Gluten Intake Interferes With the Humoral Immune Response to Recombinant Hepatitis B Vaccine in Patients With Celiac Disease

Nemes, Éva; Lefler, Eva; Szegedi, László; Kapitány, Anikó; Kovács, Judit B.; Balogh, Márta; Szabados, Katalin; Tumpek, Judit; Sipka, Sándor; Korponay-Szabó, Ilma Rita

doi:10.1542/peds.2007-2446

Cited by 60 publications

(90 citation statements)

References 42 publications

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“…CD patients may have a failure of induction of humoral immune response, needed for development of long-term immunity, though the relevant mechanism is as yet unclear. Nemes et al (9) observed that the seroconversion rate after HBV vaccination was significantly lower among untreated versus treated and Table 3. Anti-HBs titers according to the groups diet-compliant subjects with CD or control subjects.…”

Section: Discussionmentioning

confidence: 99%

Responsiveness of children with celiac disease to different hepatitis B vaccination protocols

Balamtekin

Uslu²,

Baysoy³

et al. 2011

Turk J Gastroenterol

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Celiac disease (CD) is a common autoimmune disease characterized by permanent intolerance to ingested gluten, which results in immune-mediated injury of the small bowel mucosa. Genetic, environmental and immunological factors are responsible for the disease. Susceptibility to CD is determined, in part, by a common human leukocyte antigen (HLA) association; specifically, the major histocompatibility complex class II antigen DQ2, which is present in 86% to 100% of the patients (1).Hepatitis B virus (HBV) infection is one of the most important public health problems worldwide. HBV infection acquired during the perinatal, infancy and early childhood periods is a major cause of chronic liver disease and liver cancer (2). Hepatitis B vaccine is highly effective and safe, and it can prevent the morbidity and occasional mortality associated with infection (3). For this reason, HBV vaccine is considered as the main strategy in the control of the infection and viral transmission. HBV vaccine was introduced into clinical practice

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Section: Discussionmentioning

confidence: 99%

Responsiveness of children with celiac disease to different hepatitis B vaccination protocols

Balamtekin

Uslu²,

Baysoy³

et al. 2011

Turk J Gastroenterol

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“…10 Nonresponsiveness to HBV vaccine has been associated with factors such as chronic diseases, smoking, obesity and the male gender. 3 A genetic predisposition to HBV vaccine non-responsiveness has been attributed to particular HLA antigens, 11,12 mainly DQ2 haplotype, which is also involved in autoimmunity.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, a prospective study, with the same lag time between vaccine and testing, described a failure to respond to HBV vaccine in CD patients on gluten-free diet in a percentage similar to that observed in healthy people. 10 Once again, the hypothesis of immune hyporesponsiveness is not sustainable considering that a high percentage of responders to a booster dose of HBV vaccine is reported in previously vaccinated CD patients without protective anti HBs antibodies. 10 In this case, as well, blood testing was performed in all the patients with the same time interval, a short period after vaccination.…”

mentioning

confidence: 99%

Normal or defective immune response to Hepatitis B vaccine in patients with diabetes and celiac disease

Zanoni

Contreas

Valletta

et al. 2014

Human Vaccines & Immunotherapeutics

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“…Gluten might be implicated because both hepatitis B surface antigen (HBsAg) protein fragments and gliadin peptides bind to HLA-DQ2 molecules and induce proliferation of T lymphocytes. Competition between the proteins may result in defective antibody production (6)(7)(8).…”

mentioning

confidence: 99%

Role of Gluten Intake at the Time of Hepatitis B Virus Vaccination in the Immune Response of Celiac Patients

Zingone¹,

Capone²,

Tortora³

et al. 2013

Clin. Vaccine Immunol.

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bSome reports have demonstrated an inadequate response to hepatitis B vaccination in patients affected by celiac disease. The aim of our study was to evaluate hepatitis B vaccination response in relation to gluten exposure status in patients with celiac disease. To measure the gluten exposure status at the time of vaccination, we considered three groups: group A (exposed to gluten), including patients vaccinated as 12-year-old adolescents (the celiac disease diagnosis was established after vaccination); group B (not exposed to gluten), including patients vaccinated as 12-year-old adolescents on a gluten-free diet at the time of vaccination; and group C (infants), including patients vaccinated at birth. The response of celiac patients to hepatitis B vaccination was compared to that of healthy subjects, i.e., those in the control group (group D). This study included 163 celiac patients (group A, 57 patients; group B, 46 patients; and group C, 60 patients) and 48 controls (group D). An inadequate response to hepatitis B immunization was present in 43.9% of patients in group A, 34.8% of patients in group B, 58.3% of patients in group C, and 8.3% of patients in group D (group A versus group D, P < 0.001; group B versus group D, P ‫؍‬ 0.002; group C versus group D, P ‫؍‬ 0.001) (no significant difference for group A versus group B and group A versus group C was evident). Our data suggest that gluten exposure does not influence the response to hepatitis B immunization and that the human leukocyte antigen probably plays the main immunological role in poor responses to hepatitis B-vaccinated celiac patients. Several studies have reported an inadequate response to hepatitis B virus (HBV) vaccination in patients affected by celiac disease (CD). Unfortunately, the causes of this impaired response are unknown (1-8).In the general population, it is recognized that several factors influence the production of protective levels of antibodies against HBV after the standard immunization. Well-known modifiers include age, obesity, smoking, drug abuse, alcoholism, infections, immune suppression, and the route of vaccination (9, 10). Additionally, hepatitis B vaccine nonresponsiveness, due to the presence of specific human leukocyte antigen (HLA) genotypes, has been described (11-13).Celiac disease (CD) is an HLA-associated immunological disease, and for this reason, a genetic predisposition as a possible cause of a lower grade of immunization to recombinant hepatitis B vaccines has been considered (4, 5). In fact, HLA-DQ2 status may predispose CD patients to fail to develop immunity after hepatitis B vaccination through a Th2 response that is inadequate for B-cell differentiation and the formation of memory B cells (5). In contrast, several studies have hypothesized gluten intake as a cause of failed immunity at the time of vaccination. Gluten might be implicated because both hepatitis B surface antigen (HBsAg) protein fragments and gliadin peptides bind to HLA-DQ2 molecules and induce proliferation of T lymphocytes. Competition bet...

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Gluten Intake Interferes With the Humoral Immune Response to Recombinant Hepatitis B Vaccine in Patients With Celiac Disease

Cited by 60 publications

References 42 publications

Responsiveness of children with celiac disease to different hepatitis B vaccination protocols

Responsiveness of children with celiac disease to different hepatitis B vaccination protocols

Normal or defective immune response to Hepatitis B vaccine in patients with diabetes and celiac disease

Role of Gluten Intake at the Time of Hepatitis B Virus Vaccination in the Immune Response of Celiac Patients

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