Müller Katalin Eszter, Dohos Dóra, Sipos Zoltán, Kiss Szabolcs, Dembrovszky Fanni, Kovács Norbert, Solymár Margit, Erőss Bálint, Hegyi Péter, Sarlós Patrícia
Institute for Translational Medicine, Medical School, University of Pécs, Szigeti street 12, 7624 Pécs, Hungary; Heim Pál National Pediatric Institute, Üllői street 89, 1086 Budapest, Hungary.
Institute for Translational Medicine, Medical School, University of Pécs, Szigeti street 12, 7624 Pécs, Hungary; Szentágothai Research Centre, University of Pécs, Ifjúság útja 20, 7624 Pécs, Hungary.
Vaccine. 2022 Mar 18;40(13):2076-2086. doi: 10.1016/j.vaccine.2022.02.027. Epub 2022 Feb 25.
Patients with inflammatory bowel disease (IBD) have a high risk for infection. Pneumonia related to influenza and pneumococcal infection is one of the most common infection-related complications in IBD.
To evaluate the immunogenicity of pneumococcal and influenza vaccination in patients with IBD receiving different treatments.
We searched four databases for studies evaluating seroprotection and seroconversion rates after influenza or pneumococcal vaccination in IBD on 20th October 2020. In the meta-analysis, odds ratios (OR) were calculated with 95% confidence intervals (CI).
We included twelve studies (1429 patients with IBD) in this meta-analysis. The seroconversion rate after pneumococcal vaccination and the seroprotection rate after influenza vaccination were not significantly lower in patients receiving conventional immunosuppressive treatment compared to the non-immunosuppressed patients. Meanwhile, the seroconversion rate following pneumococcal vaccine was significantly lower in patients with anti-TNF mono- or combination therapy (OR = 0.28, CI: 0.15-0.53, and OR = 0.27, CI: 0.15-0.49, respectively). In the analysis of patients with IBD on conventional immunosuppressive monotherapy versus anti-TNF therapy, the seroprotection rate after influenza immunization did not differ between patients receiving either anti-TNF mono-or combination therapy (OR = 1.45, CI: 0.62-3.38 and OR = 0.91, CI: 0.37-2.22, respectively).
Our data suggest that the immunization against Pneumococcus and influenza is safe and immunogenic despite immunosuppression.
炎症性肠病（IBD）患者感染风险较高。与流感和肺炎球菌感染相关的肺炎是IBD中最常见的感染相关并发症之一。
评估接受不同治疗的IBD患者接种肺炎球菌疫苗和流感疫苗的免疫原性。
2020年10月20日，我们在四个数据库中检索了评估IBD患者接种流感或肺炎球菌疫苗后血清保护率和血清转化率的研究。在荟萃分析中，计算优势比（OR）及95%置信区间（CI）。
本荟萃分析纳入了12项研究（1429例IBD患者）。与未接受免疫抑制治疗的患者相比，接受传统免疫抑制治疗的患者接种肺炎球菌疫苗后的血清转化率和接种流感疫苗后的血清保护率并无显著降低。同时，接受抗TNF单药或联合治疗的患者接种肺炎球菌疫苗后的血清转化率显著较低（OR分别为0.28，CI：0.15 - 0.53；以及OR为0.27，CI：0.15 - 0.49）。在对接受传统免疫抑制单药治疗与抗TNF治疗的IBD患者的分析中，接受抗TNF单药或联合治疗的患者接种流感疫苗后的血清保护率无差异（OR分别为1.45，CI：0.62 - 3.38；以及OR为0.91，CI：0.37 - 2.22）。
我们的数据表明，尽管存在免疫抑制，接种肺炎球菌疫苗和流感疫苗仍是安全且具有免疫原性的。
