Bile Acids Impair Vaccine Response in Children With Biliary Atresia

Frontiers in Immunology

Cuiping Zhou¹  Yi Fei¹  Pengfei Deng¹  Tian Yang¹  Bijun Qiu²  Yi Luo²  Jinchuan Liu²  Tao Zhou²  Feng Xue²  Ping Wan²  Hao Ji²  Mingxuan Feng²  Xiangqian Gu²  Yefeng Lu²  Ji Wu²  Jianjun Zhu²  Qiang Xia²  Dongcheng Gong³  Jun Deng³ 

[1] Department of Immunology, Shanghai Pudong District Center for Disease Control and Prevention, Shanghai, China;Department of Liver Surgery and Liver Transplantation, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China;State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, and China-Australia Centre for Personalized Immunology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China;

关键词: bile acids;    vaccine response;    children;    biliary atresia;    B cells;   

DOI  :  10.3389/fimmu.2021.642546

来源: DOAJ

【 摘 要 】

BackgroundVaccination is the best way to protect children under 5 years from death or disability. Children with biliary atresia (BA), which is the most common pediatric cholestatic end-stage liver disease (PELD), are more vulnerable to infectious diseases. However, the vaccination coverage and factors modulating vaccine responses in children with BA are largely unknown.MethodsIn this study, 288 children (median age: 7 months) diagnosed with BA before liver transplantation were enrolled for the evaluation of vaccination status and the factors affecting the immune response to the hepatitis B (HBV) vaccine. Moreover, 49 BA children (median age: 4 months) were enrolled for flow cytometric analysis of CD4+ T cells and CD19+ B cell subsets and correlations with serum bile acid levels.ResultsGenerally, these children had very low routine vaccination rates for the meningococcal serogroup AC (Men AC) (41.2%), measles-mumps-rubella (MMR) (31.3%), poliomyelitis (Polio) (25.3%), hepatitis A (HAV) (25.0%), Japanese encephalitis (JE) (15.0%), diphtheria-tetanus-pertussis (DTP) (14.2%), meningococcal serogroup A (Men A) (13.5%) and varicella (VAR) (10.8%) vaccines, but not for the HBV (96.2%) and bacillus Calmette-Guérin (BCG) (84.7%) vaccines. Remarkably, 19.8% (57/288) of the patients had HBV infection. Out of 220 patients vaccinated for HBV, 113 (51.4%), 85 (38.6%) and 22 (10%) had one, two or three doses of the HBV vaccine, respectively. Furthermore, logistic regression analysis revealed that the bile acid level was an independent factor associated with poor HBV vaccine response (p = 0.03; OR = 0.394; 95% CI = 0.170-0.969). Immunophenotyping showed that bile acids were only negatively correlated with the CD19+CD27+IgG+ post-class-switched memory B cell ratio (p = 0.01).ConclusionThis study reveals the overall vaccination rates of routine vaccines in Chinese BA children are very low and the poor HBV vaccine responses are associated with bile acids, possibly via the inhibition of CD19+CD27+IgG+ post-class-switched memory B cell response.Clinical Trial Registrationhttp://www.chictr.org.cn, identifier ChiCTR1800019165.

【 授权许可】

Unknown