FRIDAY, July 31 (HealthDay News) -- Patients with systemic lupus erythematosus (SLE) may be more susceptible to influenza infection after vaccination because of impaired cell-mediated and antibody responses, according to a study in the August issue of Arthritis & Rheumatism.

Albert Holvast, M.D., of the University of Groningen in the Netherlands, and colleagues randomized 54 SLE patients and 54 healthy control subjects to undergo subunit influenza vaccination. Blood samples were taken before the vaccination and one month after. Cell-mediated responses to A/H1N1 and A/H3N2 vaccines were assessed, and antibody response was measured.

Before being vaccinated, the researchers found the SLE patients exhibited fewer interferon-γ (IFNγ) spot-forming cells against A/H1N1 and fewer IFNγ-positive CD8+ T cells than the controls. Following the vaccination, the number of IFNγ spot-forming cells increased in both groups, but was still lower in the SLE patients; there also were fewer CD4+ T cells in the SLE patients than in the controls. An impaired cell-mediated response to influenza vaccination was associated with use of prednisone and azathioprine. The authors further note that, following vaccination, the increase in A/H1N1-specific and A/H3N2-specific antibodies was lower in SLE patients than controls.

"In addition to a decreased antibody response, cell-mediated responses to influenza vaccination are diminished in patients with SLE, which may reflect the effects of the concomitant use of immunosuppressive drugs. This may render these patients more susceptible to (complicated) influenza infections," the authors write.

The study was supported by grants from the Jan Kornelis de Cock Foundation and Solvay Pharmaceuticals.

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