The effect of immunosuppression or thymectomy on the response to tetanus revaccination in myasthenia gravis

Abstract

Objective: To determine the effect of tetanus toxoid (TT) revaccination on circulating B-, T- and NK-cell compartments in myasthenia gravis (MG) patients.

Methods: Lymphocyte (sub)populations and differentiation stages were assessed by flow cytometry in 50 TT revaccinated MG patients. TT-specific proliferative responses were explored in PBMC cultures.

Results: In patients treated with azathioprine B- and NK cell numbers were strongly decreased. Lymphocyte (sub)populations remained unaffected upon TT revaccination. t All patients showed a significant TT-induced proliferative response.

Conclusion: TT revaccination is effective in MG patients with stable disease irrespective of their thymectomy status and medication and does not alter the composition of the lymphocyte compartment.

Keywords: Autoimmunity; B lymphocyte; Immunosuppression; Myasthenia gravis; NK cells; T lymphocyte; Thymectomy; Vaccination.