Humoral and cellular immune responses after influenza vaccination in patients with postcancer fatigue

• Published in: Human vaccines & immunotherapeutics Vol. 11; no. 7; pp. 1634 - 1640
• Main Authors: Prinsen, Hetty, van Laarhoven, Hanneke WM, Pots, Jeanette M, Duiveman-de Boer, Tjitske, Mulder, Sasja F, van Herpen, Carla ML, Jacobs, Joannes FM, Leer, Jan Willem H, Bleijenberg, Gijs, Stelma, Foekje F, Torensma, Ruurd, de Vries, I Jolanda M
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 03-07-2015
• Subjects: Adolescent; Adult; cancer; CBT, cognitive behavior therapy; CIS-fatigue, Checklist Individual Strength fatigue subscale; Cytokines - immunology; fatigue; Fatigue - etiology; Fatigue - immunology; Female; Hemagglutination Inhibition Tests; HI, hemagglutination-inhibition; HSP90 Heat-Shock Proteins - blood; HSP90α, human heat shock protein 90 alpha; Humans; IFN- γ, interferon gamma; IL-10, interleukin 10; IL-2, interleukin 2; IL-4, interleukin 4; IL-5, interleukin 5; immunity; Immunity, Cellular; Immunity, Humoral; influenza; Influenza A Virus, H1N1 Subtype - immunology; Influenza A Virus, H3N2 Subtype - immunology; Influenza Vaccines - administration & dosage; Influenza Vaccines - immunology; Influenza, Human - prevention & control; Interleukin-2 - immunology; Lymphocyte Activation; Male; Middle Aged; Neoplasms - complications; PBMC, peripheral blood mononuclear cells; PHA, phytohemagglutinin; Radboudumc, Radboud University Medical Center; Research Paper; T-Lymphocytes, Regulatory - immunology; Treg, regulatory T lymphocytes; vaccination; Young Adult; influenza; CIS-fatigue, Checklist Individual Strength fatigue subscale; IL-2, interleukin 2; PBMC, peripheral blood mononuclear cells; Treg, regulatory T lymphocytes; PHA, phytohemagglutinin; immunity; IL-4, interleukin 4; HSP90α, human heat shock protein 90 alpha; fatigue; IFN- γ, interferon gamma; Radboudumc, Radboud University Medical Center; CBT, cognitive behavior therapy; cancer; HI, hemagglutination-inhibition; IL-5, interleukin 5; IL-10, interleukin 10; vaccination
• ISSN: 2164-5515; 2164-554X
• DOI: 10.1080/21645515.2015.1040207

The aim of this study was to compare humoral and cellular immune responses to influenza vaccination in cancer survivors with and without severe symptoms of fatigue. Severely fatigued (n = 15) and non-fatigued (n = 12) disease-free cancer survivors were vaccinated against seasonal influenza. Humoral immunity was evaluated at baseline and post-vaccination by a hemagglutination inhibition assay. Cellular immunity was evaluated at baseline and post-vaccination by lymphocyte proliferation and activation assays. Regulatory T cells were measured at baseline by flow cytometry and heat-shock protein 90 alpha levels by ELISA. Comparable humoral immune responses were observed in fatigued and non-fatigued patients, both pre- and post-vaccination. At baseline, fatigued patients showed a significantly diminished cellular proliferation upon virus stimulation with strain H3N2 (1414 ± 1201 counts), and a trend in a similar direction with strain H1N1 (3025 ± 2339 counts), compared to non-fatigued patients (3099 ± 2401 and 5877 ± 4604 counts, respectively). The percentage of regulatory T lymphocytes was significantly increased (4.4 ± 2.1% versus 2.4 ± 0.8%) and significantly lower amounts of interleukin 2 were detected prior to vaccination in fatigued compared to non-fatigued patients (36.3 ± 44.3 pg/ml vs. 94.0 ± 45.4 pg/ml with strain H3N2 and 28.4 ± 44.0 pg/ml versus 74.5 ± 56.1 pg/ml with strain H1N1). Pre-vaccination heat-shock protein 90 alpha concentrations, post-vaccination cellular proliferation, and post-vaccination cytokine concentrations did not differ between both groups. In conclusion, influenza vaccination is favorable for severely fatigued cancer survivors and should be recommended when indicated. However, compared to non-fatigued cancer survivors, fatigued cancer survivors showed several significant differences in immunological reactivity at baseline, which warrants further investigation.