Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter September 22, 2016

Seroprotection status of hepatitis B and measles vaccines in children with type 1 diabetes mellitus

  • Zerrin Onal EMAIL logo , Atilla Ersen , Elvan Bayramoglu , Selcen Yaroglu Kazancı , Hasan Onal and Erdal Adal

Abstract

Background:

Type 1 diabetes mellitus (T1DM) is speculated to have an impaired immunological response to vaccines. This paper aimed to investigate the presence of specific antibodies against hepatitis B virus (HBV) and measles in diabetic children who had been immunized according to the standard national calendar of immunization.

Methods:

Two hundred and one diabetic children and 140 healthy controls were prospectively evaluated. Antibodies against hepatitis B (anti-HBs) and measles were detected in all individuals who completed the vaccination schedule. We noted onset of T1DM, duration of the disease, diabetes-related autoantibodies and mean HbA1c levels.

Results:

Some 72.6% of diabetics and 82.1% of controls had anti-HBs (+) (p=0.04). We found a reduced efficacy of measles vaccination in anti-HBs (–) diabetic children (p=0.009), even though there was no significant difference between the study and control groups. Onset of the disease was earlier in anti-HBs (–) diabetics than in controls (p=0.038). No difference with respect to other parameters was found.

Conclusions:

Our data showed a reduced seroprotection rate for HBV vaccination in diabetic children and for measles with anti-HBs (–) diabetics. Larger studies should be encouraged to confirm the vaccine efficacy in diabetic children and to elucidate possible pathogenic mechanisms.


Corresponding author: Zerrin Onal, MD, Kanuni Sultan Suleyman Training and Research Hospital, Department of Pediatrics, Kınalıtepe sok simitaş 7.blok no:61, Merter, Istanbul, Turkey, Phone:+ 90 532 509 29 88, Fax: +90 212 414 31 77

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Hiltunen M, Lönnrot M, Hyöty H. Immunisation and type 1 diabetes mellitus: is there a link? Drug Saf 1999;20:207–12.10.2165/00002018-199920030-00001Search in Google Scholar

2. Salemi S, D’Amelio R. Could autoimmunity be induced by vaccination? Int Rev Immunol 2010;29:247–69.10.3109/08830181003746304Search in Google Scholar

3. Schattner A. Consequence or coincidence? The occurrence, pathogenesis and significance of autoimmune manifestations after viral vaccines. Vaccine 2005;23:3876–86.10.1016/j.vaccine.2005.03.005Search in Google Scholar

4. Hviid A, Stellfeld M, Wohlfahrt J, Melbye M. Childhood vaccination and type 1 diabetes. N Engl J Med 2004;350:1398–404.10.1056/NEJMoa032665Search in Google Scholar

5. Classen JB, Classen DC. Clustering of cases of type 1 diabetes mellitus occurring 2–4 years after vaccination is consistent with clustering after infections and progression to type 1 diabetes mellitus in autoantibody positive individuals. J Pediatr Endocrinol Metab 2003; 16:495–508.10.1515/JPEM.2003.16.4.495Search in Google Scholar

6. Hiltunen M, Hyöty H, Leinikki P, Akerblom HK, Tuomilehto J, et al. Low mumps antibody levels induced by mumps-measles-rubella vaccinations in type 1 diabetic children. DiabetMed 1994;11:942–6.10.1111/j.1464-5491.1994.tb00251.xSearch in Google Scholar

7. Leonardi S, Vitaliti G, Garozzo MT, Miraglia del Giudice M, Marseglia G, et al. Hepatitis B vaccination failure in children with diabetes mellitus? The debate continues. Hum Vaccin Immunother 2012;8:448–52.10.4161/hv.19107Search in Google Scholar

8. Douvin C, Simon D, Charles MA, Deforges L, Bierling P, et al. Hepatitis B vaccination in diabetic patients. Randomized trial comparing recombinant vaccines containing and not containing pre-S2 antigen. Diabetes Care 1997;20:148–51.10.2337/diacare.20.2.148Search in Google Scholar

