Lupus Factors Tied to Weak Response to Influenza Vaccine

Ethnicity, prednisone treatment, increased disease flares linked to low antibody response

THURSDAY, May 26 (HealthDay News) -- Patients with systemic lupus erythematosus (SLE), particularly those with a history of hematological disorder or taking prednisone, may have a low antibody response to influenza vaccination, according to a study published online May 19 in Arthritis & Rheumatism.

Sherry R. Crowe, Ph.D., from the Oklahoma Medical Research Foundation in Oklahoma City, and colleagues assessed the influence of clinical, serological, demographic, and therapeutic factors on the response to influenza vaccination in 72 patients with SLE. Blood samples and information on disease activity were obtained at baseline and two, six, and 12 weeks after vaccination. Antibody concentration, relative affinity, and hemagglutination inhibition were assessed to give a cumulative score for influenza-specific antibody responses, and patients were divided into low and high responders. At each time point, autoantibody levels were evaluated.

The investigators found that low responders were significantly more likely to have hematological manifestations (P = 0.05), show more American College of Rheumatology SLE criteria (P = 0.04), and currently be treated with prednisone (P = 0.04). Compared to African-Americans, European-American patients had a significantly increased likelihood of being low responders. After vaccination, low responders had a significantly increased likelihood of experiencing disease flares and having increased antinuclear antibody titers. Patients who experienced a flare after vaccination had significantly higher baseline serum interferon alpha activity compared to a matched group of patients who did not experience a flare.

"Ancestral background, prednisone treatment, hematological criteria and evidence of increased disease flares were associated with low antibody responses to influenza vaccination in SLE patients," the authors write.

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