Immune response to Hepatitis B vaccine in patients with celiac disease: A systematic review and meta-analysis

Opri, Roberta; Veneri, Dino; Mengoli, Carlo; Zanoni, Giovanna

doi:10.1080/21645515.2015.1069448

Cited by 21 publications

(15 citation statements)

References 28 publications

(26 reference statements)

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“…The role of interferons in mucosal permeability is supported by studies where the occurrence of CD was observed during the course of hepatitis C treatment with interferon [59,61]. As for HBV-related chronic liver disease, a metanalysis of retrospective and prospective studies found that CD patients have lower rate of protective HBV antibodies [in the retrospective studies relative risk (RR): 0.732, 95%CI: 0.664-0.808; in the prospective studies, RR: 0.777, 95%CI: 0.629-0.960] [62]. However, the lack of randomized, controlled trials and the low number of participantsmaking it difficult to draw definitive conclusions -were acknowledged by the authors of this analysis.…”

Section: Viral Infectionsmentioning

confidence: 99%

Coeliac disease: beyond genetic susceptibility and gluten. A narrative review

2019

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Coeliac disease (CD) is an immune-mediated disorder triggered by the ingestion of gluten in genetically susceptible individuals. However, only a small proportion of subjects harbouring CDrelated genetic risk develop the disease. Among the environmental factors that may influence CD risk, pre-and perinatal factors, delivery methods, parental lifestyle, infant feeding practices, seasonality, dietary factors, drug use, childhood infections and variability in gut microbiota are those most widely studied regarding the risk to develop CD. Although for many of these external factors the exact mechanism of action is unknown, most of them are thought to act by disrupting the intestinal barrier, facilitating contact between potential antigens and the immune system effector cells. Management of CD is relatively easy in patients with a definite diagnosis and requires a strict, lifelong, gluten-free diet. Better knowledge of environmental exposures apart from gluten can facilitate understanding of the pathogenesis of the disorder and the wide heterogeneity of its clinical spectrum. The purpose of this review is to discuss current knowledge on environmental CD risk factors, as well as possible interaction between them, on the grounds of the reliable scientific evidence available. KEY MESSAGESThe risk of developing CD is influenced not only by gluten ingestion but also by a number of environmental factors including childhood infections and variability in gut microbiota, preand perinatal factors, infant feeding practices, delivery methods, parental lifestyle, seasonality, dietary factors and drug use, acting mainly by disrupting intestinal permeability. Better knowledge of exposure to these factors can facilitate their identification, and subsequent elimination, in the individual patient.

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Section: Viral Infectionsmentioning

confidence: 99%

Coeliac disease: beyond genetic susceptibility and gluten. A narrative review

2019

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“…Several studies have reported lower efficacy of anti-HBV vaccines in individuals with CD[ 176 , 177 ] , which has been confirmed by a recent meta-analysis[ 178 ]. Therefore, novel immunization strategies have been proposed to ensure complete protection in such cases; these strategies include higher doses of vaccine and/or additional injection and intramuscular or preferably intradermal administration of booster doses of HBV vaccine because direct administration into the skin can activate an immune response mediated by dendritic cells through lower doses of antigen as opposed to intramuscular route of administration, which acts on cellular immune response.…”

Section: Hepatitis Bmentioning

confidence: 76%

To screen or not to screen? Celiac antibodies in liver diseases

Narciso-Schiavon

Schiavon

2017

WJG

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Celiac disease (CD) is a systemic immune-mediated disorder triggered by dietary gluten in genetically predisposed individuals. The typical symptoms are anemia, diarrhea, fatigue, weight loss, and abdominal pain. CD has been reported in patients with primary sclerosing cholangitis, primary biliary cholangitis, autoimmune hepatitis, aminotransferase elevations, nonalcoholic fatty liver disease, hepatitis B, hepatitis C, portal hypertension and liver cirrhosis. We evaluate recommendations for active screening for CD in patients with liver diseases, and the effect of a gluten-free diet in these different settings. Active screening for CD is recommended in patients with liver diseases, particularly in those with autoimmune disorders, steatosis in the absence of metabolic syndrome, noncirrhotic intrahepatic portal hypertension, cryptogenic cirrhosis, and in the context of liver transplantation. In hepatitis C, diagnosis of CD can be important as a relative contraindication to interferon use. Gluten-free diet ameliorates the symptoms associated with CD; however, the associated liver disease may improve, remain the same, or progress.

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“…Lack of response has been correlated with age, smoking, obesity, male gender, and the presence of specific HLA molecules, including HLA-DQ2, DR3, and DR7 [ 25 ]. A 2015 meta-analysis [ 10 ] concluded that CD patients had a significantly lower rate of protective antibody response to HBV vaccination than healthy controls. An evaluation of the response to HBV should be implemented as a routine assessment in newly diagnosed patients who had previously been vaccinated [ 11 ].…”

Section: Vaccination Immunogenicitymentioning

confidence: 99%

“…Scientific interest in this topic arose in the 1970s, when early papers reported a large variety of immunological abnormalities in patients with CD [ 7 , 8 , 9 ]. Numerous clinical trials, meta-analyses and systematic reviews have since been conducted to better investigate the link between CD and vaccination [ 10 , 11 , 12 ]. However, a comprehensive vaccination program for CD patients is still missing.…”

Section: Introductionmentioning

confidence: 99%

Vaccinations and Immune Response in Celiac Disease

2020

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Immune response to vaccinations in celiac patients is of growing scientific interest. However, some aspects of the relationship between celiac disease (CD) and vaccines are still unclear. A comprehensive search of published literature using the PubMed database was carried out using the following key terms: “adaptive immunity”, “celiac disease”, “humoral immune response”, “immunization”, and “vaccination”. To date, there is no evidence showing any causative association between vaccines and CD development. Therefore, vaccinations may be administered according to the modalities and timing of the National Immunization Schedule for each country. The rotavirus vaccine is currently recommended for the general population, and according to some data, it appears to reduce the risk for the development of CD autoimmunity in the early years of life. Regarding the hepatitis B virus, a booster dose of the vaccine is often required due to the low or the lost immune response rate in CD. Furthermore, determination of hepatitis B antibody titers could be useful in newly diagnosed CD subjects regardless of age at diagnosis. Finally, pneumococcal vaccines may be administered in patients with advancing age at diagnosis and concomitant risk factors. Future clinical practice guidelines for vaccination and monitoring programs in celiac patients could be recommended.

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Immune response to Hepatitis B vaccine in patients with celiac disease: A systematic review and meta-analysis

Abstract: These authors equally contributed to this work.

Cited by 21 publications

References 28 publications

Coeliac disease: beyond genetic susceptibility and gluten. A narrative review

Coeliac disease: beyond genetic susceptibility and gluten. A narrative review

To screen or not to screen? Celiac antibodies in liver diseases

Vaccinations and Immune Response in Celiac Disease

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