Prospective Analysis of Factors Influencing the Antibody Response to Hepatitis B Vaccine in Hemodialysis Patients

Abstract Background. Patients on maintenance hemodialysis typically show a suboptimal immune response to hepatitis B (HB) virus vaccination compared to the non-uremic population. The aim or our study was the identification of factors implicated in the vaccine response of our hemodialysis patients. Methods. We studied prospectively 63 hemodialysis patients who were seronegative for HB (37 males, 26 females). Their mean age was 62.2±11.28 years (range 35-80) and hemodialysis. Duration 55.96±50.1 months (range 6-225) fourteen of them (22.2%) were diabetics. Our patients followed a four-dose vaccination schedule (0, 1, 2 and 6 months) with 40 μg of a recombinant DNA HB vaccine. The antibody response was determined 1 month after the fourth dose of vaccination by assessing the titre of antiHBs antibodies (ab). Immune response was defined as sufficient when the antiHBs ab level was ≥ 12 mIU/ml. During the 6-month vaccination period we also monitored monthly and time-averaged Kt/V, residual renal function (RRF), BMI, serum creatinine, albumin, transferrin, ferritin, CRP, iPTH and the dose of erythropoietin and Vitamin D that they received. Results. An optimal immune response was achieved in 34 patients (54%, responders) (antiHBs: 295.95±341.67 mIU/ml), whereas 29 patients (46%, non-responders) showed a suboptimal response (antiHBs: 1.98±2.92 mIU/ml) (p=1.75x10 -5 ). There was a statistically significant negative correlation between the antiHBs ab titre and BMI (r=-0.28, p=0.024). A significant difference was also found between the BMI of responders and non-responders as groups (24.8±5.5 vs. 27.2±4.5, p=0.02). Grouping our patients according to the existence of diabetes, age (cut off 60 years), and hemodialysis efficiency (Kt/V≥1.2) we found a statistically significant difference in the antiHBs ab titre between diabetics and non-diabetics (8.43±12.3 vs. 200.2±317.7 mIU/ml, p=0.03), younger and older patients (262±365.09 vs. 84.36±189.1 mIU/ml, p=0.0145) and patients with efficient and inefficient hemodialysis (234.71±337.1 vs. 79.14±200.99 mIU/ml, p=0.032). Treatment with vitamin D analogues, RRF and hypoalbuminemia were not found to be implicated in the immune response of our patients

In vitro and in vivo evaluation of the genotoxic and antigenotoxic potential of the major Chios mastic water constituents

International audienceChios mastic products are well-known for their broad applications in food industry, cosmetics, and healthcare since the antiquity. Given our recent finding that Chios mastic water (CMW) exerts antigenotoxic action, in the present study, we evaluated the genotoxic as well as the antigenotoxic potential of the four major compounds of CMW, namely, verbenone, α-terpineol, linalool, and transpinocarveol. The cytokinesis block micronucleus (CBMN) assay in cultured human lymphocytes and the Drosophila Somatic Mutation And Recombination Test (SMART), also known as the wing spot test, were employed. None of the four major CMW's constituents or their mixtures showed genotoxic or recombinogenic activity in either of the assays used. Co-treatment of each of the constituents with MMC revealed that all except trans-pinocarveol exerted antigenotoxic potential. Moreover, coadministration of verbenone with linalool or α-terpineol presented statistically significant reduction of MMC-induced mutagenicity. In conclusion, the major CMW constituents were shown to be free of genotoxic effects, while some exerted antigenotoxic activity either alone or in combinations, suggesting synergistic phenomena. Our results provide evidence on the key antigenotoxicity effectors of the plant extract CMW