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Biomedical subjects

N Masurel

Publications and source records attributed to N Masurel.

At least 55 records · Page 3Linked to original sources
PubMed1989

Antibody induction by influenza vaccines in the elderly: a review of the literature.

Conflicting results have been reported concerning the association between high age and response to influenza vaccines. Some authors have found a reduced response in aged subjects, others have found no difference or even better results as compared with younger control subjects. Seventeen papers were selected from international literature published in the period 1968-1988 for a review of the anti-haemagglutinin-IgG sero-response following vaccination: among 30 cases in which vaccine components could be studied independently, ten revealed a better immune response in young subjects than in the elderly, four found more favourable results in the elderly, and 16 could not detect any significant between-group-differences, the latter most probably because of a high type-2-error. Nine of these 16 cases tended to favour young subjects. These results were relativated by the finding that each paper had at least one of three methodological limitations: (1) the failure to exclude subjects with illnesses or using drugs influencing the immune system, (2) the failure to exclude subjects with previous vaccinations against influenza, (3) the failure to exclude subjects with high prevaccination antibody titres. The direction of these biases is such that failure to address any one issue will lead to an underestimate of the response of aged subjects. In view of the failure to control these biases, it was not surprising that the papers reviewed presented a heterogeneous picture. Thus, the association between high age per se and response to influenza vaccines, if any, has not yet been established. Suggestions are made for future studies in which admission criteria should control health state and previous exposure to influenza antigens.

Aged↗
PubMed1989

Influenza mortality and excess deaths in the elderly, 1967-82.

This study assessed the influence of influenza on mortality from heart and lung diseases in people over 70 years of age. The data used were obtained from the Dutch Bureau of Statistics. With a regression model, the observed monthly mortality from heart and lung diseases (influenza not included) in people over 70 years is explained with a yearly variable, a monthly variable and the overall monthly number of influenza mortality cases, assuming that monthly mortality has a Poisson distribution. The monthly excess mortality from heart and lung diseases (influenza not included) due to influenza among elderly people (greater than 70 years) is estimated. This study suggests that 1400 deaths per million per year were due to influenza in people over 70 years of age in the study period of 16 years. It can be concluded that one influenza death in the population over 70 years 'generates' almost two deaths diagnosed as heart and lung diseases in the elderly.

Aged↗
PubMed1989

Humoral immune response to influenza vaccination in patients with primary immunoglobulin A nephropathy. An analysis of isotype distribution and size of the influenza-specific antibodies.

Primary IgA nephropathy (IgAN) is characterized by mesangial deposits of IgA1, increased serum IgA1 levels, and circulating immune complexes containing predominantly IgA1. It has previously been found that patients with IgAN have a higher than normal IgA response to vaccination, but the IgA subclasses have not been studied. To investigate whether the IgA hyperresponsiveness is limited to the subclass IgA1, which is involved in the pathogenesis of IgAN, we compared the immune responses of 18 patients with 22 healthy controls after intramuscular vaccination with inactivated influenza virus. Antibody titers were significantly higher (P less than 0.0001) for the IgA1 subclass in patients versus controls, but not for the other isotypes. A substantial portion of the IgA and IgA1 antiinfluenza immune response comprised polymers in both patients and controls. There was no preferential response of polymers in patients. Patients produced significantly more monomeric IgA1 antibodies than controls. These results show that patients with IgAN have a hyperresponsiveness limited to the subclass IgA1 and mainly expressed by an excess of monomers.

Adult↗
PubMed1989

Cytotoxic T-cell response to influenza A subunit vaccine in patients with type 1 diabetes mellitus.

The cytotoxic T-cell and humoral immune response to a commercially available influenza A-H1N1 subunit vaccine in 14 patients with type 1 diabetes mellitus was compared with the response in 13 healthy volunteers. Cytotoxic T-cell response to vaccination was poor in both patients and controls. At a calculated 50: 1 effector-target cell ratio, however, significantly more controls than patients showed an increase of over 5% cytotoxic T-cell mediated lysis after vaccination (P less than 0.05). In patients the cytotoxic T-cell response decreased with higher percentages of glycosylated haemoglobin (regression coefficient not equal to 0 with P less than 0.05). No significant difference was found between diabetic patients and control subjects with respect to antibody response after vaccination. Implications for vaccination strategy are discussed.

