Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.

The Cellular Response to Vaccination against Pandemic 2009 Influenza A (H1N1) Virus Among Patients with Rheumatic Diseases.

Elkayam,  Ori, Amir,  Sharon, Arad,  Uri, Wollman,  Jonathan, Brill,  Ayelet, Paran,  Daphna, Levartovsky,  David


Antibody and cell mediated responses are both involved in the defense against virus. We have previously shown that vaccination against pandemic H1N1 using an adjuvanted H1N1v monovalent influenza vaccine induced an appropriate humoral response response in patients with rheumatoid arthritis (RA), Systemic lupus erythematosus (SLE), Ankylosing spondylitis (AS) and Psoriatic arthritis (PsA). The purpose of this study was to assess the cellular response to vaccination against pandemic H1N1 virus in patients with rheumatic diseases compared with healthy controls.


The study population comprised 43 patients (16 RA, 12 SLE, 10 PsA, 5 AS) and 10 healthy controls, all vaccinated by Novartis MF59-adjuvanted H1N1v monovalent influenza vaccine. Peripheral blood mononuclear cells were obtained before and 4 weeks after vaccination. Cell-mediated response was evaluated by flow cytometry for IFNg and interleukin 2 (IL-2) producing CD4+ and CD8+ T-cells, following in vitro stimulation with virus antigen.


CD4 T cell-mediated immune response to A/H1N1: Following vaccination, the percentage of IFNg producing CD4+ cells increased in the SLE, PsA and AS groups while it was decreased in RA and healthy groups. The percentage of IL-2 producing CD4+ cells increased in all groups except PsA. Among patients on TNFa blockers, RA patients had a greater response compared to PsA patients. Notably, the percentage of cytokine producing T-cells (CD4 and CD8) in either, pre- and post-vaccination was higher among the healthy group compared to the 4 patients groups.

CD8 T cell-mediated immune response to A/H1N1: After vaccination, the percentage of IL-2 producing CD8+ cells increased considerably (6-fold) in the healthy control group, the response being significantly stronger compared to the entire patient population (P= 0.02) and to the RA group (P= 0.05). In contrast, except for a slight increase among the SLE and AS groups, no increase in IFNg producing CD8+ T cells was observed.


The cellular response of IL-2 producing CD8+ cells following vaccination against pandemic influenza H1N1 is impaired in patients suffering from RA, SLE, PsA and AS in comparison with healthy controls. The IFNg producing CD4+ and CD8+ T-cell response was similar in patients and controls.

To cite this abstract, please use the following information:
Elkayam, Ori, Amir, Sharon, Arad, Uri, Wollman, Jonathan, Brill, Ayelet, Paran, Daphna, et al; The Cellular Response to Vaccination against Pandemic 2009 Influenza A (H1N1) Virus Among Patients with Rheumatic Diseases. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1944

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