B-cell function in chronic heart failure: Antibody response to pneumococcal vaccine

Background: Several immune system abnormalities have been noted in patients with chronic heart failure (CHF) including autoantibody production and abnormalities in tumor necrosis factor, interleukin 2, interleukin 6, natural killer cells, helper/inducer lymphocytes, lymphocyte reactivity, and subtherapeutic responses to the influenza vaccination. Patients with CHF have a higher risk of nosocomial infections, mainly pulmonary. Immune function abnormalities in patients with CHF raise concern over the ability of patients with symptomatic CHF to mount an effective and protective B-cell response. Methods and Results: B-cell function was assessed by measuring antibody production in response to pneumococcal vaccination. Antibody levels were increased markedly for all serotypes tested (P less than or equal to .001), and all patients had an increase in the number of serotypes for which they had protective antibody levels from a mean of 7.9 to 10.5 of 12 serotypes tested (P less than or equal to .001). These responses are consistent with normal responses to vaccination. Conclusions: Despite evidence of multiple immune system abnormalities., patients with CHF seem to have an intact B-cell function and the etiology of CHF does not affect antibody response. The normal response to vaccination confirms the potential utility of the vaccination.