Adult↗
PubMed1988

Low dose intradermal vaccination against hepatitis B in mentally retarded patients.

Ninety-two patients and 28 staff members of an institute for mentally retarded patients were immunized intradermally with 2 microgram doses hepatitis B vaccine (HB-Vax), initially at month 0 and 1, and after evaluation followed by two booster injections at month 5 and 10, respectively. Blood samples were taken at months 2 and 11. Seroconversion rates of the two groups were similar on both occasions. Titre distributions for mentally retarded patients and staff members corrected for age, side effects and sex using multiple regression were significantly different at month 2 (p = 0.05) but not at month 11. Geometric mean titres for mentally retarded patients and staff members were 39 and 67 at month 2, respectively, and 1082 and 672 IU l-1 at month 11, respectively. Percentage anti-HBs/a(w) differed significantly between patients and staff members. Side effects, largely local (pigmentation), were observed with a frequency of about 35% in both mentally retarded patients and staff members. Since 92% of the mentally retarded patients had anti-HBs titres greater than 10 IU l-1 and approximately equal to 80% greater than 100 IU l-1, low dose vaccination, four injections by intradermal route, seems to be a suitable cost-reducing immunization system in institutes for mentally retarded patients.

Female↗
PubMed1988

Intact humoral immune response in patients on continuous ambulatory peritoneal dialysis.

After influenza vaccination no statistically significant difference in antibody response was observed between patients on continuous ambulatory peritoneal dialysis (CAPD) and healthy volunteers while a large group of hemodialysis (HD) patients was found to have a significantly lower response rate. This difference remained statistically significant when CAPD patients were compared to a matched HD group. As the antibody formation after influenza vaccination is a T cell-dependent phenomenon, the normal immune response to vaccination suggests an intact humoral and cellular immunity in CAPD patients.

Adolescent↗
PubMed1987

Humoral immune response and delayed type hypersensitivity to influenza vaccine in patients with diabetes mellitus.

The antibody response and delayed type hypersensitivity reaction to commercially available trivalent influenza vaccine in 159 patients with diabetes mellitus was compared with response and reaction in 28 healthy volunteers. A correction for prevaccination titres was made. No differences were found between diabetic patients and control subjects with respect to antibody response to the three vaccine strains as measured by the difference between geometric mean titres of post- and prevaccination sera. In Type 1 (insulin-dependent) diabetic patients the incidence of non-responders to two vaccine components was significantly increased (p less than 0.05). The delayed type hypersensitivity reaction to influenza antigen was significantly decreased in patients with high concentrations of glycosylated haemoglobin (p less than 0.01). These findings suggest a role for impaired immune response in the increased influenza morbidity and mortality in patients with diabetes mellitus. Implications for therapy and vaccination strategy are discussed.

Antibody Formation↗
PubMed1987

Influenza A and B antibody status in Tanzania.

Sera from 200 babies and young children and from 205 mother-newborn pairs were tested for haemagglutination inhibiting antibody against three A-H1N1, one A-H2N2, four A-H3N2, and two influenza B viruses. The results indicated that a higher concentration of antibody against all influenza A and B viruses tested was found more frequently in maternal sera than in neonatal sera. High prevalences of antibody and high geometric mean titres against the A-H2N2-1957 and A-H3N2-1968 viruses from the eras 1957-1968 and 1968-now, respectively, were found in the age groups above 15 years. The antibodies against former and recent epidemic influenza viruses of the A-H3N2 subtype, found among different adult age groups in Mwanza, Tanzania, showed a pattern similar to that in the population of The Netherlands.

Antibodies, Viral↗
PubMed1987

Trivalent influenza vaccine in patients on haemodialysis: impaired seroresponse with differences for A-H3N2 and A-H1N1 vaccine components.