9. Marseglia G, Alibrandi A, d’Annunzio G, Gulminetti R, Avanzini MA, et al. Long term persistence of anti-HBs protective levels in young patients with type 1 diabetes after recombinant hepatitis B vaccine. Vaccine 2000;19:680–3.10.1016/S0264-410X(00)00268-1Search in Google Scholar

10. Halota W, Muszyńska M, Pawłowska M. Hepatitis B virus serologic markers and anti-hepatitis B vaccination in patients with diabetes. Med Sci Monit 2002;8:CR516–9.Search in Google Scholar

11. Arslanoğlu I, Cetin B, Işgüven P, Karavuş M. Anti-HBs response to standard hepatitis B vaccination in children and adolescents with diabetes mellitus. J Pediatr Endocrinol Metab 2002;15: 389–95.10.1515/JPEM.2002.15.4.389Search in Google Scholar PubMed

12. Atkinson MA, Maclaren NK. The pathogenesis of insulin-dependent diabetes mellitus. N Engl J Med 1994;331:1428–36.10.1056/NEJM199411243312107Search in Google Scholar

13. Foulis AK, Stewart JA. The pancreas in recent-onset type 1 (insulin-dependent) diabetes mellitus: insulin content of islets, insulitis and associated changes in the exocrine acinar tissue. Diabetologia 1984;26:456–61.10.1007/BF00262221Search in Google Scholar

14. Jansen A, van Hagen M, Drexhage HA. Defective maturation and function of antigen-presenting cells in type 1 diabetes. Lancet 1995;345:491–2.10.1016/S0140-6736(95)90586-3Search in Google Scholar

15. Takahashi K, Honeyman MC, Harrison LC. Impaired yield, phenotype, and function of monocyte-derived dendritic cells in humans at risk for insulin-dependent diabetes. J Immunol 1998;161:2629–35.10.4049/jimmunol.161.5.2629Search in Google Scholar

16. Litherland SA, Xie XT, Hutson AD, Wasserfall C, Whittaker DS, et al. Aberrant prostaglandin synthase 2 expression defines an antigen-presenting cell defect for insulin-dependent diabetes mellitus. J Clin Invest 1999;104:515–23.10.1172/JCI4852Search in Google Scholar PubMed PubMed Central

17. Wilson SB, Kent SC, Patton KT, Orban T, Jackson RA, et al. Extreme Th1 bias of invariant Valpha24JalphaQ T cells in type 1 diabetes. Nature 1998;391:177–81.10.1038/34419Search in Google Scholar PubMed

18. Beyan H, Buckley LR, Yousaf N, Londei M, Leslie RD. A role for innate immunity in type 1 diabetes? Diabetes Metab Res Rev 2003;19:89–100.10.1002/dmrr.341Search in Google Scholar PubMed

19. Ramondetti F, Sacco S, Comelli M, Bruno G, Falorni A, et al; RIDI Study Group. Type 1 diabetes and measles, mumps and rubella childhood infections within the Italian Insulin-dependent Diabetes Registry. Diabet Med 2012;29:761–6.10.1111/j.1464-5491.2011.03529.xSearch in Google Scholar PubMed

20. Rewers M, Atkinson M. The possible role of enteroviruses in diabetes mellitus. In: Rotbart HA, editor. Human enterovirus infections. Washington, DC: American Society for Microbiology, 1995:353–85.Search in Google Scholar

21. Cohen AD, Shoenfeld Y. Vaccine-induced autoimmunity. J Autoimmun 1996;9:699–703.10.1006/jaut.1996.0091Search in Google Scholar PubMed

22. Kubba AK, Taylor P, Graneek B, Strobel S. Non-responders to hepatitis B vaccination: a review. Commun Dis Public Health 2003;6:106–12.Search in Google Scholar

