo

Baek

Jacob

et al. 2015

Clin Vaccine Immunol

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cNo previous studies have assessed the persistence of immune responses in individuals with diabetes. We conducted this study to evaluate the long-term immunogenicity and safety of an influenza vaccine in type 2 diabetic subjects compared with nondiabetic controls. A randomized and controlled study was conducted at two university hospitals during the 2012-2013 influenza season. The study vaccine was a standard-dose trivalent subunit inactivated intramuscular vaccine. Serum hemagglutination-inhibiting (HI) antibodies were measured at the time of vaccination and 1 month and 6 months after vaccination. Local and systemic reactions were recorded for 7 days. A total of 105 diabetic patients and 108 controls were included in the analysis. One month after vaccination, both the diabetic and nondiabetic groups satisfied all of the criteria of the Committee for Medical Products for Human Use (CHMP), and the immunogenicity profiles were statistically similar between the two groups. Although the vaccine was well tolerated, and all adverse reactions were mild to moderate, there was a tendency toward a reduced incidence of local reactions in the diabetic group. All values in the long-term immunogenicity profiles were statistically similar between the two groups, except for the seroprotection rate for the A/H1N1 influenza virus strain, which was significantly lower in the elderly diabetic group than that in the elderly nondiabetic group. However, in multivariate analysis, long-term immunogenicity was associated with age and prevaccination titer, regardless of diabetes status. (This study has been registered at CRIS [https://cris.nih.go .kr/cris/en/] under registration no. KCT0001423.)A lthough the available data are limited, diabetic individuals may be more susceptible to influenza infections than nondiabetic individuals (1). In addition, individuals with diabetes are at increased risk of severe influenza virus infection and its complications compared to nondiabetic persons (2-4). Such phenomena are thought to be mediated by impairments in cellular and humoral immunity, which include reduced T cell responses, decreased neutrophil function, and B cell disorders (5). For this reason, annual influenza vaccination is universally recommended for patients with diabetes.To achieve protection against influenza virus infection, vaccinations should elicit a sufficient antibody response. Many studies have shown that diabetic individuals have an immune response to influenza vaccination similar to that of healthy controls, while a few studies have reported suboptimal responses in diabetic subjects (6-12). Immunogenicity should be maintained throughout the entire seasonal epidemic; therefore, an evaluation of longterm immunogenicity is essential before the current conventional vaccination program can be recommended. However, no study has assessed long-term immunogenicity in individuals with diabetes.If the immune responses and safety profiles prove to be unsatisfactory with the conventional influenza vaccine, immunogenicity-enhancing strateg...

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The humoral immune response to the inactivated influenza A (H1N1) 2009 monovalent vaccine in patients with Type 2 diabetes mellitus in Korea

Cited by 18 publications

References 7 publications

Immunogenicity of influenza A(H1N1)pdm09 vaccine in patients with diabetes mellitus

Immunogenicity of influenza A(H1N1)pdm09 vaccine in patients with diabetes mellitus

Impaired Function of Antibodies to Pneumococcal Surface Protein A but Not to Capsular Polysaccharide in Mexican American Adults with Type 2 Diabetes Mellitus

Long-Term Immunogenicity and Safety of a Conventional Influenza Vaccine in Patients with Type 2 Diabetes

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