Immune Response to Seasonal Flu Vaccination in Patients with Primary Sjogren's Syndrome

Albin Björk¹, Marika Kvarnström², Gudny Ella Thorlacius² and Marie Wahren-Herlenius², ¹Department of Medicine, Unit of Experimental Rheumatology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden, Stockholm, Sweden, ²Unit of Experimental Rheumatology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden, Stockholm, Sweden

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: interferons and vaccines, Sjogren's syndrome, Sjӧgrens

Session Information

Date: Sunday, November 5, 2017

Title: Sjögren's Syndrome Poster I: Translational Research

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Vaccination of rheumatic patients has been reported to induce lower antibody titers than in healthy individuals. However, studies have primarily included patients treated with immunomodulatory drugs. Previous data from our group revealed that untreated patients with primary Sjögren’s syndrome (pSS) respond with higher vaccine specific antibody titers than healthy controls (HC) following vaccination with a squalene adjuvanted H1N1 vaccine. Whether non-adjuvanted vaccines would also induce higher specific antibody responses in non-treated patients is not known. In the present study, we therefore monitored the vaccination response to the adjuvant-free vaccine for seasonal flu (Fluarix) in HC and untreated patients as well as that in patients receiving hydroxychloroquine (HCQ).

Methods: The study included 17 pSS patients without treatment, 8 pSS patients receiving HCQ, and 16 HC. All participants were women and all pSS patients were positive for SSA autoantibodies at the time of diagnosis. All individuals were vaccinated with the Fluarix 2015/2016 vaccine as part of the standard vaccination program. Clinical parameters were recorded using a questionnaire based on ESSPRI. Antibody titers were analysed by ELISA. RNA expression analysis was performed in CD14+ monocytes and CD19+ B cells using the Human Immunology v2 CodeSet (Nanostring).

Results: Untreated patients with pSS responded with significantly higher vaccine specific IgG titers than HC after immunization. Further, levels of anti-Ro52 autoantibodies increased in untreated patients, but not in HCQ-treated patients after vaccination. Nanostring RNA expression data confirmed the presence of an interferon (IFN)-signature in monocytes and in B cells from pSS patients and an IFN score calculated from B cell expression data could discriminate between high and low vaccine antibody response at day 29. No significant changes in self-reported clinical parameters were registered.

Conclusion: Untreated pSS patients display an increased serological responsiveness to the non-adjuvanted seasonal flu vaccine when compared to healthy controls. The increased response is however not mirrored by any clinical aggravation of the patients’ rheumatic disease.

Disclosure: A. Björk, None; M. Kvarnström, None; G. E. Thorlacius, None; M. Wahren-Herlenius, None.

To cite this abstract in AMA style:

Björk A, Kvarnström M, Thorlacius GE, Wahren-Herlenius M. Immune Response to Seasonal Flu Vaccination in Patients with Primary Sjogren’s Syndrome [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/immune-response-to-seasonal-flu-vaccination-in-patients-with-primary-sjogrens-syndrome/. Accessed .

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