Adequate tetanus but poor diphtheria and pertussis response to a Tdap booster in adolescents with juvenile systemic lupus erythematosus

Author(s)

Peracchi, Octavio A. B. ^[1] ; Nicacio, Aline Alencar M. F. ^[1] ; Yamada, Juliana ^[2] ; Len, Claudio Arnaldo ^[1] ; Moraes-Pinto, Maria Isabel de ^[2] ; Terreri, Maria Teresa ^[1]

Affiliation

^[1] Univ Fed Sao Paulo UNIFESP, Unit Pediat Rheumatol, Dept Pediat, Sao Paulo - Brazil

^[2] Univ Fed Sao Paulo UNIFESP, Res Lab, Div Pediat Infect Dis, Dept Pediat, Sao Paulo - Brazil

• Document type: Journal article
• Source: Lupus; v. 30, n. 2, p. 299-306, FEB 2021.
• Web of Science Citations: 0

Abstract

Background Reports on vaccine responses in immunocompromised patients, such as juvenile systemic lupus erythematosus (jSLE), have shown highly variable results. Objective To compare the immune response and safety after a Tdap booster in 26 jSLE patients and 26 matched healthy adolescents. Methodology: Adverse events and disease activity were evaluated. Lymphocyte immunophenotyping was performed by flow cytometry. Tetanus, diphtheria and pertussis toxin antibodies were assessed by ELISA; whole blood was stimulated with whole cell pertussis and supernatants were assessed for cytokines by xMAP. Results Both groups showed a similar frequency of adverse events. There was no evidence of disease reactivation after Tdap booster in the jSLE cohort. Both groups showed a significant increase in antibody titers for all three antigens on D14 and D28 (p < 0.001). jSLE patients had a significantly lower increase in diphtheria titers than the control group (p = 0.007). jSLE patients had a distinct titer increase of tetanus and pertussis antibodies when compared to controls (p = 0.004 and p < 0.001, respectively). There was a lower frequency of pertussis seroconversion in the jSLE group on D14 (p = 0.009), D28 (p = 0.023), D12m (p = 0.015) and D24m (p = 0.004). Cellular immune response to Bordetella pertussis showed significantly lower levels of IFN gamma (p < 0.001) and higher levels of IL10, IL12, IL21 and TNF alpha in jSLE patients than controls. Conclusions jSLE patients had good response to Tdap booster dose for the tetanus antigen, but not for diphtheria and pertussis. This vaccine was safe in relation to adverse events and absence of disease reactivation. (AU)

• FAPESP's process: 13/19611-0 - Immune response and tolerability of combined tetanus, diphtheria and acellular pertussis (Tdap) vaccine in adolescents with systemic lupus erythematosus and juvenile idiopathic arthritis
• Grantee: Maria Teresa de Sande e Lemos Ramos Ascensão Terreri
• Support Opportunities: Regular Research Grants