controversy most of it centering around preservatives and immune
adjuvants. (Hemispherx Biopharma has a patent to add Ampligen as an
immune adjuvant to seasonal influenza vaccines
http://www.immunizationinfo.org/pressroom/news-briefs/2011-07-19/hemispherx=
-gets-patent-ampligen-flu-vaccine-enhancer).
Vaccinations are used in order to stimulate the immune system to
induce a persistent immunity against the favorable antigens. Appel et
al 2007 looked at whether vaccinations induce the aberrant immune
response of CFS, and concluded that further studies are required to
examine this issue since it is very conceivable that if infection can
lead to CFS, vaccination may also lead to it in the same
immune-mediated pathogenesis. Results of such studies could be highly
definition dependent and would need to be large enough to determine
statistical significant in subgroups.
There are many variables that need to be accounted for. For example,
scientists with the FDA are working on detection of latent viruses in
cell substrates for vaccine safety. According to the FDA, the
detection of persistent, latent DNA viruses, and endogenous
retroviruses in vaccine cell substrates is important for vaccine
safety, particularly in the development of live viral vaccines, where
there are no or minimal virus inactivation and removal steps during
vaccine manufacturing.
http://www.fda.gov/biologicsbloodvaccines/scienceresearch/biologicsresearch=
areas/ucm127327.htm
And, as the following study in patients with the autoimmune disease of
lupus shows, other variables include immune status (in this case
medications which lower immune response), race, and disease severity.
People who were low responders to the vaccine were more likely to
experience disease flares following vaccination - with a possible
correlation with central nervous system manifestations. These
researchers believe biomarkers might help predict vaccine responses
and flares. The same may be true in ME and CFS.
Response to Flu Vaccine Varies in Lupus
By Nancy Walsh, Staff Writer, MedPage Today
Published: August 06, 2011
=09
Race and the presence of hematologic abnormalities were among the
factors influencing response to influenza vaccine among patients with
systemic lupus erythematosus, a prospective study found.
African-American patients were three times more likely to mount a
successful response to vaccination than were patients of European
ancestry (95% CI 1.07 to 9.94, P=3D0.03), according to Judith A. James,
MD, PhD, of the University of Oklahoma in Oklahoma City, and
colleagues... As treatment for systemic lupus erythematosus has
improved in recent years, lowering mortality rates from complications
such as renal disease, infections have become a more common cause of
morbidity and mortality. Accordingly, immunization against influenza
has become standard of care for lupus patients.However, previous
studies have yielded limited and conflicting data on individual
responses to the vaccine and on the effects of immunization on lupus
disease activity.
To more fully explore the issues involved, James and colleagues
enrolled 72 patients and an equal number of healthy controls,
collecting blood samples before vaccination and at two, six, and 12
weeks after the immunization.
Response to the vaccine was classified as low or high according to
scores calculated from total antibody concentrations, relative
affinity of serum antibodies, and levels of hemagglutination
inhibition....
The stronger response to the vaccine among African-American patients
could not be explained by differences in age, as the average ages of
low and high responders were similar...."This discrepancy in vaccine
responsiveness may be due to the impact of HLA haplotypes in the
different racial groups, although this requires further
investigation," the researchers wrote.
Patients with low responses had more American College of Rheumatology
(ACR) lupus criteria than high responders (6 versus 5, P=3D0.05), with
almost two-thirds of low responders having six or more criteria...The
use of prednisone was associated with low response, with 67% of low
responders having taken the steroid in doses of 10 mg or higher per
day compared with 47% of those who had higher responses to the vaccine
(P=3D0.04).
...Certain patterns of autoantibodies also differed between low and
high responders.
For instance, low responders more often had an increase in antinuclear
antibody (14% versus 8%), while 22% of high responders had decreases
in titers of this antibody.
Low responders also were more likely to have a disease flare. Within
six weeks of vaccination, 14 patients had experienced a flare, 71.4%
of whom were low responders (P=3D0.01).
When the researchers looked for characteristics among these patients
who flared, they found no correlation for baseline disease activity,
number of ACR lupus criteria, or age at diagnosis.
Certain ACR criteria were more common among patients who flared,
including renal involvement, central nervous system manifestations,
and hematologic abnormalities, but the numbers were inadequate for
statistical analysis.
One factor that did correlate with flare was baseline serum interferon
(IFN)-=CE=B1 activity.
The mean IFN-=CE=B1 activity among patients who flared was 19.3 standard
deviations above the mean in healthy controls, compared with 2.7 among
those without flare (P=3D0.04).
"The relationships between IFN activity, vaccination responses, and
subsequent disease flares need to be confirmed in a larger cohort, and
the biologic significance of these processes should be examined,"
wrote James and colleagues.
Further studies of biomarkers that might help predict vaccine
responses and flares could help identify patients who could benefit
from more intensive lupus treatment before they are given vaccines,
they concluded.
The full article can be read here:
http://www.medpagetoday.com/Rheumatology/Lupus/27925?utm_content=3D&utm_med=
ium=3Demail&utm_campaign=3DDailyHeadlines&utm_source=3DWC&userid=3D267244
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