According to a new study by Dutch researchers of the University of Groningen, the two prime means by which the seasonal influenza vaccine activates the immune system against the virus appear to be diminished in people with lupus.

The human immune system goes on alert against the seasonal flu virus after vaccination in two ways. First, it generates antibodies specifically reacting to the flu virus, and secondly, it primes certain immune T-cells to respond to the flu bug.   The new study, involving 54 patients with lupus and 54 healthy controls, replicated earlier findings that showed the antibody-mediated vaccine response was dimmed in lupus patients who were on immune-suppressive drugs.  Lupus patients who are taking these drugs at the same time they get their flu shots may be vulnerable to flu complications.

Immune-boosting substances called adjuvants are being developed to increase the depth and breadth of the immune responses elicited by vaccines. None of these adjuvants has been approved in the U.S., although some of the products are used in Europe.

The new study, published in the August issue of Arthritis & Rheumatism, also found that another arm of the immune system, cell-mediated immunity, also responds less well to flu vaccination in lupus patients.  The researchers advise that clinicians be aware “that this combined defect might increase the morbidity and mortality due to influenza virus infection, in particular in patients receiving prednisone and/or azathioprine.”  They also called for more investigation into whether alternate flu vaccination strategies might offer better protection to people with lupus.

Source:  WebMD - Immune-Suppressing Lupus Treatments Dampen Flu Vaccination