Systemic Lupus Erythematosus (SLE) Clinical Trial
Official title:
Role of CXCR4/CXCL12 Axis on the Control of Humoral Immunity and Auto-immunity in Lupus Patients After Influenza Vaccine Challenge
Annual influenza vaccination is recommended in patients with systemic lupus erythematosus (SLE). However some concerns remain about vaccination and the risk of lupus flare
SLE is a chronic autoimmune disease associated with the production of pathogenic anti-nuclear
autoantibodies (ANAs) and characterized by the loss of self tolerance and the overexpression
of B cells, leading to a high immunoglobulin production, 90% being autoantibodies.
There have been concerns about the safety of vaccination in patients with autoimmune diseases
as it has been hypothesised that stimulation of the immune system via vaccination may lead to
an increase in disease activity. Furthermore, SLE patients display a variety of immune
dysfunctions which may influence their response to influenza vaccination.
Studies indicate that, although influenza vaccination in SLE may generate autoimmune
phenomena, no clinically significant increase in SLE disease activity can be expected.
Therefore, influenza vaccination can be considered safe in quiescent SLE, in accordance with
previous reviews on this subject
The aim of this study is to evaluate if the level of CXCR4 on leucocytes of patients with SLE
could be a good prognostic marker for the efficacy and the safety of influenza vaccine in SLE
patients. For that purpose, we will assay in lupus patients the cellular level of CXCR4
before and after administration of influenza vaccine and correlate the expression levels of
CXCR4 with: 1) the evolution of clinical and biological signs of autoimmunity and 2) the
humoral immune response towards influenza. If influenza vaccine has not been associated so
far with increased risk of lupus flare, it is important to determine if patients with
elevated leucocytes levels of CXCR4, (due to the impact of this molecule in humoral
immunity), are more at risk of vaccine side effects particularly of autoimmune origin.
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