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Stone VM, Utorova R, Butrym M, Sioofy-Khojine AB, Hankaniemi MM, Ringqvist EE, Blanter M, Parajuli A, Pincikova T, Fischler B, Karpati F, Hytönen VP, Hyöty H, Hjelte L, Flodström-Tullberg M. Coxsackievirus B infections are common in Cystic Fibrosis and experimental evidence supports protection by vaccination. iScience 2022; 25:105070. [PMID: 36157581 PMCID: PMC9490033 DOI: 10.1016/j.isci.2022.105070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/10/2022] [Accepted: 08/30/2022] [Indexed: 11/05/2022] Open
Abstract
Viral respiratory tract infections exacerbate airway disease and facilitate life-threatening bacterial colonization in cystic fibrosis (CF). Annual influenza vaccination is recommended and vaccines against other common respiratory viruses may further reduce pulmonary morbidity risk. Enteroviruses have been found in nasopharyngeal samples from CF patients experiencing pulmonary exacerbations. Using serology tests, we found that infections by a group of enteroviruses, Coxsackievirus Bs (CVBs), are prevalent in CF. We next showed that a CVB vaccine, currently undergoing clinical development, prevents infection and CVB-instigated lung damage in a murine model of CF. Finally, we demonstrate that individuals with CF have normal vaccine responses to a similar, commonly used enterovirus vaccine (inactivated poliovirus vaccine). Our study demonstrates that CVB infections are common in CF and provides experimental evidence indicating that CVB vaccines could be efficacious in the CF population. The role of CVB infections in contributing to pulmonary exacerbations in CF should be further studied. CVB infections are common in CF A CVB vaccine prevents infection and tissue damage in a model of CF Most people with CF have robust antibody responses to a similar enterovirus vaccine
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Affiliation(s)
- Virginia M Stone
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 52 Stockholm, Sweden
| | - Renata Utorova
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 52 Stockholm, Sweden
| | - Marta Butrym
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 52 Stockholm, Sweden
| | | | - Minna M Hankaniemi
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
| | - Emma E Ringqvist
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 52 Stockholm, Sweden
| | - Marfa Blanter
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 52 Stockholm, Sweden
| | - Anirudra Parajuli
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 52 Stockholm, Sweden
| | - Terezia Pincikova
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 52 Stockholm, Sweden.,Stockholm CF Center, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.,Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Department of Pediatrics, Karolinska University Hospital, 141 86 Stockholm, Sweden
| | - Björn Fischler
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Department of Pediatrics, Karolinska University Hospital, 141 86 Stockholm, Sweden
| | - Ferenc Karpati
- Stockholm CF Center, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.,Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Department of Pediatrics, Karolinska University Hospital, 141 86 Stockholm, Sweden
| | - Vesa P Hytönen
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland.,Fimlab Laboratories, 33520 Tampere, Finland
| | - Heikki Hyöty
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland.,Fimlab Laboratories, 33520 Tampere, Finland
| | - Lena Hjelte
- Stockholm CF Center, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden.,Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Department of Pediatrics, Karolinska University Hospital, 141 86 Stockholm, Sweden
| | - Malin Flodström-Tullberg
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet and Karolinska University Hospital Huddinge, 141 52 Stockholm, Sweden
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Hayney MS, Welter DL, Reynolds AM, Francois M, Love RB. High-dose hepatitis B vaccine in patients waiting for lung transplantation. Pharmacotherapy 2003; 23:555-60. [PMID: 12741428 DOI: 10.1592/phco.23.5.555.32194] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
STUDY OBJECTIVE To increase the response rate to hepatitis B vaccine in patients awaiting lung transplantation. DESIGN Historically controlled, open-label study. SETTING Lung transplant clinic at a university hospital. SUBJECTS Twenty-seven consecutive individuals with end-stage pulmonary disease who were enrolled to accrue 15 subjects who would complete the vaccine series before transplantation; and 27 lung transplant recipients who were immunized with the conventional dose before the study and served as historical controls. INTERVENTION Intramuscular injection of high-dose hepatitis B vaccine 40 microgram at 0, 1, and 6 months. MEASUREMENTS AND MAIN RESULTS Hepatitis B surface antibody (anti-HBs) concentrations were measured 1-2 months after completing the high-dose series. Individuals with undetectable anti-HBs received additional vaccine to a maximum of six doses. The response rate to the series was compared with that in the control group. Seventeen individuals in the high-dose group and 14 controls met the study criterion of complete vaccine series before transplantation. The former had a much higher response rate than the latter (9 [53%] vs 1 [7%], p<0.01). Four of six patients who received additional doses of vaccine seroconverted. Two of them underwent transplantation shortly after completing the three-dose series. CONCLUSION The high-dose hepatitis B vaccine series produced a protective immune response in lung transplant recipients; however, the response was suboptimal, and alternative immunization strategies should be studied.
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Affiliation(s)
- Mary S Hayney
- School of Pharmacy, University of Wisconsin, Madison 53705-2222, USA.
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