Rituximab-treated patients have a poor response to influenza vaccination.
Rituximab-treated patients have a poor response to influenza vaccination.
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DOI：
10.1007/s10875-012-9813-x
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发表时间：
2013-02
影响因子：
9.1
通讯作者：
Sullivan KE
中科院分区：
文献类型：
--
作者：
Eisenberg RA;Jawad AF;Boyer J;Maurer K;McDonald K;Prak ET;Sullivan KE
在接受利妥昔单抗治疗的患者中接种流感疫苗的有效性是一个重要的临床问题。风湿病诊所里挤满了接受利妥昔单抗治疗的患者，这些患者治疗的疾病范围很广。尽管有几项研究探索了其他疫苗在接受利妥昔单抗治疗的人群中的有效性，但结果一直相互矛盾。我们希望在利妥昔单抗治疗的队列中确定流感疫苗的效力。我们检查了17名接受利妥昔单抗治疗的可评估受试者的风湿状况。在接种标准灭活流感疫苗后，在特定时间点评估T细胞亚群、B细胞亚群、T细胞功能和B细胞功能以及血凝抑制效价。T细胞亚群计数与对照组有显著差异，但不随利妥昔单抗的变化而变化。所有患者的B细胞都耗尽了，但在接种疫苗时处于不同的恢复阶段。流感疫苗的整体响应性很差，只有16%的受试者效价增加了四倍。然而，在整个研究过程中，先前存在的效价被保留了下来。对流感疫苗的反应能力似乎与接种疫苗时B细胞恢复的程度有关。这项研究强调，接受利妥昔单抗治疗的受试者对疫苗的抗体反应受到损害，并支持B细胞恢复影响流感疫苗应答的概念。
The efficacy of influenza vaccination in patients treated with rituximab is a clinically important question. Rheumatology clinics are populated with patients receiving rituximab for a broad array of disorders. Although several studies have explored the efficacy of other vaccines in rituximab-treated populations, results have been conflicting. We wished to define influenza vaccine efficacy in a rituximab-treated cohort. We examined 17 evaluable subjects treated with rituximab for rheumatologic conditions. T cell subsets, B cells subsets, T cell function, and B cell function were evaluated at specific time points along with hemagglutinination inhibition titers after receiving the standard inactivated influenza vaccine. T cell subset counts were significantly different than controls but did not change with rituximab. B cells depleted in all patients but were in various stages of recovery at the time of vaccination. Influenza vaccine responsiveness was poor overall, with only 16% of subjects having a four-fold increase in titer. Pre-existing titers were retained throughout the study, however. The ability to respond to the influenza vaccine appeared to be related to the degree of B cell recovery at the time of vaccination. This study emphasizes that antibody responses to vaccine are impaired in subjects treated with rituximab and supports the concept that B cell recovery influences influenza vaccine responsiveness.
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影响因子：
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