Vaccination; Infection
Conditions
Keywords
Influenza, Kidney transplant, Vaccination
Brief summary
Immune response to influenza vaccine in kidney transplant patients
Detailed description
Seasonal influenza vaccination is recommended for kidney transplant patients, as influenza is responsible for significant morbidity and mortality in this immunocompromised population. Nevertheless, injection of influenza vaccine induces a protective immune response in only 20% to 40% of patients. Today, there are no recommendations regarding the injection time of influenza vaccine in the general population or in immunocompromised patients. In this context, recent studies conducted in healthy subjects have shown that the time of vaccination can have an impact on vaccine efficacy. This is the case for BCG, influenza, COVID-19. On this basis, we formulate the main hypothesis that the administration of influenza vaccine to kidney transplant patients would be more effective when carried out in the morning than in the evening.
Interventions
OTHERVaccine injection
Injection of the vaccine in renal transplant patients.
Sponsors
Centre Hospitalier Universitaire de Nice
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Renal transplant patient; * Follow-up at Nice University Hospital; * Age \> 18 years; * Indication for influenza vaccination * Free and informed consent; * Immunosuppressive treatment including anti-calcineurin and/or Mycophenolate Mofetil (with or without corticoids).
Exclusion criteria
* Known hypersensitivity to influenza vaccine or egg proteins; * Influenza vaccination for the 2023-2024 season already performed; * Current infection; * Current acute medical condition; * Treatment of rejection within the previous 3 months; * Immunosuppressive therapy including CTLA4 agonist, mTOR inhibitor, complement inhibitor, anti-CD19; * Polyvalent immunoglobulin infusion within the preceding 3 months; * Vulnerable persons (minors, adults under guardianship or trusteeship, pregnant women, persons deprived of their liberty, persons unable to speak French); * Subjects not affiliated to the Social Security system.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Comparison of antibody titer (seroconversion) 4 weeks after inactivated influenza vaccine injection in each arm. | 7 months | Seroconversion will be defined as an increase in antibody titer of at least 4-fold (≥4) over pre-vaccination titer AND an antibody titer ≥ 1:40 (seroprotection) four weeks post-vaccination, for at least one of the three vaccine antigens. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of seasonal influenza virus infections in each arm. | 8 months | Comparing the number of seasonal influenza virus infections in kidney transplant patients between a group of patients vaccinated in the morning and a group vaccinated in the evening. The occurrence of influenza, as confirmed by a PCR test, will be noted in the follow-up consultation. |
| Comparison the evolution of antibody titres reacting in each arm. | 7 months | In kidney transplant patients, compare the evolution of antibody titres reacting with vaccine antigens 4 weeks after influenza vaccination between a group of patients vaccinated in the morning and a group of patients vaccinated in the evening. The titer of antibodies reacting with vaccine antigens is measured by ELISA ; |
| Evolution of the number of memory B cells in each arm. | 7 months | To compare in kidney transplant patients the evolution of the number of memory B cells reacting with vaccine antigens 4 weeks after influenza vaccination between a group of patients vaccinated in the morning and a group of patients vaccinated in the evening. The number of memory B cells reacting with vaccine antigens will be measured by ELISPOT ; |
| Evolution of the number of CD4+ T cells in each arm. | 7 months | Comparing the evolution of CD4+ T cells reacting with vaccine antigens in kidney transplant patients 4 weeks after influenza vaccination between a group of patients vaccinated in the morning and a group of patients vaccinated in the evening. The number of CD4+ T cells reacting with vaccine antigens will be measured by in vitro proliferation assay; |
| Evolution of the number of CD8+ T cells in each arm. | 7 months | Comparing the evolution of CD8+ T cells reacting with vaccine antigens in kidney transplant patients 4 weeks after influenza vaccination between a group of patients vaccinated in the morning and a group of patients vaccinated in the evening. The number of CD8+ T cells reacting with vaccine antigens will be measured by in vitro proliferation assay; |
Countries
France
Outcome results
None listed