TY - JOUR
T1 - Immune response to influenza vaccination in children and adults with asthma
T2 - Effect of corticosteroid therapy
AU - Hanania, Nicola A.
AU - Sockrider, Marianna
AU - Castro, Mario
AU - Holbrook, Janet T.
AU - Tonascia, James
AU - Wise, Robert
AU - Atmar, Robert L.
N1 - Funding Information:
The Asthma Clinical Research Centers investigators would like to thank David M. Shade, JD, RPFT, for his help in compiling the data for this project, the American Lung Association, and the following organizations that provided grant support for this study: the American Lung Associations of Alabama, Central Florida, Colorado, Delaware, Eastern Missouri, Florida, Georgia, Gulfcoast Florida, Hudson Valley, Indiana, Louisiana, Maine, Metropolitan Chicago, Mid-Ohio, Minnesota, Nassua-Suffolk, New Hampshire, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, South Florida, Southeast Florida, Texas, Vermont, Western Missouri, Wisconsin, Finger Lakes, Greater Norfolk County, Hawaii, Middlesex County, New York State, Northern Rockies, Queens, Western Massachusetts, and Virginia; Baylor College of Medicine; the Thalheim Family; Duke University; Ernest N. Morial Asthma; Allergy and Respiratory Disease Center; the Merck Foundation; and Glaxo-Smith Kline.
PY - 2004/4
Y1 - 2004/4
N2 - Background: Annual influenza vaccination is currently recommended as a preventative measure for all patients with asthma. However, the effect of maintenance corticosteroid therapy on the immune response to influenza vaccine has received limited evaluation. Objective: In this study, we evaluated the effect of corticosteroid therapy on the immune response to influenza vaccine in children and adults with asthma. Methods: This was a substudy of a larger multicenter, randomized, double-masked, placebo-controlled, crossover study investigating the safety of trivalent influenza vaccine in patients with asthma. At baseline, 294 subjects were randomized to receive either placebo first (n = 139) or inactivated trivalent split-virus influenza vaccine first (n = 155). Study subjects were categorized into 2 groups: subjects in group 1 (n = 148) were receiving medium-dose or high-dose inhaled corticosteroids (ICSs) or oral corticosteroids, whereas subjects in group 2 (n = 146) were not receiving corticosteroids or were receiving low-dose ICSs. Serum hemagglutination inhibition antibody titers for the vaccine antigens were measured before and 4 weeks after the administration of placebo or vaccine. Results: Serologic responses to each influenza vaccine antigen were significantly higher in vaccine than in placebo recipients and were similar among influenza vaccine recipients in groups 1 and 2 for the following endpoints: rise in antibody titer, percent of participants who developed a serological response, and percent of subjects who developed a serum hemagglutination inhibition antibody titer ≥1:32. Post hoc subgroup analyses demonstrated an attenuated response to influenza B antigen in subjects receiving high-dose ICS compared with subjects who were steroid-naïve (P < .05). Conclusion: The immune response to the A antigens of the inactivated influenza vaccine in subjects with asthma is not adversely affected by ICS therapy. High-dose ICS therapy may diminish the response to the B antigen of the vaccine, an observation that needs further investigation.
AB - Background: Annual influenza vaccination is currently recommended as a preventative measure for all patients with asthma. However, the effect of maintenance corticosteroid therapy on the immune response to influenza vaccine has received limited evaluation. Objective: In this study, we evaluated the effect of corticosteroid therapy on the immune response to influenza vaccine in children and adults with asthma. Methods: This was a substudy of a larger multicenter, randomized, double-masked, placebo-controlled, crossover study investigating the safety of trivalent influenza vaccine in patients with asthma. At baseline, 294 subjects were randomized to receive either placebo first (n = 139) or inactivated trivalent split-virus influenza vaccine first (n = 155). Study subjects were categorized into 2 groups: subjects in group 1 (n = 148) were receiving medium-dose or high-dose inhaled corticosteroids (ICSs) or oral corticosteroids, whereas subjects in group 2 (n = 146) were not receiving corticosteroids or were receiving low-dose ICSs. Serum hemagglutination inhibition antibody titers for the vaccine antigens were measured before and 4 weeks after the administration of placebo or vaccine. Results: Serologic responses to each influenza vaccine antigen were significantly higher in vaccine than in placebo recipients and were similar among influenza vaccine recipients in groups 1 and 2 for the following endpoints: rise in antibody titer, percent of participants who developed a serological response, and percent of subjects who developed a serum hemagglutination inhibition antibody titer ≥1:32. Post hoc subgroup analyses demonstrated an attenuated response to influenza B antigen in subjects receiving high-dose ICS compared with subjects who were steroid-naïve (P < .05). Conclusion: The immune response to the A antigens of the inactivated influenza vaccine in subjects with asthma is not adversely affected by ICS therapy. High-dose ICS therapy may diminish the response to the B antigen of the vaccine, an observation that needs further investigation.
KW - Antibodies
KW - Asthma
KW - Immune response
KW - Influenza
KW - Inhaled corticosteroids
KW - Vaccination
UR - http://www.scopus.com/inward/record.url?scp=1942467810&partnerID=8YFLogxK
U2 - 10.1016/j.jaci.2003.12.584
DO - 10.1016/j.jaci.2003.12.584
M3 - Article
C2 - 15100679
AN - SCOPUS:1942467810
SN - 0091-6749
VL - 113
SP - 717
EP - 724
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
IS - 4
ER -