Resposta imune à vacina contra hepatite B com suplementação de beta-glucanas
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Data
2020-02-26
Autores
Oba, Paula Franco
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Universidade Estadual Paulista (Unesp)
Resumo
A infecção crônica pelo vírus da hepatite B (VHB) é a principal causa de cronificação da hepatite, cirrose hepática e carcinoma hepatocelular em humanos. A vacinação contra hepatite B é essencial a saúde da população, sendo a medida de menor custo e maior eficiência para controlar o vírus. A vacina desencadeia resposta imune com produção de anticorpos contra o antígeno de superfície do VHB (anti-HBs), contudo, alguns indivíduos não desenvolvem imunidade efetiva, havendo necessidade de doses adicionais. Assim, estimular a resposta imune nos indivíduos já vacinados, porém pouco respondedores ou não respondedores previamente, poderia contribuir para o aumento da produção de anticorpos e persistência dos mesmos ao longo do tempo. Considerando o potencial imunomodulador de β-glucanas, inclusive no aumento da ativação de células T e B em resposta a antígenos, propôs-se neste estudo avaliar a influência do uso de β-glucanas como suplemento alimentar em indivíduos com imunidade não efetiva pós-vacina, que necessitassem de dose booster. Foram incluídos 46 doadores de sangue do Hemocentro de Botucatu, com idade entre 18 anos e 25 anos completos, do sexo masculino, vacinados com três doses para hepatite B na primeira infância. Aqueles que apresentaram anti-HBs<10UI/L foram considerados não imunes, sendo mantidos no estudo (n=31) e divididos em dois grupos de forma aleatória. Ambos os grupos receberam booster da vacina, sendo um grupo suplementado via oral com cápsulas de amido (n=11; placebo - 500mg/dia), e outro com β-glucanas (n=20; 500mg/dia), durante duas semanas. Na comparação intergrupos, não foi observado diferença significativa em relação a soroproteção, através da dosagem de anti-HBs, com 7 e 14 dias após dose de reforço vacinal. Não se pôde avaliar se o uso de β-glucanas teve efeito imunoestimulador, possivelmente devido a memória imunológica presente e com rápida resposta, representada pelo fato de que com apenas uma dose de reforço, 93,34% dos pacientes anti-HBs<10UI/L desenvolveram soroproteção, independente do estímulo. Os dados obtidos abrem perspectiva de reavaliação dos protocolos vigentes de vacinação da hepatite B, considerando a recomendação de booster na adolescência, para assegurar a real imunização, pois apenas 30,44% dos participantes, todos vacinados na infância, tinham imunização efetiva, e tendo em vista a boa resposta a uma dose booster. Além disso, há que se considerar o potencial uso da suplementação com β-glucana como imunomodulador na primovacinação, modelo em que não há influencia da memória imunológica.
Chronic hepatitis B virus (HBV) infection is the main cause of hepatitis chronification, liver cirrhosis and hepatocellular carcinoma in humans. Vaccination against hepatitis B is essential to the health of the population, being the least costly and most efficient measure to control the virus. The vaccine triggers an immune response with the production of antibodies against HBV surface antigen (Anti-HBs), however, some individuals do not develop effective immunity, requiring additional doses. Thus, stimulating the immune response in individuals who have already been vaccinated, but with little or no previous response, could contribute to increased antibody production and persistence over time. Considering the immunomodulatory potential of β-glucans, including the increased activation of T and B cells in response to antigens, it was proposed in this study to evaluate the influence of the use of βglucans as a food supplement in individuals with post-vaccine ineffective immunity , who needed a booster dose. 46 blood donors from the Hemocenter of Botucatu, aged between 18 and 25 years old, male, who received three doses of hepatitis B vaccine in childhood were included. Those who had anti-HBs <10 IU / L were considered non-immune, being maintained in the study (n = 31) and randomly divided into two groups. Both groups received a vaccine booster, one group supplemented orally with starch capsules (n = 11; placebo - 500mg / day), and the other with β-glucans (n = 20; 500mg / day) for two weeks. In the intergroup comparison, no significant difference was observed in relation to seroprotection, through the dosage of anti-HBs, at 7 and 14 days after the vaccine booster dose. It was not possible to assess whether the use of β-glucans had an immunostimulatory effect, possibly due to the present immunological memory and rapid response, represented by the fact that with only one booster dose, 93.34% of anti-HBs patients <10UI / L developed seroprotection. The study provides a new approach to the potential use of β-glucan supplementation as an immunomodulator in the primary vaccination. The data obtained also opens the prospect of reassessing the current hepatitis B vaccination protocols, considering the recommendation of booster in adolescence, to ensure real immunization, because only 30.44% of the participants, all vaccinated in childhood, had effective immunization, and in view of the good response to one booster dose. In addition, it is necessary to consider the potential use of β-glucan supplementation as an immunomodulator in the primary vaccination, a model in which there is no influence on immunological memory.
Chronic hepatitis B virus (HBV) infection is the main cause of hepatitis chronification, liver cirrhosis and hepatocellular carcinoma in humans. Vaccination against hepatitis B is essential to the health of the population, being the least costly and most efficient measure to control the virus. The vaccine triggers an immune response with the production of antibodies against HBV surface antigen (Anti-HBs), however, some individuals do not develop effective immunity, requiring additional doses. Thus, stimulating the immune response in individuals who have already been vaccinated, but with little or no previous response, could contribute to increased antibody production and persistence over time. Considering the immunomodulatory potential of β-glucans, including the increased activation of T and B cells in response to antigens, it was proposed in this study to evaluate the influence of the use of βglucans as a food supplement in individuals with post-vaccine ineffective immunity , who needed a booster dose. 46 blood donors from the Hemocenter of Botucatu, aged between 18 and 25 years old, male, who received three doses of hepatitis B vaccine in childhood were included. Those who had anti-HBs <10 IU / L were considered non-immune, being maintained in the study (n = 31) and randomly divided into two groups. Both groups received a vaccine booster, one group supplemented orally with starch capsules (n = 11; placebo - 500mg / day), and the other with β-glucans (n = 20; 500mg / day) for two weeks. In the intergroup comparison, no significant difference was observed in relation to seroprotection, through the dosage of anti-HBs, at 7 and 14 days after the vaccine booster dose. It was not possible to assess whether the use of β-glucans had an immunostimulatory effect, possibly due to the present immunological memory and rapid response, represented by the fact that with only one booster dose, 93.34% of anti-HBs patients <10UI / L developed seroprotection. The study provides a new approach to the potential use of β-glucan supplementation as an immunomodulator in the primary vaccination. The data obtained also opens the prospect of reassessing the current hepatitis B vaccination protocols, considering the recommendation of booster in adolescence, to ensure real immunization, because only 30.44% of the participants, all vaccinated in childhood, had effective immunization, and in view of the good response to one booster dose. In addition, it is necessary to consider the potential use of β-glucan supplementation as an immunomodulator in the primary vaccination, a model in which there is no influence on immunological memory.
Descrição
Palavras-chave
Beta-glucanas, Vacina Hepatite B, VHB, Antígenos de superfície da Hepatite B, Beta-glucans, Hepatitis B vaccines, Immunological adjuvants, Immunogenicity of the vaccine, Hepatitis B surface antigens