title: Effect of chronic human recombinant erythropoietin therapy on antibody responses to immunization in chronic hemodialysis patients.
abstract: There are multiple lines of evidence suggesting that human recombinant erythropoietin (rEPO) could influence immune responses by direct effects of rEPO on T or B cells. The present study tested this hypothesis by measuring antibody responses after immunization to tetanus toxoid (TT, a T cell dependent antigen) or pneumococcal capsular polysaccharide antigen (PA, a T cell independent antigen). The patients chosen for this prospective study were chronic hemodialysis patients receiving chronic rEPO therapy, and a comparable group of chronic hemodialysis patients not receiving rEPO therapy. We found that the patients immunized with PA and receiving rEPO therapy (N = 15) had IgG anti-PA responses comparable to that of those not receiving rEPO therapy (N = 15). In contrast, in the patients immunized with TT, those receiving rEPO (N = 15) developed significantly higher IgG anti-TT levels than those not receiving rEPO (N = 14) (time-group interaction P = 0.005). The peak difference between these groups was at two weeks, where the rEPO-treated patients developed a 4.1-fold mean increase in IgG anti-TT level and those not receiving rEPO developed only a 1.4-fold mean increase in IgG anti-TT level (P < 0.01). The difference in immune response to TT in the rEPO compared to the non-rEPO-treated patients could not be explained by differences between the groups in any of the parameters measured at baseline or during the post-immunization period. In conclusion, rEPO therapy increased immune response to TT but not PA, which suggests that rEPO enhances immune response to T cell dependent antigens.
authors.affiliation: Department of Internal Medicine, Ohio State University, Columbus, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Birmingham
authors.forename: X P
authors.initials: XP
authors.lastname: Shen
authors.forename: J A
authors.initials: JA
authors.lastname: Hartman
authors.forename: J J
authors.initials: JJ
authors.lastname: Dillon
authors.forename: L A
authors.initials: LA
authors.lastname: Hebert
mesh_terms: D000328:Adult; D000368:Aged; D000917:Antibody Formation / Q000187:drug effects*; D001428:Bacterial Vaccines / Q000276:immunology; D004921:Erythropoietin / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007114:Immunization; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000276:immunology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines; D011446:Prospective Studies; D011994:Recombinant Proteins; D006435:Renal Dialysis; D013296:Streptococcus pneumoniae / Q000276:immunology; D013745:Tetanus Toxoid / Q000276:immunology; D013997:Time Factors
chemical_list: D001428:Bacterial Vaccines; D022242:Pneumococcal Vaccines; D011994:Recombinant Proteins; D013745:Tetanus Toxoid; D004921:Erythropoietin