title: C-reactive protein response to influenza vaccination as a model of mild inflammatory stimulation in the Philippines.
abstract: BACKGROUND
  C-reactive protein (CRP) is increasingly measured as a marker of systemic inflammation that predicts elevated risk for cardiovascular disease. Influenza vaccination is a mild pro-inflammatory stimulus, and the CRP response to vaccination may provide additional information on individual differences in inflammatory response and risk for disease.
  
  
  OBJECTIVE
  To document the pattern of CRP response to influenza vaccination among a large sample of older women in the Philippines. The Philippines exemplifies current global trends toward increasing rates of overweight/obesity, but also maintains relatively high rates of infectious disease. The secondary aim of the study is to investigate the impact of infectious symptoms on the pattern of response to vaccination.
  
  
  METHODS
  A community-based sample of 934 women (mean age=55.4 years) received the influenza vaccine. CRP was assessed at baseline and 72h post-vaccination. Descriptive, non-parametric, and parametric analyses were implemented to assess the magnitude of CRP response, and to investigate whether responses were associated with baseline CRP or the presence of infectious symptoms prior to vaccination.
  
  
  RESULTS
  Influenza vaccination resulted in a statistically significant CRP response of 0.35mg/L (p<0.001), representing a 30.2% increase from baseline. For individuals with symptoms of infectious disease at baseline, the CRP response was smaller (12.9%) and not statistically significant (p=0.77). Lower CRP at baseline was associated with larger CRP response to vaccination in the entire sample, and among participants without recent symptoms of infection.
  
  
  CONCLUSIONS
  Influenza vaccination produces a mild CRP response in the Philippines. This study extends prior research in US and European populations validating influenza vaccination as an in vivo model for investigating the dynamics of inflammation, but also raises potential complications in settings where rates of infectious disease are elevated.
authors: Department of Anthropology, Northwestern University, Evanston, IL 60208, United States; Cells to Society (C2S): The Center on Social Disparities and Health, Institute for Policy Research, Northwestern University, Evanston, IL 60208, United States. Electronic address: t-mcdade@northwestern.edu.
authors: Thomas W
authors: TW
authors: McDade
authors: Office of Population Studies Foundation and Department of Nutrition and Dietetics, University of San Carlos, Cebu City, Philippines.
authors: Judith B
authors: JB
authors: Borja
authors: Department of Anthropology, Northwestern University, Evanston, IL 60208, United States; Cells to Society (C2S): The Center on Social Disparities and Health, Institute for Policy Research, Northwestern University, Evanston, IL 60208, United States.
authors: Christopher W
authors: CW
authors: Kuzawa
authors: Office of Population Studies Foundation and Department of Nutrition and Dietetics, University of San Carlos, Cebu City, Philippines.
authors: Tita Lorna L
authors: TL
authors: Perez
authors: Carolina Population Center and Department of Nutrition, University of North Carolina, Chapel Hill, NC, United States.
authors: Linda S
authors: LS
authors: Adair
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000032:analysis*; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006801:Humans; D007249:Inflammation; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology*; D008875:Middle Aged; D010679:Philippines; D014611:Vaccination
chemical_list: D015415:Biomarkers; D007252:Influenza Vaccines; D002097:C-Reactive Protein
keywords: C-reactive protein; Inflammation; Influenza vaccination