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- Title
Reduced Maintainance of Influenza-Specific T-Cell Memory after Standard Vaccination in Hemodialysis Patients.
- Authors
Sester, M.; Sester, U.; Gärtner, B. C.; Kuhlmann, M. K.; Köhler, H.
- Abstract
Objective: Complications related to influenza virus infections can efficiently be prevented by vaccination. To investigate molecular correlates for the well-known impaired response of hemodialysis (HD) patients to a variety of recommended vaccinations, the kinetics in the induction of specific cellular and humoral immunity were characterised after influenza vaccination of 24 healthy controls (C) and 26 HD patients. Moreover, in the following year, these kinetics were compared with those after re-vaccination. Methods: Blood was drawn before and 1, 2, 4, 7 and 26 weeks after vaccination with 'Influsplit-SSW 2002' and '-2003'. Influenza-specific T-cells were flow-cytometrically quantified and phenotypically characterised from whole blood by the induction of IFNγ and TNFα as well as memory and maturation markers. Antibody-titers were quantified using ELISA (Virotech). Results: Low levels of influenza-specific CD4 T-cells were detectable in both study populations prior to vaccination (C: 0.16± 0.12%; HD: 0.13±0.11% CD4 T-cells). Specific T-cell responses significantly increased 1-2 weeks after the first vaccination (C: median increase by 0.50±0.64%, max: 3.01%; HD: median increase by 0.55±0.71%, max: 3.44%). Thereafter, specific T-cell frequencies continuously decreased to pre-vaccination levels after approximately 7 weeks. In contrast, antibody titers were more stable over time. Specific T-cells had the characteristics of recently activated, CD27+ memory Th1-cells and this phenotype did not change after vaccination. Interestingly, in the following season memory maintainance in immunocompetent individuals led to a significantly less pronounced increase in cellular immunity after re-vaccination (by only 0.12±0.09%, p=0.003), whereas the vaccine readily induced a strong increase in a second control group of vaccination-naïve subjects. In large contrast, HD patients showed a similarly pronounced increase in cellular immunity after primary vaccination and re-vaccination (p=0.14). Conclusions: In conclusion, monitoring of cellular immuneresponses after influenza-vaccination may be easily performed in cohort studies. The less pronounced increase in cellular immunity after re-vaccination in controls may indicate maintainance of sufficient immunological memory. In contrast, our data suggest a more rapid loss of specific immunological memory in HD patients. This may not only contribute to impaired responses to standard vaccination but also to an increased incidence of recurrent infectious complications.
- Subjects
INFLUENZA vaccines; HEMODIALYSIS patients; INFLUENZA viruses; CELLULAR immunity; IMMUNOLOGIC memory; VACCINATION; PHENOTYPES
- Publication
Kidney & Blood Pressure Research, 2004, Vol 27, Issue 5/6, p286
- ISSN
1420-4096
- Publication type
Article