The immune response to influenza vaccination in diabetic patients

Pozzilli, Paolo; Gale, E. A. M.; Visalli, N; Baroni, Marco Giorgio; Crovari, Pietro; Frighi, V; Cavallo, Maria Gisella; Andreani, D

doi:10.1007/bf00870139

Cited by 75 publications

(48 citation statements)

References 20 publications

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“…22 Another study in patients with well-controlled diabetes showed that humoral and cellmediated immune responses to seasonal influenza vaccine were normal and immune response did not differ from those observed in age-matched normal subjects. 23 A third study showed that diabetic patients in the older age range or with longer disease duration showed a lower sero-conversion proportion with A(H1N1)pdm09 vaccine. 24 Such results are broadly consistent with our findings that immunity was sufficient as a whole, but older age, decreased BMI and increased HbA1c level were associated with poor immunogenicity.…”

Section: Discussionmentioning

confidence: 99%

Immunogenicity of influenza A(H1N1)pdm09 vaccine in patients with diabetes mellitus

Egawa

Ohfuji

Fukushima

et al. 2014

Human Vaccines & Immunotherapeutics

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Section: Discussionmentioning

confidence: 99%

Immunogenicity of influenza A(H1N1)pdm09 vaccine in patients with diabetes mellitus

Egawa

Ohfuji

Fukushima

et al. 2014

Human Vaccines & Immunotherapeutics

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“…In one study, the antigen-binding fragment of IgG was glycosylated in preference to the effector fragment [34]. The clinical relevance of these observations is unclear since the antibody response and protection after vaccination against the common infections, influenza, pneumococcal infection and hepatitis B show adequate responses in patients with diabetes [35][36][37][38][39][40][41][42][43][44]. Thus, we support the recommendation that adult diabetic patients receive the influenza vaccine before every epidemic season and the polysaccharide pneumococcal vaccine on one occasion followed by a booster at 5 years [45][46][47][48][49].…”

Section: Adaptive Immunitymentioning

confidence: 99%

Common infections in diabetes: pathogenesis, management and relationship to glycaemic control

Peleg

Weerarathna

McCarthy

et al. 2006

Diabetes Metabolism Res

499

406

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SummarySpecific defects in innate and adaptive immune function have been identified in diabetic patients in a range of in vitro studies. However, the relevance of these findings to the integrated response to infection in vivo remains unclear, especially in patients with good glycaemic control. Vaccine efficacy seems adequate in most diabetic patients, but those with type 1 diabetes and high glycosylated haemoglobin levels are most likely to exhibit hyporesponsiveness. While particular infections are closely associated with diabetes, this is usually in the context of extreme metabolic disturbances such as ketoacidosis. The link between glycaemic control and the risk of common community-acquired infections is less well established but could be clarified if infection data from large community-based observational or intervention studies were available. The relationship between hospital-acquired infections and diabetes is well recognized, particularly among post-operative cardiac and critically ill surgical patients in whom intensive insulin therapy improves clinical outcome independent of glycaemia. Nevertheless, further research is needed to improve our understanding of the role of diabetes and glycaemic control in the pathogenesis and management of community-and hospitalacquired infections.

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“…Many studies have shown that diabetic individuals have an immune response to influenza vaccination similar to that of healthy controls, while a few studies have reported suboptimal responses in diabetic subjects (6)(7)(8)(9)(10)(11)(12). Immunogenicity should be maintained throughout the entire seasonal epidemic; therefore, an evaluation of longterm immunogenicity is essential before the current conventional vaccination program can be recommended.…”

mentioning

confidence: 99%

Long-Term Immunogenicity and Safety of a Conventional Influenza Vaccine in Patients with Type 2 Diabetes

Seo

Baek

Jacob

et al. 2015

Clin Vaccine Immunol

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cNo previous studies have assessed the persistence of immune responses in individuals with diabetes. We conducted this study to evaluate the long-term immunogenicity and safety of an influenza vaccine in type 2 diabetic subjects compared with nondiabetic controls. A randomized and controlled study was conducted at two university hospitals during the 2012-2013 influenza season. The study vaccine was a standard-dose trivalent subunit inactivated intramuscular vaccine. Serum hemagglutination-inhibiting (HI) antibodies were measured at the time of vaccination and 1 month and 6 months after vaccination. Local and systemic reactions were recorded for 7 days. A total of 105 diabetic patients and 108 controls were included in the analysis. One month after vaccination, both the diabetic and nondiabetic groups satisfied all of the criteria of the Committee for Medical Products for Human Use (CHMP), and the immunogenicity profiles were statistically similar between the two groups. Although the vaccine was well tolerated, and all adverse reactions were mild to moderate, there was a tendency toward a reduced incidence of local reactions in the diabetic group. All values in the long-term immunogenicity profiles were statistically similar between the two groups, except for the seroprotection rate for the A/H1N1 influenza virus strain, which was significantly lower in the elderly diabetic group than that in the elderly nondiabetic group. However, in multivariate analysis, long-term immunogenicity was associated with age and prevaccination titer, regardless of diabetes status. (This study has been registered at CRIS [https://cris.nih.go .kr/cris/en/] under registration no. KCT0001423.)A lthough the available data are limited, diabetic individuals may be more susceptible to influenza infections than nondiabetic individuals (1). In addition, individuals with diabetes are at increased risk of severe influenza virus infection and its complications compared to nondiabetic persons (2-4). Such phenomena are thought to be mediated by impairments in cellular and humoral immunity, which include reduced T cell responses, decreased neutrophil function, and B cell disorders (5). For this reason, annual influenza vaccination is universally recommended for patients with diabetes.To achieve protection against influenza virus infection, vaccinations should elicit a sufficient antibody response. Many studies have shown that diabetic individuals have an immune response to influenza vaccination similar to that of healthy controls, while a few studies have reported suboptimal responses in diabetic subjects (6-12). Immunogenicity should be maintained throughout the entire seasonal epidemic; therefore, an evaluation of longterm immunogenicity is essential before the current conventional vaccination program can be recommended. However, no study has assessed long-term immunogenicity in individuals with diabetes.If the immune responses and safety profiles prove to be unsatisfactory with the conventional influenza vaccine, immunogenicity-enhancing strateg...

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The immune response to influenza vaccination in diabetic patients

Cited by 75 publications

References 20 publications

Immunogenicity of influenza A(H1N1)pdm09 vaccine in patients with diabetes mellitus

Immunogenicity of influenza A(H1N1)pdm09 vaccine in patients with diabetes mellitus

Common infections in diabetes: pathogenesis, management and relationship to glycaemic control

Long-Term Immunogenicity and Safety of a Conventional Influenza Vaccine in Patients with Type 2 Diabetes

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