PT  - JOURNAL ARTICLE
AU  - Urban Sester
AU  - Tina Schmidt
AU  - Martin Kuhlmann
AU  - Barbara Gärtner
AU  - Heike Uhlmann-Schiffler
AU  - Martina Sester
TI  - Serial influenza-vaccination reveals impaired maintenance of specific T-cell memory in patients with end-stage renal failure
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P1885
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P1885.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P1885.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - To investigate correlates for the well-known impaired response of hemodialysis-patients to a variety of recommended vaccinations, the induction of antigen-specific cellular and humoral immunity was characterised after influenza-vaccination in two following seasons where the identical vaccine-composition was used.Influenza-specific T-cells were flow-cytometrically characterised from whole blood of 24 healthy controls and 26 hemodialysis-patients by proliferation assays, induction of IFN-γ and TNF-α, and maturation markers. Antibody-titers were quantified using ELISA and hemagglutinaton inhibiton test.Influenza-specific T-cells significantly increased 1-2 weeks after primary vaccination in both controls (by 0.50±0.64%) and patients (by 0.55±0.71%). Thereafter, T-cell levels decreased within 7 weeks, whereas antibody-titers were more stable. By 6 months, patients had lower precursor-frequencies of proliferating influenza-specific memory T-cells (p=0.006). In the following season, controls showed a less pronounced increase in cellular immunity after re-vaccination (by only 0.12±0.09%, p=0.003), whereas the vaccine induced a strong increase in a 2nd group of vaccination-naïve controls. Of note, patients responded like vaccination-naïve individuals, as the T-cell increase after re-vaccination was as pronounced as in the year before.The less pronounced T-cell increase after re-vaccination in controls may indicate maintainance of sufficient immunological memory. In contrast, the more rapid loss of proliferating cells in hemodialysis-patients may contribute to an increased incidence of recurrent infectious complications.