Safety and efficacy of vaccination against chickenpox for children with juvenile idiopathic arthritis and other autoimmune diseases receiving immunomodulatory therapy

Otroci z avtoimunsko boleznijo juvenilni idiopatski artritis (JIA) prejemajo imunomodulatorno terapijo, ki zmanjšuje delovanje imunskega odziva, zato so zanje lahko usodne že okužbe, ki jih zdravi otroci prebolijo brez posledic. Marsikatero okužbo lahko učinkovito preprečimo s cepljenjem, vendar se moramo vprašati kako se bo cepljenje obneslo pri neučinkovitem imunskem odzivu. Izkazalo se je, da v daljšem časovnem obdobju po cepljenju proti noricam ni prišlo do poslabšanja stanja JIA ali kakršnihkoli drugih težav. V naši raziskavi smo ugotavljali, če se po cepljenju otrok z JIA proti noricam izoblikuje učinkovit T celični odziv. Limfocite T smo izolirali iz periferne krvi otrok z JIA, ki so bili cepljeni proti noricam in jih spodbujali s peptidi humanega herpes virusa 3 (HHV-3). Nato smo s pretočnim citometrom merili deleže posameznih površinskih in znotrajceličnih označevalcev imunskih celic in citokinov ter na podlagi rezultatov poskušali določiti, če je prišlo do T celičnega odziva. Iz rezultatov smo sklepali, da se je po cepljenju otrok z JIA proti noricam, v večini primerov, izoblikoval učinkovit T celični odziv, ki bi tudi v primeru imunske oslabelosti lahko zagotovil zaščito. Za dokončno potrditev te hipoteze pa bi potrebovali primerjavo s skupino zdravih otrok, ki so norice preboleli.Children with autoimmune disease, juvenile idiopathic arthritis (JIA), receive immunomodular therapy that reduces the function of the immune response. This is why the infections, that healthy children overcome easily, can be fatal for them. Many infections can be prevented by vaccination, but there is a question of efficiency of the vaccine in an ineffective immune response. The results showed that in longer period after vaccination there was no deterioration in the JIA condition nor were there any other problems. In our study we wanted to research if the effective T cell response is formed when children with JIA receive vaccination against varicella. We isolated lymphocytes T from the peripheral blood of children whit JIA, vaccinated against varicella, and stimulated them by human herpes virus 3 (HHV-3) viral peptides. Further on, we measured, the proportions of the individual surface and intracellular markers of immune cells and cytokins with flow cytometer, and on the basis of the results, we tried to determine if there was a T cell response. Based on the results we concluded that after the vaccination of children with JIA against varicella, in most cases, an effective T cell response, which could provide protection, was formed, even in weak immune system cases. However, for a definitive confirmation of this hypothesis, a group of healthy children who have been overcome chickenpox, would be needed