title: The effect of sirolimus therapy on vaccine responses in transplant recipients.
abstract: Different immunosuppressant regimens vary in their effects on antibody responses to vaccination. The combination of prednisolone and azathioprine has only a minor effect, whereas the addition of ciclosporin attenuates protective antibody responses to influenza vaccination. The effect of sirolimus, a new immunosuppressant, on vaccine responses has been little studied. Thirty-two hepatic or renal transplant patients randomized to calcineurin inhibitor-based or sirolimus-based immunosuppression were vaccinated against influenza and pneumococcus. Following tri-valent influenza vaccination, a similar rise in antibody titer occurred in sirolimus and calcineurin inhibitor (CNI) treated patients, though sirolimus treated patients developed a 'protective' titer to more influenza antigens. The pneumococcal polysaccharide vaccine was equally effective in both groups. Hence, vaccination guidelines in place for CNI treated patients are likely to be appropriate for transplant recipients maintained on sirolimus.
authors.affiliation: Cambridge Institute for Medical Research, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Hills Road, Cambridge, UK.
authors.forename: L C
authors.initials: LC
authors.lastname: Willcocks
authors.forename: A N
authors.initials: AN
authors.lastname: Chaudhry
authors.forename: J C
authors.initials: JC
authors.lastname: Smith
authors.forename: S
authors.initials: S
authors.lastname: Ojha
authors.forename: R
authors.initials: R
authors.lastname: Doffinger
authors.forename: C J E
authors.initials: CJ
authors.lastname: Watson
authors.forename: K G C
authors.initials: KG
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000942:Antigens, Bacterial / Q000276:immunology; D000956:Antigens, Viral / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000188:drug therapy* / Q000382:microbiology / Q000821:virology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology; D053122:Influenza A Virus, H3N2 Subtype / Q000276:immunology; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000517:prevention & control / Q000821:virology; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000382:microbiology / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D012189:Retrospective Studies; D020123:Sirolimus / Q000627:therapeutic use*; D013296:Streptococcus pneumoniae / Q000276:immunology; D016896:Treatment Outcome; D014611:Vaccination
chemical_list: D000942:Antigens, Bacterial; D000956:Antigens, Viral; D007166:Immunosuppressive Agents; D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines; D020123:Sirolimus