One hundred and one patients on haemodialysis, 21 patients on peritoneal dialysis and 30 healthy controls received a trivalent split vaccine containing 15 micrograms haemagglutinin of a recent influenza A-H3N2, influenza A-H1N1 and influenza B strain, respectively. Antibody production after four weeks was determined by the haemagglutination-inhibition test and expressed as response rate, protection rate and overall mean fold increase. The patients on haemodialysis revealed a diminished seroresponse, as compared to patients on peritoneal dialysis and controls. For influenza A-H3N2, this was less distinct than for the other two antigens. In patients on haemodialysis the protection rate was 66% against the A-H3N2 vaccine component (versus 85% in controls, not significant), but only 25% against A-H1N1 and 27% against B (versus 84 and 77% in controls, p less than 0.001). Duration of haemodialysis up to eight years did not affect seroresponse. Patients on haemodialysis who were primed for influenza A-H1N1 in the period 1947-1957, reacted markedly better to the A-H1N1 vaccine component than subjects of other priming periods. A booster injection of the same vaccine dosage four weeks after the first immunization, performed in 98 patients on haemodialysis, was of little value: it had virtually no effect with regard to influenza A-H1N1 and influenza B, and showed, though significantly better, still poor results for A-H3N2. The differences in seroresponse between the A-H3N2 and A-H1N1 vaccine component suggest a major defect of primary, and a minor defect of secondary humoral response in patients on haemodialysis. The consequences for vaccine policy in these patients are discussed.

Adolescent↗
PubMed1986

Mononuclear subsets during cytomegalovirus disease in renal transplant recipients treated with cyclosporine and rabbit antithymocyte globulin.

The effect of cytomegalovirus (CMV) disease on mononuclear subpopulations of 49 renal transplant recipients treated with cyclosporine and prednisone are reported. Clinical overt CMV infection developed in 8/21 patients treated for rejection with rabbit antithymocyte globulin. They all showed true inversions of the T helper/T suppressor-cytotoxic (Th/Ts-c) ratio. A reduction of T helper cells and increase in T suppressor-cytotoxic cells preceded clinical symptoms of CMV disease by one week. None of the 26 patients without RATG anti-rejection treatment developed CMV disease and in only three of them an inversion of Th/Ts-c ratio was found.

Antilymphocyte Serum↗
PubMed1986

Immunoglobulin G, A and M response to influenza vaccination in different age groups: effects of priming and boosting.

Fifty volunteers, treated with an inactivated trivalent influenza vaccine containing A/Bangkok/1/79 (H3N2), A/Brazil/11/78 (H1N1) and B/Singapore/222/79 virus, were subdivided according to the estimated first exposure to influenza in their lifetime (priming) and the presence of antibodies against the vaccine components in the pre-vaccination sera. The isotypic antibody response (IgG, IgA, IgM) was determined by means of an antibody capture haemadsorption immunosorbent technique. For all three vaccine components, previously seropositive subjects produced antibodies of the IgG- and IgA-class more frequently than previously seronegative persons. Subjects primed to one of the influenza A subtypes showed more IgG and IgA responses in comparison with those unprimed (prime-effect). In contrast, IgM antibodies occurred in only 19 and 11% of primed, but in 59 and 54% of unprimed subjects, for A (H3N2) and A (H1N1), respectively. The incidence of IgM titre rises was not influenced by the prevaccination state. However, the mean magnitude of anti-A (H1N1)-IgM titre rises was greater in those previously seronegative. The concepts of primary and reinfection and of 'original antigenic sin' are discussed, and it is suggested that age and, if possible, serological state prior to antigen-exposure should be taken into account when studying isotypic antibody responses after influenza infection or vaccination.

Adolescent↗
PubMed1986

Impairment of the immune response to influenza vaccination in renal transplant recipients by cyclosporine, but not azathioprine.

Influenza vaccination has been strongly recommended for immunosuppressed renal transplant recipients. However, immunosuppression may lead to impaired antibody responses. We studied the antibody response to an inactivated trivalent influenza vaccine in 59 renal transplant recipients with life-sustaining kidney function: 21 were on cyclosporine and prednisone, 38 on azathioprine and prednisone. Healthy volunteers (n = 29) and patients on hemodialysis (n = 28) served as controls. Despite comparable renal allograft function, cyclosporine-treated patients had a significantly lower immune response against influenza A viruses than azathioprine-treated patients, whether mean antibody levels, fourfold titer rise, or seroconversion to protective titers was analyzed. No significant differences in antibody responses were found between healthy controls and patients on azathioprine. The patients on hemodialysis showed an impaired response to vaccination. However, in contrast to the cyclosporine-treated patients, booster immunization proved valuable in this group.

Adult↗