title: Hepatitis B vaccine in celiac disease: yesterday, today and tomorrow.
abstract: Some studies showed that in celiac patients the immunological response to vaccination is similar to that one found in general population except for vaccine against hepatitis B virus (HBV). The non-responsiveness to HBV vaccine has also been described in healthy people, nevertheless the number of non-responders has been demonstrated to be higher in celiac disease (CD) patients than in healthy controls. Several hypothesis explaining this higher rate of unresponsiveness to HBV vaccine in CD patients have been described, such as the genetic hypothesis, according with CD patients carrying the disease-specific haplotype HLA-B8, DR3, and DQ2, show a lower response to HBV vaccine both in clinical expressed CD patients and in healthy people carrying the same haplotype. On the other hand, it has been demonstrated that the gluten intake during the vaccination seems to influence the response to the same vaccine. Moreover, it has been demonstrated a possible genetic predisposition to hepatitis B vaccine non-responsiveness likely due to the presence of specific human leukocyte antigen haplotypes and specific single nucleotide polymorphism in genes of cytokine/cytokine receptors and toll like receptors, but the pathogenic mechanism responsible for this low responsiveness still remains unclear. The aim of this review is to focus on the possible pathogenic causes of unresponsiveness to HBV vaccine in CD patients and to propose an alternative vaccination schedule in order to improve the responsiveness to HBV vaccine in this at-risk patients.
authors: Department of Pediatrics, University of Catania, 95100 Catania, Italy.
authors: Giovanna
authors: G
authors: Vitaliti
authors: Andrea Domenico
authors: AD
authors: Praticò
authors: Carla
authors: C
authors: Cimino
authors: Giovanna
authors: G
authors: Di Dio
authors: Elena
authors: E
authors: Lionetti
authors: Mario
authors: M
authors: La Rosa
authors: Salvatore
authors: S
authors: Leonardi
mesh_terms: D002446:Celiac Disease / Q000453:epidemiology / Q000266:history / Q000276:immunology*; D006509:Hepatitis B / Q000453:epidemiology / Q000266:history / Q000276:immunology / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000266:history / Q000276:immunology; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007115:Immunization Schedule; D012307:Risk Factors; D017211:Treatment Failure; D014611:Vaccination / Q000266:history / Q000639:trends
chemical_list: D017325:Hepatitis B Vaccines
keywords: Celiac disease; Hepatitis B vaccine; Non responders; Vaccination schedules