Granulocyte-macrophage colony-stimulating factor enhances the efficacy of hepatitis B virus vaccine in previously unvaccinated haemodialysis patients
Granulocyte-macrophage colony-stimulating factor enhances the efficacy of hepatitis B virus vaccine in previously unvaccinated haemodialysis patients
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DOI：
10.1046/j.1365-2893.1999.00180.x
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发表时间：
1999-09-01
影响因子：
2.5
通讯作者：
Sarin, SK
中科院分区：
文献类型：
--
作者：
Kapoor, D;Aggarwal, SR;Sarin, SK
The response to vaccination with recombinant hepatitis B virus (HBV) vaccine is poor in haemodialysis patients. A defect in the antigen-presenting cells may be responsible for this hyporesponsiveness, To overcome this and to improve the response to HBV vaccine in dialysis patients, we used granulocyte-macrophage colony-stimulating factor (GM-CSF) as a vaccine adjuvant, Fifteen consecutive patients with chronic renal failure (CRF), commenced on dialysis, were stratified to receive either 40 mu g HBV vaccine (Engerix-B) at 0, 1, 2 and 6 months (group A, n = 9) or 3 mu g kg(-1) GM-CSF (Leucomax) on day 1 followed by the vaccination schedule described above (group B, n = 6). All patients were negative for hepatitis B surface anti gen (HBsAg), antibodies to hepatitis C virus (anti-HCV) and human immunodeficiency virus (HIV) serology. Titres of antibody to HBsAg (HBsAb) were quantitatively assayed, using enzyme-linked immunosorbent assay (ELISA), at 1, 2, 6 and 7 months from the first dose of vaccination. Only 44% of the patients in group A developed protective antibody levels (mean HBsAb: 22 IU l(-1)) Fifty per cent of responders developed protective antibody levels (HBsAb >10 IU l(-1)) only after the fourth dose of vaccination. In contrast, all six patients (100%) in group B developed protective levels of HBsAb (mean HBsAb: 70 IU l(-1)) (P < 0.02). Sixty-seven per cent of the responders were protected after only the second dose of vaccination (P = 0.046). No serious adverse effects of GM-CSF were observed in group B. Hence, haemodialysis patients respond poorly to HBV vaccine. GM-CSF is a safe vaccine adjuvant capable of stimulating an earlier and a stronger antibody response to HBV vaccine in haemodialysis patients.
