Title |
Pneumococcal polysaccharide vaccination in rheumatoid arthritis patients receiving tacrolimus
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Published in |
Arthritis Research & Therapy, June 2015
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DOI | 10.1186/s13075-015-0662-x |
Pubmed ID | |
Authors |
Kiyoshi Migita, Yukihiro Akeda, Manabu Akazawa, Shigeto Tohma, Fuminori Hirano, Haruko Ideguchi, Ryutaro Matsumura, Eiichi Suematsu, Tomoya Miyamura, Shunsuke Mori, Takahiro Fukui, Yasumori Izumi, Nozomi Iwanaga, Hiroshi Tsutani, Kouichirou Saisyo, Takao Yamanaka, Shiro Ohshima, Takao Sugiyama, Yojiro Kawabe, Masao Katayama, Yasuo Suenaga, Akira Okamoto, Hisaji Ohshima, Yasumasa Okada, Kenji Ichikawa, Shigeru Yoshizawa, Kenji Kawakami, Toshihiro Matsui, Hiroshi Furukawa, Kazunori Oishi |
Abstract |
In patients with rheumatoid arthritis (RA) receiving immunosuppressive treatments, vaccination against Streptococcus pneumoniae is recommended. The objective of the study was to evaluate the effects of tacrolimus (TAC) on immune response following administration of a 23-valent pneumococcal polysaccharide vaccine (PPSV23) in patients with established RA. Patients with Rheumatoid arthritis (n = 133) were vaccinated with PPSV23. Patients were classified into TAC (n = 29), methotrexate (MTX; n = 55), control (n = 35), and TAC/MTX (n = 14) treatment groups. We measured the concentrations of pneumococcal serotypes 6B and 23F using an enzyme-linked immunosorbant assay (ELISA) and determined antibody functionality using a multiplexed opsonophagocytic killing assay, reported as the opsonization index (OI), before and 4 to 6 weeks after vaccination. A positive antibody response was defined as a 2-fold or more increase in the IgG concentration or as a 10-fold or more increase in the OI. IgG concentrations and OIs were significantly increased in all treatment groups post PPSV23 vaccination. The TAC treatment group appears to respond in a manner similar to that of the RA control group in terms of 6B and 23F serotype concentration and function. In contrast, the MTX group had the lowest immune response. Patients treated with a combination of TAC and MTX (TAC/MTX) also had a diminished immune response compared to those treated with TAC alone. TAC monotherapy does not appear to impair PPSV23 immunogenicity in RA patients, whereas antibody production and function may be reduced when TAC is used with MTX. Thus, PPSV23 administration during ongoing TAC treatment should be encouraged for infection prone TAC-treated patients with rheumatic diseases. University Hospital Medical Information Network Clinical Trials Registry: UMIN000009566 . Registered 12 December 2012. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Japan | 1 | 100% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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United Kingdom | 1 | 2% |
Unknown | 57 | 98% |
Demographic breakdown
Readers by professional status | Count | As % |
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Researcher | 10 | 17% |
Student > Ph. D. Student | 8 | 14% |
Student > Bachelor | 6 | 10% |
Student > Master | 6 | 10% |
Other | 4 | 7% |
Other | 9 | 16% |
Unknown | 15 | 26% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 27 | 47% |
Biochemistry, Genetics and Molecular Biology | 3 | 5% |
Pharmacology, Toxicology and Pharmaceutical Science | 2 | 3% |
Neuroscience | 2 | 3% |
Nursing and Health Professions | 2 | 3% |
Other | 7 | 12% |
Unknown | 15 | 26% |