Influenza Immunization and the Generation of Anti-HLA and Anti-MICA Antibodies in Patients with Renal Failure and in Kidney Transplant Recipients.

Abstract

The aim of this study was to determine whether the influenza vaccine induces the development of anti-human leukocyte antigen (HLA) and anti-major histocompatibility complex class I - chain A (MICA) antibodies. We determined the presence or de novo development of anti-HLA and anti-MICA antibodies in 3 groups of patients vaccinated against influenza: A) 42 healthy adults; B) 40 end-stage kidney disease patients; C) 25 kidney transplant recipients; and, D) 22 healthy adults who refused vaccination. Serum samples per subject were obtained: prior to vaccination, one week after vaccination, and on a monthly basis for 6 months. They were analyzed by LABScreen® Single Antigen, Luminex. The proportions of de novo antibodies (anti-HLA and anti-MICA) in the 4 groups were 2.4%, 17.5%, 20%, and 0%, respectively. Some patients developed the antibodies later, unrelated to the vaccine. We found preformed antibodies (anti-HLA and anti-MICA) in 67%, 78%, 88%, and 27% of cases in groups A, B, C, and D, respectively. The presence of preformed antibodies was the only predictive factor for the development of de novo antibodies. In conclusion, the development of de novo anti-HLA and anti-MICA antibodies after an external stimulus other than HLA antigens is possible. However, not all cases can be attributed to the vaccine.