Transcutaneous yellow fever vaccination of subjects with or without atopic dermatitis

Mark Slifka, Donald Y M Leung, Erika Hammarlund, Hans Peter Raué, Eric Simpson, Susan Tofte, Shahana Baig-Lewis, Gloria David, Henry Lynn, Rob Woolson, Tissa Hata, Henry Milgrom, Jon Hanifin

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background Atopic dermatitis (AD) is a common inflammatory skin disease with a global prevalence ranging from 3% to 20%. Patients with AD have an increased risk for complications after viral infection (eg, herpes simplex virus), and vaccination of patients with AD with live vaccinia virus is contraindicated because of a heightened risk of eczema vaccinatum, a rare but potentially lethal complication associated with smallpox vaccination. Objective We sought to develop a better understanding of immunity to cutaneous viral infection in patients with AD. Methods In a double-blind randomized study we investigated the safety and immunogenicity of live attenuated yellow fever virus (YFV) vaccination of nonatopic subjects and patients with AD after standard subcutaneous inoculation or transcutaneous vaccination administered with a bifurcated needle. Viremia, neutralizing antibody, and antiviral T-cell responses were analyzed for up to 30 days after vaccination. Results YFV vaccination administered through either route was well tolerated. Subcutaneous vaccination resulted in higher seroconversion rates than transcutaneous vaccination but elicited similar antiviral antibody levels and T-cell responses in both the nonatopic and AD groups. After transcutaneous vaccination, both groups mounted similar neutralizing antibody responses, but patients with AD demonstrated lower antiviral T-cell responses by 30 days after vaccination. Among transcutaneously vaccinated subjects, a significant inverse correlation between baseline IgE levels and the magnitude of antiviral antibody and CD4 + T-cell responses was observed. Conclusions YFV vaccination of patients with AD through the transcutaneous route revealed that high baseline IgE levels provide a potential biomarker for predicting reduced virus-specific immune memory after transcutaneous infection with a live virus.

Original languageEnglish (US)
Pages (from-to)439-447
Number of pages9
JournalJournal of Allergy and Clinical Immunology
Volume133
Issue number2
DOIs
StatePublished - Feb 2014

Fingerprint

Yellow Fever
Atopic Dermatitis
Vaccination
Yellow fever virus
Antiviral Agents
T-Lymphocytes
Virus Diseases
Neutralizing Antibodies
Immunoglobulin E
Kaposi Varicelliform Eruption
Viruses
Smallpox
Antibodies
Vaccinia virus
Viremia
Simplexvirus
Double-Blind Method
Skin Diseases
Antibody Formation
Needles

Keywords

  • antibody
  • atopic dermatitis
  • IgE
  • T-cell memory
  • Yellow fever virus

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Transcutaneous yellow fever vaccination of subjects with or without atopic dermatitis. / Slifka, Mark; Leung, Donald Y M; Hammarlund, Erika; Raué, Hans Peter; Simpson, Eric; Tofte, Susan; Baig-Lewis, Shahana; David, Gloria; Lynn, Henry; Woolson, Rob; Hata, Tissa; Milgrom, Henry; Hanifin, Jon.

In: Journal of Allergy and Clinical Immunology, Vol. 133, No. 2, 02.2014, p. 439-447.

Research output: Contribution to journalArticle

Slifka, M, Leung, DYM, Hammarlund, E, Raué, HP, Simpson, E, Tofte, S, Baig-Lewis, S, David, G, Lynn, H, Woolson, R, Hata, T, Milgrom, H & Hanifin, J 2014, 'Transcutaneous yellow fever vaccination of subjects with or without atopic dermatitis', Journal of Allergy and Clinical Immunology, vol. 133, no. 2, pp. 439-447. https://doi.org/10.1016/j.jaci.2013.10.037
Slifka, Mark ; Leung, Donald Y M ; Hammarlund, Erika ; Raué, Hans Peter ; Simpson, Eric ; Tofte, Susan ; Baig-Lewis, Shahana ; David, Gloria ; Lynn, Henry ; Woolson, Rob ; Hata, Tissa ; Milgrom, Henry ; Hanifin, Jon. / Transcutaneous yellow fever vaccination of subjects with or without atopic dermatitis. In: Journal of Allergy and Clinical Immunology. 2014 ; Vol. 133, No. 2. pp. 439-447.
@article{6d1fdf6597dd489ca58fddbb1eaecf01,
title = "Transcutaneous yellow fever vaccination of subjects with or without atopic dermatitis",
abstract = "Background Atopic dermatitis (AD) is a common inflammatory skin disease with a global prevalence ranging from 3{\%} to 20{\%}. Patients with AD have an increased risk for complications after viral infection (eg, herpes simplex virus), and vaccination of patients with AD with live vaccinia virus is contraindicated because of a heightened risk of eczema vaccinatum, a rare but potentially lethal complication associated with smallpox vaccination. Objective We sought to develop a better understanding of immunity to cutaneous viral infection in patients with AD. Methods In a double-blind randomized study we investigated the safety and immunogenicity of live attenuated yellow fever virus (YFV) vaccination of nonatopic subjects and patients with AD after standard subcutaneous inoculation or transcutaneous vaccination administered with a bifurcated needle. Viremia, neutralizing antibody, and antiviral T-cell responses were analyzed for up to 30 days after vaccination. Results YFV vaccination administered through either route was well tolerated. Subcutaneous vaccination resulted in higher seroconversion rates than transcutaneous vaccination but elicited similar antiviral antibody levels and T-cell responses in both the nonatopic and AD groups. After transcutaneous vaccination, both groups mounted similar neutralizing antibody responses, but patients with AD demonstrated lower antiviral T-cell responses by 30 days after vaccination. Among transcutaneously vaccinated subjects, a significant inverse correlation between baseline IgE levels and the magnitude of antiviral antibody and CD4 + T-cell responses was observed. Conclusions YFV vaccination of patients with AD through the transcutaneous route revealed that high baseline IgE levels provide a potential biomarker for predicting reduced virus-specific immune memory after transcutaneous infection with a live virus.",
keywords = "antibody, atopic dermatitis, IgE, T-cell memory, Yellow fever virus",
author = "Mark Slifka and Leung, {Donald Y M} and Erika Hammarlund and Rau{\'e}, {Hans Peter} and Eric Simpson and Susan Tofte and Shahana Baig-Lewis and Gloria David and Henry Lynn and Rob Woolson and Tissa Hata and Henry Milgrom and Jon Hanifin",
year = "2014",
month = "2",
doi = "10.1016/j.jaci.2013.10.037",
language = "English (US)",
volume = "133",
pages = "439--447",
journal = "Journal of Allergy and Clinical Immunology",
issn = "0091-6749",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Transcutaneous yellow fever vaccination of subjects with or without atopic dermatitis

