title: Control of humoral immunity and auto-immunity by the CXCR4/CXCL12 axis in lupus patients following influenza vaccine.
abstract: BACKGROUND
  CXCR4 is a chemokine receptor with multiple effects on the immune system, upregulated in patients with SLE, and correlated with disease severity.
  
  
  OBJECTIVE
  This study has investigated whether the levels of CXCR4 expressed on leucocyte subsets in lupus patients are correlated with the efficacy and the safety of the influenza vaccine.
  
  
  METHODS
  Twenty-seven patients were vaccinated and vaccine immunogenicity and tolerance were evaluated. CXCR4 was assayed on leucocyte subsets and correlated with clinical and immunological signs of diseases activity.
  
  
  RESULTS
  A significant increase in the titres of antibodies to the three viral strains was observed along with trends towards an increased vaccine efficacy in patients with quiescent disease vs patients with active disease. Recent flu vaccine history and, to a lesser extent, immunosuppressive treatment may influence vaccine immunogenicity. Influenza immunization was not associated with clinical side-effects or clinical lupus flare but with an increase in rheumatoid factor levels. Our study also confirms the correlation of CXCR4 expression with biological autoimmunity as shown by the correlation between the percentage of CXCR4-positive T cells and the ANA titres at D0, and the reverse correlation between CXCR4 expression and vaccine immunogenicity as demonstrated by the higher percentage of CXCR4-positive T cells at D0 and D30 in non-responders vs responders.
  
  
  CONCLUSIONS
  Altogether, our study confirms the efficacy and the safety of flu vaccine in SLE patients, highlights the role of CXCR4 as a surrogate marker for autoimmunity in lupus and shows that CXCR4 expression on T cells is predictive of vaccine efficacy in SLE patients.
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, 75679 Paris Cedex 14, France.
authors.forename: Odile
authors.initials: O
authors.lastname: Launay
authors.forename: Stéphane
authors.initials: S
authors.lastname: Paul
authors.forename: Amélie
authors.initials: A
authors.lastname: Servettaz
authors.forename: Gwénaëlle
authors.initials: G
authors.lastname: Roguet
authors.forename: Flore
authors.initials: F
authors.lastname: Rozenberg
authors.forename: Frédéric
authors.initials: F
authors.lastname: Lucht
authors.forename: Claude
authors.initials: C
authors.lastname: Lambert
authors.forename: Emilie
authors.initials: E
authors.lastname: Presles
authors.forename: Claire
authors.initials: C
authors.lastname: Goulvestre
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Méritet
authors.forename: Florence
authors.initials: F
authors.lastname: Galtier
authors.forename: Claude
authors.initials: C
authors.lastname: Dubray
authors.forename: Pierre
authors.initials: P
authors.lastname: Lebon
authors.forename: Bernard
authors.initials: B
authors.lastname: Weill
authors.forename: Frédéric
authors.initials: F
authors.lastname: Batteux
mesh_terms: D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D000917:Antibody Formation / Q000276:immunology; D054377:Chemokine CXCL12 / Q000096:biosynthesis / Q000276:immunology*; D005260:Female; D006801:Humans; D056724:Immunity, Humoral / Q000276:immunology; D007252:Influenza Vaccines / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use; D007251:Influenza, Human / Q000276:immunology* / Q000517:prevention & control; D016898:Interferon-alpha / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000276:immunology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019718:Receptors, CXCR4 / Q000096:biosynthesis / Q000276:immunology*; D013601:T-Lymphocytes / Q000276:immunology / Q000378:metabolism; D014611:Vaccination
chemical_list: D000914:Antibodies, Viral; C515255:CXCL12 protein, human; C527276:CXCR4 protein, human; D054377:Chemokine CXCL12; D007252:Influenza Vaccines; D016898:Interferon-alpha; D019718:Receptors, CXCR4
keywords: CXCR4; Influenza; Leucocytes; Systemic lupus erythematosus; Vaccine