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Apr 9, 2013 - 2013 Bos et al; licensee Herbert Publications Ltd. This is an Open ...... Rubtsov AV, Rubtsova K, Fischer A, Meehan RT, Gillis JZ, Kappler JW.
Hematology and Leukemia ISSN 2052-434X

Research

Open Access

IgG antibody and TH1 immune responses to influenza vaccination negatively correlate with M-protein burden in monoclonal gammopathy of undetermined significance Sarah M. Tete1,2, Kasper R. Wilting3, Gerda Horst1, Michiel A. Klijn4, Johanna Westra1, Aalzen de Haan5, Anke L.W. Huckriede5, Hanneke C. Kluin-Nelemans6, Surinder S. Sahota2, Marc Bijl7 and Nico Bos1* *Correspondence: [email protected] 1 Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands. 2 Cancer Sciences Division, University of Southampton School of Medicine, Southampton, UK. 3 Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands. 4 General Practitioners Practice, Huisartsen Boterdiep, Groningen, Netherlands. 5 Department of Medical Microbiology, Molecular Virology section, University of Groningen, University Medical Center Groningen, Groningen, Netherlands. 6 Department of Hematology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands. 7 Department of Internal Medicine and Rheumatology, Martini Hospital, Groningen, Netherlands.

Abstract

Background: The emergence of non-malignant conditions such as monoclonal gammopathy of undetermined significance (MGUS) in the elderly may further alter their increased susceptibility to infections, however this remains poorly defined. The immune response to influenza vaccination has not been examined in MGUS, a benign plasma cell monoclonal expansion in the bone marrow that secretes elevated levels of monoclonal immunoglobulin (M-protein). Pre-existing antibody titers to infectious agents can be depressed, but the degree of immunosuppression in response to active vaccination remains unclear. Furthermore, the association of M-protein levels with impaired antigen specific response has not been examined to date in MGUS. Methods: We investigated antibody as well as T cell responses in 19 MGUS patients and age-matched healthy controls following influenza vaccination. H1N1 and H3N2 influenza-specific IgG antibodies were measured by ELISA. The frequencies of H1N1 and H3N2 specific IFN-γ secreting cells were measured by ELISpot. Results: Polyclonal isotype-switched immunoglobulin levels were significantly reduced in the MGUS cohort (p