AU - Slifka, Mark

AU - Leung, Donald Y M

AU - Hammarlund, Erika

AU - Raué, Hans Peter

AU - Simpson, Eric

AU - Tofte, Susan

AU - Baig-Lewis, Shahana

AU - David, Gloria

AU - Lynn, Henry

AU - Woolson, Rob

AU - Hata, Tissa

AU - Milgrom, Henry

AU - Hanifin, Jon

PY - 2014/2

Y1 - 2014/2

N2 - Background Atopic dermatitis (AD) is a common inflammatory skin disease with a global prevalence ranging from 3% to 20%. Patients with AD have an increased risk for complications after viral infection (eg, herpes simplex virus), and vaccination of patients with AD with live vaccinia virus is contraindicated because of a heightened risk of eczema vaccinatum, a rare but potentially lethal complication associated with smallpox vaccination. Objective We sought to develop a better understanding of immunity to cutaneous viral infection in patients with AD. Methods In a double-blind randomized study we investigated the safety and immunogenicity of live attenuated yellow fever virus (YFV) vaccination of nonatopic subjects and patients with AD after standard subcutaneous inoculation or transcutaneous vaccination administered with a bifurcated needle. Viremia, neutralizing antibody, and antiviral T-cell responses were analyzed for up to 30 days after vaccination. Results YFV vaccination administered through either route was well tolerated. Subcutaneous vaccination resulted in higher seroconversion rates than transcutaneous vaccination but elicited similar antiviral antibody levels and T-cell responses in both the nonatopic and AD groups. After transcutaneous vaccination, both groups mounted similar neutralizing antibody responses, but patients with AD demonstrated lower antiviral T-cell responses by 30 days after vaccination. Among transcutaneously vaccinated subjects, a significant inverse correlation between baseline IgE levels and the magnitude of antiviral antibody and CD4 + T-cell responses was observed. Conclusions YFV vaccination of patients with AD through the transcutaneous route revealed that high baseline IgE levels provide a potential biomarker for predicting reduced virus-specific immune memory after transcutaneous infection with a live virus.

AB - Background Atopic dermatitis (AD) is a common inflammatory skin disease with a global prevalence ranging from 3% to 20%. Patients with AD have an increased risk for complications after viral infection (eg, herpes simplex virus), and vaccination of patients with AD with live vaccinia virus is contraindicated because of a heightened risk of eczema vaccinatum, a rare but potentially lethal complication associated with smallpox vaccination. Objective We sought to develop a better understanding of immunity to cutaneous viral infection in patients with AD. Methods In a double-blind randomized study we investigated the safety and immunogenicity of live attenuated yellow fever virus (YFV) vaccination of nonatopic subjects and patients with AD after standard subcutaneous inoculation or transcutaneous vaccination administered with a bifurcated needle. Viremia, neutralizing antibody, and antiviral T-cell responses were analyzed for up to 30 days after vaccination. Results YFV vaccination administered through either route was well tolerated. Subcutaneous vaccination resulted in higher seroconversion rates than transcutaneous vaccination but elicited similar antiviral antibody levels and T-cell responses in both the nonatopic and AD groups. After transcutaneous vaccination, both groups mounted similar neutralizing antibody responses, but patients with AD demonstrated lower antiviral T-cell responses by 30 days after vaccination. Among transcutaneously vaccinated subjects, a significant inverse correlation between baseline IgE levels and the magnitude of antiviral antibody and CD4 + T-cell responses was observed. Conclusions YFV vaccination of patients with AD through the transcutaneous route revealed that high baseline IgE levels provide a potential biomarker for predicting reduced virus-specific immune memory after transcutaneous infection with a live virus.

KW - antibody

KW - atopic dermatitis

KW - IgE

KW - T-cell memory

KW - Yellow fever virus

UR - http://www.scopus.com/inward/record.url?scp=84895063557&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84895063557&partnerID=8YFLogxK

U2 - 10.1016/j.jaci.2013.10.037

DO - 10.1016/j.jaci.2013.10.037

M3 - Article

C2 - 24331381

AN - SCOPUS:84895063557

VL - 133

SP - 439

EP - 447

JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

SN - 0091-6749

IS - 2

ER -