Robust immunogenicity to the H3N2 component of influenza A vaccine in primary Sjogren syndrome

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Pasoto, Sandra Gofinet ; Borba, Eduardo Ferreira ; Formiga, Francisco Fellipe Claudino ; do Nascimento Pedrosa, Tatiana ; Aikawa, Nadia Emi ; de Siqueira, Marilda Agudo Mendonca Teixeira ; Capao, Artur Silva Vidal ; de Proenca, Adriana Coracini Tonacio ; Fuller, Ricardo ; Yuki, Emily Figueiredo Neves ; Leon, Elaine Pires ; de Oliveira Martins, Victor Adriano ; Lopes, Marta Heloisa ; da Silva Duarte, Alberto Jose ; da Silva, Clovis Artur Almeida ; Bonfa, Eloisa

• Document type: Journal article
• Source: CLINICAL RHEUMATOLOGY; v. 42, n. 9, p. 7-pg., 2023-06-12.

Abstract

Introduction Influenza A (H3N2) virus is the major cause of morbidity/mortality due to seasonal influenza over 50 years. Data about the safety/immunogenicity of influenza A/Singapore (H3N2) vaccine are scarce in primary Sjogren syndrome (pSS). Methods Twenty-one consecutive pSS patients and 42 HC (healthy control individuals) were immunized with influenza A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus. Rates of SP (seroprotection) and SC (seroconversion), GMT (geometric mean titers), FI-GMT (factor increase in GMT), ESSDAI (EULAR Sjogren's Syndrome Disease Activity Index), and adverse events were appraised before and 4 weeks post-vaccination. Results pSS and HC had similar mean age (51.2 +/- 14.2 vs. 50.6 +/- 12.1 years, p =0.886). Pre-vaccination SP rates were high in pSS and HC (90.5% vs. 71.4%, p =0.114), and GMT were higher in pSS [80.0 (52.4-160.0) vs. 40.0 (20.0-80.0), p =0.001]. The percentage of influenza vaccination in the preceding two years was elevated and similar in pSS and HC (94.1% vs. 94.6%, p = 1.000). GMT values augmented in both groups four weeks after vaccination and persisted higher in the first group [160.0 (80.0-320.0) vs. 80.0 (40.0-80.0), p< 0.001] with equivalent FI-GMT [1.4 (1.0-2.8) vs. 1.4 (1.0-2.0), p = 0.410]. Both groups had low and similar SC rates (19.0% vs. 9.5%, p = 0.423). ESSDAI values persisted steadily during the study (p = 0.313). No serious adverse events have occurred. Conclusion The novel demonstration that the influenza A/Singapore (H3N2) vaccine induces a different pattern of immunogenicity from other influenza A constituents in pSS, featured by a desirable high pre- and post-vaccination immunogenicity, is in line with reported differences in immune responses between strains in trivalent vaccines and may be related to pre-existing immunity. Clinicaltrials.gov: #NCT03540823. (AU)

• FAPESP's process: 17/14352-7 - Assessment of relevance of blood levels of drugs in the monitoring rheumatic autoimmune diseases: safety, effectiveness and adherence to therapy
• Grantee: Tatiana Do Nascimento Pedrosa
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 18/16162-3 - Yellow fever and influenza 2018 vaccination campaign: safety and immunogenicity in patients with rheumatological autoimmune diseases
• Grantee: Eduardo Ferreira Borba Neto
• Support Opportunities: Regular Research Grants
• FAPESP's process: 15/03756-4 - Assessment of relevance of blood levels of drugs in the monitoring rheumatic autoimmune diseases: safety, effectiveness and adherence to therapy
• Grantee: Eloisa Silva Dutra de Oliveira Bonfá
• Support Opportunities: Research Projects - Thematic Grants