David M Leone1, Hong-Jai Park2, Serhan Unlu2, Michelle Gurvitz3, Insoo Kang2, Robert W Elder1,4. 1. Section of Pediatric Cardiology, Yale School of Medicine, New Haven, CT. 2. Section of Rheumatology, Allergy & Immunology, Yale School of Medicine, New Haven, CT. 3. Department of Cardiology, Boston Children's Hospital, Boston, MA. 4. Adult Congenital Heart Program, Yale School of Medicine, New Haven, CT.
Abstract
Introduction: T cells developed in the thymus play a key role in vaccine immunity. Thymectomy occurs during infant congenital heart surgery and results in an altered T cell distribution. We investigated if adults with congenital heart disease (ACHD) who underwent early thymectomy have a diminished response to influenza vaccination. Methods: Blood samples from ACHD with early thymectomy ≤ 1 year of age (ACHD-ET; n = 12), no thymectomy (ACHD-NT; n = 8), and healthy controls (HC; n = 14) were collected prior to and 4 weeks after influenza vaccination. Flow cytometric analysis of T cell subsets and vaccine-specific cytokine expressing CD4+ T cells as well as hemagglutination inhibition (HI) assays were completed. Results: The mean age of the cohort was 34 ± 10.6 years and similar in all groups. The mean frequencies of naïve CD4+ and CD8+ T cells were lower in ACHD-ET than in HC (32.7% vs. 46.5%, p = 0.027 and 37.2% vs. 57.4%, p = 0.032, respectively). There was a rise in the frequency of memory CD4+ and CD8+ T cells in the ACHD-ET group. The ACHD-NT had no statistical difference from either group. The frequencies of influenza-specific memory CD4+ T cells expressing IFN-γ and TNF-α were increased after vaccination across all groups (p < 0.05). Conclusions: ACHD-ET have fewer naïve T cells, suggesting immunosenescence. Despite this, they show an adequate T Cell response to vaccination in young adulthood. Our findings support routine vaccination is effective in this population, but research into older ACHD is necessary.
Introduction: T cells developed in the thymus play a key role in vaccine immunity. Thymectomy occurs during infant congenital heart surgery and results in an altered T cell distribution. We investigated if adults with congenital heart disease (ACHD) who underwent early thymectomy have a diminished response to influenza vaccination. Methods: Blood samples from ACHD with early thymectomy ≤ 1 year of age (ACHD-ET; n = 12), no thymectomy (ACHD-NT; n = 8), and healthy controls (HC; n = 14) were collected prior to and 4 weeks after influenza vaccination. Flow cytometric analysis of T cell subsets and vaccine-specific cytokine expressing CD4+ T cells as well as hemagglutination inhibition (HI) assays were completed. Results: The mean age of the cohort was 34 ± 10.6 years and similar in all groups. The mean frequencies of naïve CD4+ and CD8+ T cells were lower in ACHD-ET than in HC (32.7% vs. 46.5%, p = 0.027 and 37.2% vs. 57.4%, p = 0.032, respectively). There was a rise in the frequency of memory CD4+ and CD8+ T cells in the ACHD-ET group. The ACHD-NT had no statistical difference from either group. The frequencies of influenza-specific memory CD4+ T cells expressing IFN-γ and TNF-α were increased after vaccination across all groups (p < 0.05). Conclusions: ACHD-ET have fewer naïve T cells, suggesting immunosenescence. Despite this, they show an adequate T Cell response to vaccination in young adulthood. Our findings support routine vaccination is effective in this population, but research into older ACHD is necessary.
Authors: Rogier van Gent; Alvin W L Schadenberg; Sigrid A Otto; Rutger A J Nievelstein; Gertjan T Sieswerda; Felix Haas; Frank Miedema; Kiki Tesselaar; Nicolaas J G Jansen; José A M Borghans Journal: Blood Date: 2011-05-31 Impact factor: 22.113
Authors: Sarah Cohen; Michelle Z Gurvitz; Virginie Beauséjour-Ladouceur; Patrick R Lawler; Judith Therrien; Ariane J Marelli Journal: Can J Cardiol Date: 2019-10-09 Impact factor: 5.223
Authors: George K Lui; Arwa Saidi; Ami B Bhatt; Luke J Burchill; Jason F Deen; Michael G Earing; Michael Gewitz; Jonathan Ginns; Joseph D Kay; Yuli Y Kim; Adrienne H Kovacs; Eric V Krieger; Fred M Wu; Shi-Joon Yoo Journal: Circulation Date: 2017-10-09 Impact factor: 29.690