Immune Response to Influenza Virus Vaccine in Asthma and COPD Patients

Abstract

Bronchial asthma is a serious public health problem throughout the world, affecting people of all ages. It is a highly prevalent chronic respiratory disease affecting 300 million people worldwide. The global prevalence of asthma ranges from 1% to 18% of the population in different countries. It is estimated that asthma accounts for about 250,000 deaths per year worldwide. Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. It is defined by the history of respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough that vary over time and in intensity, together with variable expiratory airflow limitation. COPD is the most common chronic respiratory condition in adults. According to WHO estimates; 65 million people have moderate to severe chronic COPD. More than 3 million people died of COPD in 2005, which corresponds to 5% of all deaths globally. COPD is a disease state characterized by persistent airflow limitation that is usually progressive, not fully reversible, and is associated with an enhanced chronic inflammatory response in the airways and the lungs to inhaled noxious particles or gases. In asthma Airway obstruction is typically fully or nearly fully reversible. While in COPD airway obstruction is characterized by being not fully reversible. Although asthma and chronic obstructive pulmonary disease (COPD) are both obstructive airway diseases that involve chronic inflammation of the respiratory tract, yet the type of inflammation is markedly different between the two diseases, with different patterns of inflammatory cells and mediators being involved. Inflammation in asthma consists of airway infiltration by mast cells,eosinophils, and T-lymphocytes (T cells that are predominantly Th2 cells). While in in COPD there are an infiltration of T- cells (predominantly Th1cells) with increased numbers of neutrophils and macrophages. Influenza is a single-stranded, helically shaped, RNA virus of the orthomyxovirus family. Basic antigen types A, B, and C are determined by the nuclear material. Influenza A viruses are divided into subtypes based on two proteins on the surface of the virus: the hemagglutinin (H) and the neuraminidase (N). Each injected seasonal influenza vaccine (trivalent inactivated vaccine, TIV) contains three influenza viruses: one influenza type A subtype H3N2 virus strain, one influenza type A subtype H1N1 (seasonal) virus strain, and one influenza type B virus strain. Our study was designed to assess the difference in the humoral antibody immune response to trivalent inactivated influenza virus vaccine among patients with bronchial asthma in comparison to patients with COPD. A total of 40 patients were enrolled in this prospective study. They were divided into 2 groups of comparable ages;a group of 20 asthmatic patients and another group of 20 COPD patients. Asthma patients were diagnosed according to GINA guide lines 2010. While COPD patients were diagnosed according to GOLD guide lines 2011.