Re: Decreased Immune Responses to Influenza Vaccination in Patients With Heart Failure

University of Wisconsin School of Pharmacy, Madison, Wisconsin 53705-2222, USA.
Journal of cardiac failure (Impact Factor: 3.05). 06/2009; 15(4):368-73. DOI: 10.1016/j.cardfail.2008.11.009
Source: PubMed


Heart failure (HF) patients are at risk for influenza despite widespread vaccination. Both humoral (antibody) and cytotoxic T-lymphocyte (CTL) responses are important for protection. We explored antibody- and CTL-mediated responses to the influenza vaccine in HF patients compared with healthy controls.
We studied 29 HF patients (9 ischemic, 20 nonischemic) stable on HF therapies and 17 healthy controls. Participants had phlebotomy before and after influenza vaccination. Antibody production was measured in serum by hemagglutination inhibition assay and CTL responses (via interferon [IFN]-gamma and interleukin [IL]-10 production) were measured in isolated peripheral blood mononuclear cells with enzyme-linked immunosorbent assay. CTL responses demonstrated increased IL-10 production in HF patients after vaccination (P = .002), but similar IFN-gamma responses to healthy controls. All participants demonstrated antibody seroprotection; groups had similar rates of seroconversion (P = NS). Antibody-mediated response to the newest vaccine antigen, H3N2, was reduced in HF (P = .009).
Patients with HF had higher vaccine induced IL-10 concentrations, suggesting a different CTL phenotype for vaccine responses. HF patients did not mount as vigorous of an antibody immune response to the newest vaccine viral strain compared with healthy individuals. These data suggest that immunologic memory may be important for vaccine protection in HF patients.

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Available from: Maryl R Johnson, Nov 01, 2014
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    • "In this study, dogs in heart failure produced lower anti-AAV titers than normal dogs. This observation may parallel those studies in which humans with heart failure produced lower viral titers after influenza vaccination when compared with healthy control subjects (Vardeny et al., 2009). We did not assess differences in cellular responses to direct cardiac injection of AAV as a function of heart failure presence or absence. "
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