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2005/2006 流感流行季节对流感的免疫接种和已确诊炎症性肠病(IBD)儿童的体液反应。

Immunization against influenza during the 2005/2006 epidemic season and the humoral response in children with diagnosed inflammatory bowel disease (IBD).

机构信息

Department of Influenza Research, National Influenza Center, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland.

出版信息

Med Sci Monit. 2010 Sep;16(9):CR433-9.

Abstract

BACKGROUND

Patients with inflammatory bowel disease (IBD) who are treated long-term with immunosuppressive drugs can experience a decrease in their overall resistance to infections, including influenza. The purpose of this study was to evaluate the humoral response in children with IBD after being vaccinated against influenza.

MATERIAL/METHODS: Children with IBD were vaccinated with split inactivated vaccine. They were divided into 2 groups: children treated with anti-inflammatory medications and children treated with 5-acetylsalicylic acid along with immunomodulatory therapy. Antihemagglutinin (anti-HA) and antineuraminidase (anti-NA) antibodies were assessed before vaccination and 1 and 6 months after vaccination.

RESULTS

Anti-HA and anti-NA antibodies 1 and 6 months after vaccination were higher than before vaccination. In the patients treated with anti-inflammatory medications, the protection rate (PR) attained the highest level for antigens A/H1N1 and B 6 months after vaccination. However, for A/H3N2 the result was 88.9% at 1 and 6 months after vaccination. In the patients who received immunomodulatory medications, the highest PR was noted 6 months after vaccination (47.6-90.5%). The response rate (RR) in patients who were treated with the anti-inflammatory medications alone remained the same 1 and 6 months after vaccination. In patients who received the immunomodulatory regimen, the highest RR was recorded 6 months after vaccination (47.6-76.2%).

CONCLUSIONS

Response to vaccination was satisfactory, although not for all vaccine antigens, especially in patients treated with immunomodulatory medications. The higher levels of RP and RR 6 months after vaccination compared with 1 month after vaccination lends support to the argument that IBD patients should be vaccinated as soon as vaccine is available in a season.

摘要

背景

长期接受免疫抑制药物治疗的炎症性肠病(IBD)患者会出现总体抗感染能力下降,包括流感。本研究旨在评估接种流感疫苗后 IBD 患儿的体液免疫反应。

材料/方法:IBD 患儿接种流感裂解疫苗。根据治疗药物分为两组:抗炎药物治疗组和免疫调节剂治疗组。在接种前、接种后 1 个月和 6 个月评估抗血凝素(抗-HA)和神经氨酸酶(抗-NA)抗体。

结果

接种后 1 个月和 6 个月的抗-HA 和抗-NA 抗体均高于接种前。抗炎药物治疗组接种后 6 个月 A/H1N1 和 B 型流感疫苗的保护率(PR)最高,而 A/H3N2 型的 PR 为 1 个月和 6 个月后接种时的 88.9%。免疫调节剂治疗组在接种后 6 个月时 PR 最高(47.6%-90.5%)。仅接受抗炎药物治疗的患者接种后 1 个月和 6 个月的 RR 保持不变。接受免疫调节方案的患者中,RR 最高,接种后 6 个月时为 47.6%-76.2%。

结论

尽管不是所有疫苗抗原的反应都令人满意,但接种疫苗后的反应是令人满意的,尤其是接受免疫调节剂治疗的患者。与接种后 1 个月相比,接种后 6 个月时 RP 和 RR 更高,这支持了 IBD 患者应在流感季节一有疫苗就接种的观点。

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