Tuberculin Skin Test, Interferon-gamma Assay, and T Cells Subpopulations in Hemodialysis Patients

Petrescu, L.; Sica, Simona; Țârdei, Grațiela; Santimbrean, C.; Penescu, Mircea; Mircescu, Gabriel

doi:10.1053/j.jrn.2010.06.011

Cited by 7 publications

(3 citation statements)

References 24 publications

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“…Positive response to vaccines was shown to be associated with increased interferon (IFN)-gamma production (88, 89). As IL-18 is involved in IFN-gamma production (90-92), it was used to modulate DNA vaccines against HBV (89, 93, 94).…”

Section: Resultsmentioning

confidence: 99%

Hepatitis B Vaccination in Chronic Kidney Disease: Review of Evidence in Non-Dialyzed Patients

Grzegorzewska¹

2012

Hepat Mon

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ContextHepatitis B vaccination of hemodialysis patients is performed all over the world. There are also recommendations from world health organizations to vaccinate patients with chronic kidney disease (CKD) prior dialysis commencement, but the implementation of a hepatitis B vaccination program is less common and not well organized.Evidence AcquisitionThis review article summarizes data indicating why, when and how to vaccinate CKD patients before they start renal replacement therapy. Publication for this review was bringing into being from PubMed.ResultsThere is an agreement in the nephrological societies and among clinicians and scientists that CKD patients should be vaccinated in early stages of their disease, because a higher glomerular filtration rate is more likely to be associated with the responsiveness to vaccination. Schedules of vaccination and optimal vaccine doses are still being investigated. Differences in data with respect to these problems may result from comparisons of various vaccine doses and vaccination schedules without reference to one gold standard, variations in patients` clinical status and glomerular filtration rate, and also the small groups of the affected patients make statistical analysis non-conclusive. A titer of antibodies to surface antigen of hepatitis B virus (anti-HBs) > 10 IU/L or ≥ 10 IU/L is commonly considered as a marker of seroconversion to anti-HBs positivity after vaccination in both non-dialyzed and dialyzed patients. In advanced CKD, vaccine–induced serconversion rate is seldom observed in more than 90% of vaccinees. Various strategies have been utilized in order to increase vaccine-induced seroconversion rate in patients with advanced CKD. Changing the injection mode, the use of adjuvants and immunostimulants to improve the immunogenicity of existing recombinant hepatitis B vaccines, introduction of mammalian-cell derived pre-S/S HBV vaccines (third-generation vaccines) were tried in order to improve the immunization rate.ConclusionsThere are a substantial number of non-responders to the hepatitis B vaccine among CKD patients. Therefore, successful prevention of hepatitis B virus transmission and spread will only be attained when hepatitis B vaccination is applied together with full implementation of appropriate infection control procedures.

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Section: Resultsmentioning

confidence: 99%

Hepatitis B Vaccination in Chronic Kidney Disease: Review of Evidence in Non-Dialyzed Patients

Grzegorzewska¹

2012

Hepat Mon

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“…However, given the predilection of patients with ESKD for other potentially steroid-adverse medical comorbidities, including diabetes mellitus, heart failure, etc., there should be consideration for limiting corticosteroid exposure in this population (where required and permitted by the indicating irAE). Since immune senescence is known to correlate with dialysis vintage, the relationship between dialysis vintage and irAEs is a subject for future study [ 66 , 67 ].…”

Section: Introductionmentioning

confidence: 99%

Immune checkpoint inhibitor use in patients with end-stage kidney disease: an analysis of reported cases and literature review

Kitchlu

Jhaveri

Sprangers

et al. 2021

Clinical Kidney Journal

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Immune checkpoint inhibitors (ICI), immunomodulatory antibodies that are used to enhance the immune system, have substantially improved the prognosis of patients with advanced malignancy. As use of ICI therapy becomes increasingly widespread across different types of cancer, their use in patients receiving dialysis is likely to increase. In this review, we summarize the current literature on use of ICI in ESKD patients and provide aggregate data from reported cases and series. Based on available pharmacological information, ICIs require no dosing adjustment in ESKD patients. Analysis of the reported cases in the literature demonstrates similar incidence of immune-related adverse events in patients with ESKD receiving dialysis as compared to the general population (49%). Severe reactions graded as 3 and 4 have been seen in fifteen patients (16%). As such, it is important that these patients are monitored very closely for irAE, however the risk of these adverse events should not preclude patients on dialysis from receiving these therapies. Cancer remission (complete and partial) was seen in close to 30% of patients. Stable disease was seen in 28% and progression of disease in approximately 36% of patients. One-third of the patients died. Urothelial and renal cell cancer represented approximately half of all treated cancers, and accounted for approximately 50% of all deaths reported. Additional data in the dialysis population with use of ICI, and involvement in prospective studies, is needed to better assess outcomes, particularly within specific cancer types.

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“…Positive response for vaccines was shown to be associated with increased IFN-␥ production [32,33] . As IL-18 is involved in IFN-␥ production [21][22][23] , it was used to modulate DNA vaccines against HBV [33][34][35] .…”

Section: Discussionmentioning

confidence: 99%

<i>Interleukin-18</i> Promoter Polymorphism and Development of Antibodies to Surface Antigen of Hepatitis B Virus in Hemodialysis Patients

Grzegorzewska¹,

Wobszal²,

Jagodzińśki³

2011

Kidney Blood Press Res

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Background: Interleukin (IL)-18 is involved in hepatitis B virus (HBV) clearance and augments antibodies against surface antigen of HBV (anti-HBsAg) production during DNA vaccination. The IL-18 –1297C>T (rs360719) polymorphism may modulate the IL-18 expression. Aim: To determine the potential association of IL-18 –1297C>T polymorphism with development of anti-HBsAg in hemodialysis (HD) patients. Methods: The frequency of IL-18 –1297C>T alleles and genotypes was identified by polymerase chain reaction restriction fragment length polymorphism in 435 HD patients. Group 1 (n = 219) developed an anti-HBsAg titer >10 IU/l as a result of vaccination or HBV transmission. Group 2 (n = 216) included patients who did not develop an anti-HBsAg titer >10 IU/l in response to at least one full series of vaccination or HBV transmission. The significance of genotype frequency was tested using the Fisher exact test. Results: In group 1, the frequencies of –1297CC, –1297CT and –1297TT genotypes were 7.3, 39.7 and 53.0%, respectively, and in group 2 they were 1.9, 42.1 and 56.0%, respectively. The odds ratio for CC versus CT + TT was 0.239 (95% CI 0.079–0.728, p = 0.010), and for CC versus TT it was 0.240 (95% CI 0.078–0.738, p = 0.009). Conclusion: In HD patients, the IL-18 –1297CC genotype may play a role in anti-HBsAg development in response to HBV surface antigen.

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Tuberculin Skin Test, Interferon-gamma Assay, and T Cells Subpopulations in Hemodialysis Patients

Cited by 7 publications

References 24 publications

Hepatitis B Vaccination in Chronic Kidney Disease: Review of Evidence in Non-Dialyzed Patients

Hepatitis B Vaccination in Chronic Kidney Disease: Review of Evidence in Non-Dialyzed Patients

Immune checkpoint inhibitor use in patients with end-stage kidney disease: an analysis of reported cases and literature review

<i>Interleukin-18</i> Promoter Polymorphism and Development of Antibodies to Surface Antigen of Hepatitis B Virus in Hemodialysis Patients

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