Vaccination in patients with chronic rheumatic or autoimmune diseases
Vaccination in patients with chronic rheumatic or autoimmune diseases
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DOI：
10.1086/587063
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发表时间：
2008-05-01
影响因子：
11.8
通讯作者：
Mueller-Ladner, U.
中科院分区：
文献类型：
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作者：
Glueck, T.;Mueller-Ladner, U.
患有慢性风湿病或自身免疫性疾病的患者，如类风湿关节炎、系统性红斑狼疮或血管血管炎，其感染风险至少是健康个体的2倍。这种增加的风险不仅是异常免疫反应本身的结果，也可归因于控制潜在疾病活动和相关器官并发症所需的免疫抑制治疗。疫苗接种是这些感染中相当数量的一种选择。在这种情况下，肺炎球菌和流感疫苗得到了最好的评价，并得到了标准疫苗接种指南的推荐。一些研究发现，在接受长期免疫抑制治疗的患者中，对疫苗的免疫反应轻度受损，但接种后的抗体滴度通常足以为大多数免疫个体提供保护。关于疫苗安全性和有效性的累积数据证明，大多数慢性自身免疫性疾病或风湿性疾病患者都可以接种疫苗，特别是针对流感和肺炎球菌的疫苗。应在日常临床实践中更好地实施针对这一人群的疫苗接种方案。
Patients who have chronic rheumatic or autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, or vasculitides, show a risk of infection that is at least 2- fold greater than that for healthy individuals. This increased risk is not only a result of the aberrant immunologic reaction itself but also can be attributed to the immunosuppressive therapy required to control the activity of the underlying disease and the associated organ complications. Vaccination is an option for a substantial number of these infections. In this context, pneumococcal and influenza vaccines are the best evaluated and are recommended by standard vaccination guidelines. Some studies have found mildly impaired immune responses to vaccines among patients receiving long- term immunosuppressive therapy, but postvaccination antibody titers are usually sufficient to provide protection for the majority of immunized individuals. The accumulated data on the safety and effectiveness of vaccines warrant immunization with the majority of vaccines for patients with chronic autoimmune or rheumatic diseases, especially vaccination against influenza and pneumococci. Vaccination protocols for this population should be better implemented in daily clinical practice.