Pandemic influenza immunization in primary antiphospholipid syndrome (PAPS): a trigger to thrombosis and autoantibody production?

Objective The objective of this report is to conduct short- and long-term evaluation of a large panel of antiphospholipid (aPL) autoantibodies following pandemic influenza A/H1N1 non-adjuvant vaccine in primary antiphospholipid syndrome (PAPS) patients and healthy controls. Methods Forty-five PAPS and 33 healthy controls were immunized with H1N1 vaccine. They were prospectively assessed at pre-vaccination, and three weeks and six months after vaccination. aPL autoantibodies were determined by an enzyme-linked immunosorbent assay (ELISA) and included IgG/IgM: anticardiolipin (aCL), anti-beta2glycoprotein I (anti-2GPI); anti-annexin V, anti-phosphatidyl serine and anti-prothrombin antibodies. Anti-Sm was determined by ELISA and anti-double-stranded DNA (anti-dsDNA) by indirect immunofluorescence. Arterial and venous thrombosis were also clinically assessed. Results Pre-vaccination frequency of at least one aPL antibody was significantly higher in PAPS patients versus controls (58% vs. 24%, p=0.0052). The overall frequencies of aPL antibody at pre-vaccination, and three weeks and six months after immunization remained unchanged in patients (p=0.89) and controls (p=0.83). The frequency of each antibody specificity for patients and controls remained stable in the three evaluated periods (p>0.05). At three weeks, two PAPS patients developed a new but transient aPL antibody (aCL IgG and IgM), whereas at six months new aPL antibodies were observed in six PAPS patients and none had high titer. Anti-Sm and anti-dsDNA autoantibodies were uniformly negative and no new arterial or venous thrombosis were observed throughout the study. Conclusions This is the first study to demonstrate that pandemic influenza vaccine in PAPS patients does not trigger short- and long-term thrombosis or a significant production of aPL-related antibodies (ClinicalTrials.gov, #NCT01151644).

Palavras-chave

Vaccine, antiphospholipid antibodies, pandemic influenza A, H1N1, antiphospholipid syndrome

URI

https://observatorio.fm.usp.br/handle/OPI/9042

Referências

Abu-Shakra M, 2002, CLIN RHEUMATOL, V21, P369, DOI 10.1007/s100670200099
Agmon-Levin N, 2009, ISR MED ASSOC J, V11, P183
Crowe SR, 2011, ARTHRITIS RHEUM-US, V63, P2396, DOI 10.1002/art.30388
Cruz-Tapias P, 2012, CURR OPIN RHEUMATOL, V24, P389, DOI 10.1097/BOR.0b013e32835448b8
Lu CC, 2011, VACCINE, V29, P444, DOI 10.1016/j.vaccine.2010.10.081
MEYER A, 2012, ISR MED ASSOC J, V12, P638
Perdan-Pirkmajer K, 2012, LUPUS, V21, P175, DOI 10.1177/0961203311429817
Porobic JM, 2005, CLIN EXP IMMUNOL, V142, P377, DOI 10.1111/j.1365-2249.2005.02923.x
Saad CGS, 2011, ANN RHEUM DIS, V70, P1068, DOI 10.1136/ard.2011.150250
Shoenfeld Y, 2011, J AUTOIMMUN, V36, P4, DOI 10.1016/j.jaut.2010.07.003
Silva CA, 2013, NAT REV RHEUMATOL, V9, P532, DOI 10.1038/nrrheum.2013.95
Silva CAA, 2010, REV BRAS REUMATOL, V50, P351, DOI 10.1590/S0482-50042010000400002
Urowitz MB, 2011, ARTHRIT CARE RES, V63, P1517, DOI 10.1002/acr.20599
van Assen S, 2011, ANN RHEUM DIS, V70, P414, DOI 10.1136/ard.2010.137216
Vista ES, 2012, LUPUS, V21, P168, DOI 10.1177/0961203311429554
Wilson WA, 1999, ARTHRITIS RHEUM, V42, P1309, DOI 10.1002/1529-0131(199907)42:7<1309::AID-ANR1>3.0.CO;2-F

Coleções

Artigos e Materiais de Revistas Científicas - FM/MPE
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/ICr
Artigos e Materiais de Revistas Científicas - LIM/17
Artigos e Materiais de Revistas Científicas - LIM/36

Carregar mais

Página do item completo