Departments of Internal Medicine and Gastrointestinal Endoscopy, Faculty of Medicine, Saga University, Saga City, Saga, Japan.
Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga City, Saga, Japan.
Inflamm Bowel Dis. 2018 Apr 23;24(5):1082-1091. doi: 10.1093/ibd/izx101.
No reports have described the immunogenicity and boosting effect of the quadrivalent inactivated influenza vaccine (QIV) in adults with inflammatory bowel disease.
Adults with Crohn's disease or ulcerative colitis were randomly assigned to a single vaccination group or booster group, and a QIV was administered subcutaneously. Serum samples were collected before vaccination, 4 weeks after vaccination, and after the influenza season in the single vaccination group. In the booster group, serum samples were taken before vaccination, 4 weeks after the first vaccination, 4 weeks after the second vaccination, and after the influenza season. We measured hemagglutination inhibition antibody (HAI) titer and calculated the geometric mean titer ratio (GMTR), seroprotection rate, and seroconversion rate.
In total, 132 patients were enrolled. Twenty-two patients received immunomodulatory monotherapy and 16 received anti-tumor necrosis factor-α (anti-TNF-α) single-agent therapy. Fifteen patients received combination therapy comprising an immunosuppressant and anti-TNF-α agent. Each vaccine strain showed immunogenicity satisfying the European Medicines Agency criteria with a single inoculation. The booster influenza vaccination did not induce additional response. In patients administered infliximab, the seroprotection rate and seroconversion rate tended to be lower in patients who maintained blood concentrations [seroprotection rate: H1N1: OR, 0.37 (95% CI, 0.11-1.21); H3N2: 0.22 (0.07-0.68); seroconversion rate: H1N1: 0.23 (0.06-0.91); H3N2: 0.19 (0.06-0.56)].
Single dose QIV showed sufficient immunogenicity in patients with inflammatory bowel disease, and a boost in immunization by additional vaccination was not obtained. Additionally, immunogenicity was low in patients receiving infliximab therapy.
目前尚无研究报道过四价流感灭活疫苗（QIV）在炎症性肠病（IBD）成人患者中的免疫原性和增强效果。
将克罗恩病或溃疡性结肠炎患者随机分配至单剂接种组或加强免疫组，并采用皮下注射的方式接种 QIV。单剂接种组在接种前、接种后 4 周及流感季采集血清样本；加强免疫组在接种前、首针接种后 4 周、第二针接种后 4 周及流感季采集血清样本。我们测量了血凝抑制抗体（HAI）滴度，并计算了几何平均滴度比（GMTR）、血清保护率和血清转化率。
共纳入 132 例患者。22 例患者接受免疫调节单药治疗，16 例患者接受抗肿瘤坏死因子-α（anti-TNF-α）单药治疗，15 例患者接受免疫抑制剂联合 anti-TNF-α 治疗。每种疫苗株在单剂接种后均具有满足欧洲药品管理局标准的免疫原性。加强流感疫苗接种并未诱导出额外的反应。在接受英夫利昔单抗治疗的患者中，维持血药浓度的患者其血清保护率和血清转化率均较低（血清保护率：H1N1：比值比，0.37（95%CI，0.11-1.21）；H3N2：0.22（0.07-0.68）；血清转化率：H1N1：0.23（0.06-0.91）；H3N2：0.19（0.06-0.56））。
单剂 QIV 对 IBD 患者具有足够的免疫原性，且不能通过额外接种来增强免疫。此外，接受英夫利昔单抗治疗的患者免疫原性较低。
