Basic Science and Experimental StudiesDecreased Immune Responses to Influenza Vaccination in Patients With Heart Failure
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Participants
We studied patients with HF and healthy controls. Eligible HF participants had systolic or diastolic dysfunction documented by echocardiogram in previous 6 months, with American College of Cardiology/American Heart Association Stage C, New York Heart Association Functional Class I, II, or III HF. All patients with HF were on stable medical therapy for at least 30 days, including target or maximally tolerated doses of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and
Patients
Thirty-two HF patients (8 females, 24 males) and 19 healthy controls (8 females, 11 males) were enrolled, with a mean age of 58 ± 13 years (median 57 years, range 26–81 years) for HF participants, and 47 ± 10 for healthy controls (median 51 years, range 29–65). HF participants were older than healthy control participants (P = .004 for comparison between groups). Among the HF group, mean ejection fraction was 39% ± 11% (median 35%, range 15% to 55%), and patients were New York Heart Association
Discussion
In this study, we compared humoral and CTL immune responses to influenza vaccination in patients with HF compared with healthy individuals. Our results were 3-fold.
First, participants with HF exhibited higher IL-10 production in response to influenza vaccination compared with healthy controls. Additionally, HF participants had a lower IFN-γ:IL-10 ratio compared with healthy controls, indicating a Th2 dominant phenotype. There were no differences in IFNγ production between groups. CTL responses
Acknowledgments
The authors gratefully acknowledge Drs. Walter Kao, David Murray, Peter Rahko, and Elaine Winkel for allowing their patients to participate in this study.
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Dr. Vardeny was supported by NIH (NCRR) 8K12RRO23268 and the American College of Clinical Pharmacy. Dr. Sweitzer was supported by NIH K23AG01022.