title: Humoral and cellular immune responses after influenza vaccination in patients with postcancer fatigue.
abstract: The aim of this study was to compare humoral and cellular immune responses to influenza vaccination in cancer survivors with and without severe symptoms of fatigue. Severely fatigued (n = 15) and non-fatigued (n = 12) disease-free cancer survivors were vaccinated against seasonal influenza. Humoral immunity was evaluated at baseline and post-vaccination by a hemagglutination inhibition assay. Cellular immunity was evaluated at baseline and post-vaccination by lymphocyte proliferation and activation assays. Regulatory T cells were measured at baseline by flow cytometry and heat-shock protein 90 alpha levels by ELISA. Comparable humoral immune responses were observed in fatigued and non-fatigued patients, both pre- and post-vaccination. At baseline, fatigued patients showed a significantly diminished cellular proliferation upon virus stimulation with strain H3N2 (1414 ± 1201 counts), and a trend in a similar direction with strain H1N1 (3025 ± 2339 counts), compared to non-fatigued patients (3099 ± 2401 and 5877 ± 4604 counts, respectively). The percentage of regulatory T lymphocytes was significantly increased (4.4 ± 2.1% versus 2.4 ± 0.8%) and significantly lower amounts of interleukin 2 were detected prior to vaccination in fatigued compared to non-fatigued patients (36.3 ± 44.3 pg/ml vs. 94.0 ± 45.4 pg/ml with strain H3N2 and 28.4 ± 44.0 pg/ml versus 74.5 ± 56.1 pg/ml with strain H1N1). Pre-vaccination heat-shock protein 90 alpha concentrations, post-vaccination cellular proliferation, and post-vaccination cytokine concentrations did not differ between both groups. In conclusion, influenza vaccination is favorable for severely fatigued cancer survivors and should be recommended when indicated. However, compared to non-fatigued cancer survivors, fatigued cancer survivors showed several significant differences in immunological reactivity at baseline, which warrants further investigation.
authors.affiliation: a Department of Medical Oncology; Radboud University Medical Center ; Nijmegen , the Netherlands.
authors.forename: Hetty
authors.initials: H
authors.lastname: Prinsen
authors.forename: Hanneke W M
authors.initials: HW
authors.lastname: van Laarhoven
authors.forename: Jeanette M
authors.initials: JM
authors.lastname: Pots
authors.forename: Tjitske
authors.initials: T
authors.lastname: Duiveman-de Boer
authors.forename: Sasja F
authors.initials: SF
authors.lastname: Mulder
authors.forename: Carla M L
authors.initials: CM
authors.lastname: van Herpen
authors.forename: Joannes F M
authors.initials: JF
authors.lastname: Jacobs
authors.forename: Jan Willem H
authors.initials: JW
authors.lastname: Leer
authors.forename: Gijs
authors.initials: G
authors.lastname: Bleijenberg
authors.forename: Foekje F
authors.initials: FF
authors.lastname: Stelma
authors.forename: Ruurd
authors.initials: R
authors.lastname: Torensma
authors.forename: I Jolanda M
authors.initials: IJ
authors.lastname: de Vries
mesh_terms: D000293:Adolescent; D000328:Adult; D016207:Cytokines / Q000276:immunology; D005221:Fatigue / Q000209:etiology / Q000276:immunology*; D005260:Female; D018841:HSP90 Heat-Shock Proteins / Q000097:blood; D006385:Hemagglutination Inhibition Tests; D006801:Humans; D007111:Immunity, Cellular; D056724:Immunity, Humoral; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology; D053122:Influenza A Virus, H3N2 Subtype / Q000276:immunology; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000276:immunology*; D007251:Influenza, Human / Q000517:prevention & control; D007376:Interleukin-2 / Q000276:immunology; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D050378:T-Lymphocytes, Regulatory / Q000276:immunology; D055815:Young Adult
chemical_list: D016207:Cytokines; D018841:HSP90 Heat-Shock Proteins; D007252:Influenza Vaccines; D007376:Interleukin-2
keywords: CBT, cognitive behavior therapy; CIS-fatigue, Checklist Individual Strength fatigue subscale; HI, hemagglutination-inhibition; HSP90α, human heat shock protein 90 alpha; IFN- γ, interferon gamma; IL-10, interleukin 10; IL-2, interleukin 2; IL-4, interleukin 4; IL-5, interleukin 5; PBMC, peripheral blood mononuclear cells; PHA, phytohemagglutinin; Radboudumc, Radboud University Medical Center; Treg, regulatory T lymphocytes; cancer; fatigue; immunity; influenza; vaccination