Hemodialyzed (n = 55)
Healthy (n = 55)
R
NR
R
NR
A/H1N1
65
35
95
5
A/H3N2
89
11
89
11
B
80
20
75
25
Further analysis focused on the A/H1N1 antibody titer, as the response to this antigen is considered the most relevant for immunity. Serum concentrations of TLRs were inappreciably different before and 1 month after influenza vaccination in either hemodialyzed patients or healthy subjects, in both serologic responders and non-responders. Regarding the cytokine levels, IL-10 was appreciably higher before vaccination in the hemodialyzed responders than non-responders and remained so also after vaccination. The levels of other cytokines did not show any relation with the response to the A/H1N1 antigen (Table 2). On the other hand, TLRs and cytokines were appreciably lower in the healthy subjects than in hemodialyzed patients both before and after influenza vaccination, particularly in the serologic responders, with the exception of IL-1β which did not change much (Table 2).
Table 2
Serum concentrations of Toll-like receptors (TLRs), tumor necrosis factor alpha (TNF-α), and interleukins (IL) in hemodialyzed patients and control healthy subjects before and after influenza vaccination with regard to the A/H1N1 antigen response
Hemodialyzed (n = 55) | Healthy (n = 55) | |||||||
---|---|---|---|---|---|---|---|---|
Before vaccination | After vaccination | Before vaccination | After vaccination | |||||
R | NR | R | NR | R | NR | R | NR | |
TRL-2 | 10.9 ± 4.0 | 11.8 ± 5.0 | 11.3 ± 3.6 | 11.5 ± 3.9 | 0.1 ± 0.3** | 0.0 ± 0.0** | 1.3 ± 2.3*** | 5.4 ± 6.2 |
TRL-4 | 0.3 ± 0.3 | 0.4 ± 0.3 | 0.3 ± 0.2 | 0.3 ± 0.2 | 0.0 ± 0.0** | 0.0 ± 0.0** | 0.0 ± 0.1*** | 0.1 ± 0.1 |
TRL-7 | 0.7 ± 1.7 | 0.1 ± 0.1 | 0.5 ± 1.4 | 0.1 ± 0.1 | 0.2 ± 0.5** | 0.0 ± 0.0** | 0.2 ± 1.0*** | 0.4 ± 0.8 |
TNF-α | 6.9 ± 4.3 | 5.5 ± 1.9 | 7.0 ± 4.5 | 5.6 ± 3.6 | 2.0 ± 1.1** | 2.4 ± 0.6** | 2.0 ± 1.2*** | 2.4 ± 0.7*** |
IL-10 | 0.6 ± 0.9 | 0.4 ± 0.4* | 0.6 ± 1.0 | 0.3 ± 0.2* | 0.3 ± 1.0** | 0.2 ± 0.3 | 0.2 ± 0.4*** | 0.1 ± 0.2 |
IL-6 | 2.7 ± 2.0 | 3.1 ± 2.4 | 3.4 ± 2.3 | 2.9 ± 2.1 | 1.2 ± 1.2** | 1.2 ± 0.3 | 1.1 ± 0.9*** | 1.2 ± 0.4 |
IL-1β | 0.2 ± 0.3 | 0.1 ± 0.1 | 0.2 ± 0.3 | 0.3 ± 0.9 | 0.2 ± 0.4 | 0.1 ± 0.1 | 0.2 ± 0.2 | 0.5 ± 0.8 |
4 Discussion
In the present study we have analyzed if the immune response to influenza vaccine depends on the concentrations of soluble TRL-2, TRL-4, and TRL-7, and if it has any relation to the level of cytokines represented by IL-10, IL-6, IL-1β, and TNF-α. We chose to investigate the relationship between the immune response, Toll-like receptors, and cytokines in the hemodialyzed patients on the premise that immunogenicity and cytokine expression are hampered in chronic kidney disease, which might help bring out the relevant relations to the factors above outlined while comparing with healthy subjects. In addition, there is a previous study pointing to the influence of TLR on the immune response in patients with chronic kidney disease on hemodialysis (Kazimierczak et al. 2007). In contrast to that study, however, the present findings were that there was no correlation between vaccination and concentration of soluble forms of Toll-like receptors type 2, 4, and 7. Vaccination did not influence the concentrations of TLRs or cytokines in either hemodialyzed patients with compromised immunogenicity or healthy subjects. Moreover, both groups of subjects failed to show any immunogenic-responsive differences in TLRs and cytokines, despite evidently higher levels of these biomarkers in hemodialyzed patients. Understandably, increased pro-inflammatory cytokines in patients on hemodialysis point to enhanced inflammatory state in these patients.
< div class='tao-gold-member'>
Only gold members can continue reading. Log In or Register a > to continue