Varicella vaccination elicits a humoral and cellular response in children with rheumatic diseases using immune suppressive treatment

Publication date: 15 May 2017
Source:Vaccine, Volume 35, Issue 21
Author(s): Noortje Groot, Gecilmara Pileggi, Cleonice B. Sandoval, Ingrid Grein, Guy Berbers, Virginia Paes Leme Ferriani, Nico Wulffraat, Sytze de Roock
ObjectiveTo assess humoral and cellular responses to live-attenuated varicella zoster virus (VZV) vaccination of patients with juvenile idiopathic arthritis (JIA), juvenile dermatomyositis (JDM) or juvenile scleroderma (JScle) compared to those of healthy controls (HC).MethodsBefore, 4–6weeks and one year after VZV vaccination, blood samples of patients and HC were collected. VZV-specific antibody concentrations were measured by ELISA and multiplex immune-assay. IFN-γ ELISpot assays were performed to assess VZV-specific T-cell responses. Cytokine production upon VZV stimulation were measured with a Luminex-assay.Results49 patients (39 JIA, 5 JDM, 5 JScle) and 18 HC were included. All patients used methotrexate (MTX), 16 also used corticosteroids, 3 patients used biologics. No disease flares were reported after vaccination. Antibody response to the vaccine was similar in patients and controls (p=0.139). Use of immunosuppressive drugs did not affect the response (p=0.203). A second vaccination (n=21) increased VZV-specific antibody concentrations (p=0.02). VZV-specific T-cells increased after vaccination (p=0.043), with a cytokine profile suggesting a VZV-specific Th1 and cytotoxic T-cell response.ConclusionThe humoral response to VZV vaccination in patients with pediatric rheumatic diseases (PRD) is similar to that of HC. Generally, patients are able to mount a VZV-specific cellular response.This study has been registered in the Brazilian Clinical Trials Registry under number U1111-1189-9837.



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