Cell-mediated immune response to influenza vaccination in lung transplant recipients.
BACKGROUND
Lung transplant recipients are susceptible to complications from influenza infection. Antibody responses to influenza vaccination have been shown to be decreased in lung transplant recipients. Cellular immune mechanisms serve an important role in influenza clearance. The cellular immune response to influenza vaccination has not been studied in transplant populations.


METHODS
Interleukin-2, interleukin-10, interferon-gamma, and granzyme B levels to the three viral antigens included in the 1999 to 2000 influenza vaccine were measured before and 4 weeks post-vaccination in 43 lung transplant recipients and 21 healthy adult controls.


RESULTS
Interleukin-2, interleukin-10, interferon-gamma, and granzyme B levels did not increase from pre- to post-vaccination in the lung transplant group. Both pre- and post-cytokine levels were lower in the transplant group compared to the control group. Pre- and post-granzyme B levels did not differ significantly between the groups. The T-helper response in the control group varied with the different viral strains. A correlation between acute rejection episodes and the absence of both azathioprine and mycophenolate was found.


CONCLUSIONS
Influenza vaccination does not stimulate a cell-mediated immune response in lung transplant recipients as judged by interleukin-2, interleukin-10, interferon-gamma, and granzyme B levels. Alternative prevention strategies may be needed.
Department of Pulmonary and Critical Care Medicine, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. mazzonp@ccf.org
Peter J
PJ
Mazzone
Sherif B
SB
Mossad
Steven D
SD
Mawhorter
Atul C
AC
Mehta
Janet R
JR
Mauer
D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D053804:Granzymes; D006801:Humans; D007111:Immunity, Cellular; D007252:Influenza Vaccines / Q000008:administration & dosage; D007371:Interferon-gamma / Q000276:immunology; D016753:Interleukin-10 / Q000276:immunology; D007376:Interleukin-2 / Q000276:immunology; D016040:Lung Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012697:Serine Endopeptidases / Q000276:immunology; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology
D007252:Influenza Vaccines; D007376:Interleukin-2; D016753:Interleukin-10; D007371:Interferon-gamma; C509213:GZMB protein, human; D053804:Granzymes; D012697:Serine Endopeptidases