Effective humoral immunity against diphtheria and tetanus in patients with systemic lupus erythematosus or myasthenia gravis

Mol Immunol. 2013 Jul;54(3-4):453-6. doi: 10.1016/j.molimm.2013.01.012. Epub 2013 Feb 27.

Abstract

Introduction: Controversy exists about the effectiveness of vaccine-induced immune response in patients with immunoregulatory disorders. Our aim was to determine the antibody titers to diphtheria and tetanus in patients with either of two autoimmune diseases.

Methods: 279 patients with SLE (205 females, aged 45.0 ± 13.8 years), 158 patients with myasthenia gravis (MG) (101 females, aged 55 ± 18.7 years) and 208 healthy subjects (122 females, aged 48 ± 14.6 years) were enrolled. Serum concentrations of diphtheria-antitoxin-IgG (A-DIPHTH) and tetanus-antitoxoid-IgG (A-TET) were determined with ELISA.

Results: Equal proportions of healthy subjects, as well as patients with SLE or MG exhibited proper antibody responses and immune protection against diphtheria and tetanus. In all three test groups, serum concentration of A-DIPHTH decreased significantly (p<0.001) with age throughout the study population, while titers of A-TET dropped only in the elderly (>60-years-old) subjects. There were no significant differences among the groups in the age-related changes of A-TET and A-DIPHTH except that in <40-years-old subjects, A-DIPHTH level was significantly (p=0.029) lower in SLE patients than in controls.

Conclusions: Our findings suggest that the level of vaccine-induced immunity against diphtheria and tetanus infections in patients with SLE or MG is comparable to the healthy population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antibodies, Bacterial / immunology
  • Antibody Formation / immunology
  • Case-Control Studies
  • Diphtheria / complications
  • Diphtheria / immunology*
  • Diphtheria Antitoxin / immunology
  • Diphtheria Toxoid / immunology
  • Diphtheria-Tetanus-Pertussis Vaccine / administration & dosage
  • Diphtheria-Tetanus-Pertussis Vaccine / immunology*
  • Female
  • Humans
  • Immunity, Humoral / immunology
  • Immunoglobulin G / immunology
  • Lupus Erythematosus, Systemic / immunology*
  • Lupus Erythematosus, Systemic / microbiology
  • Male
  • Middle Aged
  • Myasthenia Gravis / immunology*
  • Myasthenia Gravis / microbiology
  • Tetanus / complications
  • Tetanus / immunology*
  • Tetanus Toxoid / immunology

Substances

  • Antibodies, Bacterial
  • Diphtheria Antitoxin
  • Diphtheria Toxoid
  • Diphtheria-Tetanus-Pertussis Vaccine
  • Immunoglobulin G
  • Tetanus Toxoid