Immunosuppression Impairs Response to Pneumococcal Polysaccharide Vaccination in Patients With Inflammatory Bowel Disease
| Autor: | Robert W. Frenck, Patricio Ibáñez, Joel I. Ward, Andrew Ippoliti, Cristina Barolet-Garcia, Konstantinos A. Papadakis, Stephan R. Targan, Nik Agarwal, Gil Y. Melmed, Peter Simpson, Eric A. Vasiliauskas |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_treatment medicine.disease_cause Inflammatory bowel disease Pneumococcal Vaccines Immune system Streptococcus pneumoniae medicine Humans Prospective Studies Aged Immunosuppression Therapy Hepatology business.industry digestive oral and skin physiology Gastroenterology Case-control study Immunosuppression Middle Aged Inflammatory Bowel Diseases medicine.disease Ulcerative colitis digestive system diseases Vaccination Logistic Models Immunization Case-Control Studies Immunology Linear Models Female business Immunosuppressive Agents |
| Zdroj: | American Journal of Gastroenterology. 105:148-154 |
| ISSN: | 0002-9270 |
| Popis: | The treatment of inflammatory bowel disease (IBD) often includes immunosuppressive medications, which may increase the risk of vaccine-preventable illnesses. We aimed to assess the impact of immunosuppression on immune responses to pneumococcal vaccination in patients with IBD.The study design consists of a prospective controlled clinical trial. This study was carried out at a tertiary-care IBD clinic. The subjects for the study belonged to one of the following three groups: adult patients with IBD on combination TNF-blockers and immunomodulators (Group A), those without immunosuppressive therapy (Group B), and age-matched healthy controls (Group C). The treatment consisted of immunization with 23-valent pneumococcal polysaccharide vaccines (PSVs). The main outcome was immune response for five serotypes defined as a twofold or greater increase from pre-vaccination titers andor =1 microg post-vaccination titer.Sixty-four subjects participated in the study: 20 in Group A, 25 in Group B, and 19 in Group C. Pre-vaccination titers were similar among the three groups. Vaccine responses were lower in Group A than in Group B (Por =0.01 for four out of five antigens) and Group C (P0.01 for all five antigens). Overall vaccine response was seen in 45, 80, and 85% of Groups A, B, and C (P=0.01), respectively.Immune response to PSV-23 is impaired in Crohn's disease (CD) patients on combination immunosuppressive therapy but is normal among non-immunosuppressed patients. Given the unpredictable likelihood for immunosuppressive therapy, newly diagnosed patients with IBD should undergo vaccination before the initiation of immunosuppressive therapy. |
| Databáze: | OpenAIRE |
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