title: Clinical factors associated with the humoral immune response to influenza vaccination in chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  Individuals with chronic obstructive pulmonary disease (COPD) are at a high risk of developing significant complications from infection with the influenza virus. It is therefore vital to ensure that prophylaxis with the influenza vaccine is effective in COPD. The aim of this study was to assess the immunogenicity of the 2010 trivalent influenza vaccine in persons with COPD compared to healthy subjects without lung disease, and to examine clinical factors associated with the serological response to the vaccine.
  
  
  METHODS
  In this observational study, 34 subjects (20 COPD, 14 healthy) received the 2010 influenza vaccine. Antibody titers at baseline and 28 days post-vaccination were measured using the hemagglutination inhibition assay (HAI) assay. Primary endpoints included seroconversion (≥4-fold increase in antibody titers from baseline) and the fold increase in antibody titer after vaccination.
  
  
  RESULTS
  Persons with COPD mounted a significantly lower humoral immune response to the influenza vaccine compared to healthy participants. Seroconversion occurred in 90% of healthy participants, but only in 43% of COPD patients (P=0.036). Increasing age and previous influenza vaccination were associated with lower antibody responses. Antibody titers did not vary significantly with cigarette smoking, presence of other comorbid diseases, or COPD severity.
  
  
  CONCLUSIONS
  The humoral immune response to the 2010 influenza vaccine was lower in persons with COPD compared to non-COPD controls. The antibody response also declined with increasing age and in those with a history of prior vaccination.
authors.affiliation: The University of Queensland (School of Medicine), Brisbane, QLD, Australia ; Princess Alexandra Hospital, Brisbane, QLD, Australia.
authors.forename: Karthik D
authors.initials: KD
authors.lastname: Nath
authors.affiliation: The University of Queensland (School of Medicine), Brisbane, QLD, Australia.
authors.forename: Julie G
authors.initials: JG
authors.lastname: Burel
authors.affiliation: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Shankar
authors.affiliation: The University of Queensland (School of Medicine), Brisbane, QLD, Australia.
authors.forename: Antonia L
authors.initials: AL
authors.lastname: Pritchard
authors.affiliation: Princess Alexandra Hospital, Brisbane, QLD, Australia.
authors.forename: Michelle
authors.initials: M
authors.lastname: Towers
authors.affiliation: The University of Queensland (School of Medicine), Brisbane, QLD, Australia ; Princess Alexandra Hospital, Brisbane, QLD, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Looke
authors.affiliation: The University of Queensland (School of Medicine), Brisbane, QLD, Australia.
authors.forename: Janet M
authors.initials: JM
authors.lastname: Davies
authors.affiliation: The University of Queensland (School of Medicine), Brisbane, QLD, Australia ; Princess Alexandra Hospital, Brisbane, QLD, Australia.
authors.forename: John W
authors.initials: JW
authors.lastname: Upham
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006386:Hemagglutination Tests; D006801:Humans; D056724:Immunity, Humoral; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D007252:Influenza Vaccines / Q000276:immunology*; D007251:Influenza, Human / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D012720:Severity of Illness Index; D014611:Vaccination
chemical_list: D000914:Antibodies, Viral; D015415:Biomarkers; D007252:Influenza Vaccines
keywords: COPD; human influenza; humoral immunity; influenza vaccines; vaccination