1型糖尿病患者对酵母衍生乙型肝炎疫苗的体液免疫反应。

Humoral immune response to a yeast-derived hepatitis B vaccine in patients with type 1 diabetes mellitus.

作者信息

Bouter K P, Diepersloot R J, Wismans P J, Gmelig Meyling F H, Hoekstra J B, Heijtink R A, van Hattum J

机构信息

Department of Internal Medicine, Diakonessen Hospital, Utrecht, The Netherlands.

出版信息

Diabet Med. 1992 Jan-Feb;9(1):66-9. doi: 10.1111/j.1464-5491.1992.tb01717.x.

DOI:10.1111/j.1464-5491.1992.tb01717.x

PMID:1532355

Abstract

The immune response following vaccination with a recombinant hepatitis B vaccine was investigated in 32 patients with Type 1 diabetes mellitus and compared with the outcome in 32 healthy age- and sex-matched volunteers. Participants were vaccinated at 0, 30, and 180 days and in vivo immune response was determined at 30, 60, 90, 180, and 210 days. The number of responders (anti-HBs greater than 1 IU l-1) was significantly lower (p less than 0.05) among patients at 30 (2 vs 11), 60 (17 vs 26), 90 (20 vs 28) and 180 (22 vs 29) days. The number of patients protected (anti-HBs greater than 10 IU l-1) was lower (p less than 0.05) than the number of protected volunteers at 60 (5 vs 14), 90 (10 vs 19), 180 (15 vs 24), and 210 days (24 vs 31). After the complete course of vaccination 8 out of 32 patients were still unprotected against hepatitis B (p less than 0.05). The anti-HBs titre of responders at 210 days was 251 (20, 3162) (geometric mean (-SD, +SD] IU l-1 in patients and 1259 (126, 12589) IU l-1 in control subjects (p less than 0.05). The HLA-antigen DQw1 frequency in the diabetic low responders (anti-HBs less than 100 IU l-1) was 0.27 compared with 0.86 in diabetic adequate responders. No relation between anti-HBs production and concentration of HbA1c could be demonstrated.

摘要

对32例1型糖尿病患者接种重组乙肝疫苗后的免疫反应进行了研究，并与32名年龄和性别匹配的健康志愿者的结果进行了比较。参与者在0、30和180天接种疫苗，并在30、60、90、180和210天测定体内免疫反应。在30天（2例对11例）、60天（17例对26例）、90天（20例对28例）和180天（22例对29例）时，患者中的应答者（抗-HBs大于1 IU l-1）数量显著较低（p小于0.05）。在60天（5例对14例）、90天（10例对19例）、180天（15例对24例）和210天（24例对31例）时，受保护的患者（抗-HBs大于10 IU l-1）数量低于受保护的志愿者数量（p小于0.05）。在完成疫苗接种疗程后，32例患者中有8例仍未获得乙肝保护（p小于0.05）。210天时应答者的抗-HBs滴度在患者中为251（20，3162）（几何平均数[-标准差，+标准差]IU l-1），在对照受试者中为1259（126，12589）IU l-1（p小于0.05）。糖尿病低应答者（抗-HBs小于100 IU l-1）中HLA抗原DQw1的频率为0.27，而糖尿病充分应答者中为0.86。未发现抗-HBs产生与糖化血红蛋白（HbA1c）浓度之间存在关联。