23. Wood RC, MacDonald KL, White KE, Hedberg CW, Hanson M, et al. Risk factors for lack of detectable antibody following hepatitis B vaccination of minnesota health care workers. J Am Med Assoc 1993;270:2935–9.10.1001/jama.1993.03510240047030Search in Google Scholar

24. Zanoni G, Contreas G, Valletta E, Gabrielli O, Mengoli C, et al. Normal or defective immune response to hepatitis B vaccine in patients with diabetes and celiac disease. Hum Vaccin Immunother 2014;11:708–12.10.4161/hv.34309Search in Google Scholar PubMed PubMed Central

25. Leonardi S, Spina M, Spicuzza L, Rotolo N, La Rosa M. Hepatitis B vaccination failure in celiac disease: is there a need to reassess current immunization strategies? Vaccine 2009;27:6030–3.10.1016/j.vaccine.2009.07.099Search in Google Scholar

26. Zanetti AR, Mariano A, Romanò L, D’Amelio R, Chironna M, et al; Study Group. Long-term immunogenicity of hepatitis B vaccination and policy for booster: an Italian multicentre study. Lancet 2005;366:1379–84.10.1016/S0140-6736(05)67568-XSearch in Google Scholar

27. Stachowski J, Kramer J, Füst G, Maciejewski J, Baldamus CA, et al. Relationship between the reactivity to hepatitis B virus vaccination and the frequency of MHC class I, II and III alleles in haemodialysis patients. Scand J Immunol 1995; 42:60–5.10.1111/j.1365-3083.1995.tb03626.xSearch in Google Scholar PubMed

28. Ada G. Vaccines and vaccination. N Engl J Med 2001;345: 1042–53.10.1056/NEJMra011223Search in Google Scholar PubMed

29. Pozzilli P, Arduini P, Visalli N, Sutherland J, Pezzella M, et al. Reduced protection against hepatitis B virus following vaccination in patients with type 1 (insulin-dependent) diabetes. Diabetologia 1987;30:817–9.10.1007/BF00275749Search in Google Scholar PubMed

30. Bouter KP, Diepersloot RJ, Wismans PJ, Gmelig Meyling FH, Hoekstra JB, et al. Humoral immune response to a yeast-derived hepatitis B vaccine in patients with type 1 diabetes mellitus. Diabet Med 1992;9:66–9.10.1111/j.1464-5491.1992.tb01717.xSearch in Google Scholar PubMed

31. Fiçicioğlu C, Mikla S, Midilli K, Aydin A, Cam H, et al. Reduced immune response to hepatitis B vaccine in children with insulin dependent diabetes. Acta Paediatr Jpn 1995;37:687–90.10.1111/j.1442-200X.1995.tb03404.xSearch in Google Scholar PubMed

32. Elrashidy H, Elbahrawy A, El-Didamony G, Mostafa M, George NM, et al. Antibody levels against hepatitis B virus after hepatitis B vaccination in Egyptian diabetic children and adolescents. Hum Vaccin Immunother 2013;9:2002–6.10.4161/hv.25426Search in Google Scholar PubMed PubMed Central

33. Hyöty H, Hiltunen M, Reunanen A, Leinikki P, Vesikari T, et al. Decline of mumps antibodies in type 1 (insulin-dependent) diabetic children and a plateau in the rising incidence of type 1 diabetes after introduction of the mumps-measles-rubella vaccine in Finland. Diabetologia 1993;36:1303–8.10.1007/BF00400810Search in Google Scholar PubMed

Received: 2016-1-5
Accepted: 2016-7-18
Published Online: 2016-9-22
Published in Print: 2016-9-1

©2016 Walter de Gruyter GmbH, Berlin/Boston

Downloaded on 26.2.2024 from https://www.degruyter.com/document/doi/10.1515/jpem-2015-0211/html
Scroll to top button