Young and elderly patients with type 2 diabetes have optimal B cell responses to the seasonal influenza vaccine

Vaccine. 2013 Aug 2;31(35):3603-10. doi: 10.1016/j.vaccine.2013.05.003. Epub 2013 May 25.


We evaluated immune response to the seasonal influenza vaccine in young and elderly patients with type 2 diabetes (T2D). Immune measures included the in vivo serum response to the vaccine by hemagglutination inhibition (HAI) and ELISA in 22 patients (14 young, 8 elderly) and 65 healthy age-matched controls (37 young, 28 elderly). B cell-specific biomarkers of optimal vaccine response were measured ex vivo by switched memory B cells and plasmablasts and in vitro by activation-induced cytidine deaminase (AID) in stimulated cells. Markers of systemic and B cell-intrinsic inflammation were also measured. Results show that in vivo responses, as well as B cell-specific markers identified above, decrease by age in healthy individuals but not in T2D patients. This occurred despite high levels of B cell-intrinsic inflammation (TNF-α) in T2D patients, which was surprising as we had previously demonstrated this negatively impacts B cell function. These results altogether suggest that valid protection against influenza can be achieved in T2D patients and proposed mechanisms are discussed.

Keywords: Antibody responses; Inflammation; Influenza vaccine; Type 2 diabetes.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Viral / blood
  • Antibodies, Viral / immunology
  • B-Lymphocytes / immunology*
  • Biomarkers / blood
  • Cytidine Deaminase / genetics
  • Cytidine Deaminase / metabolism*
  • Diabetes Mellitus, Type 2 / immunology*
  • Female
  • Hemagglutination Inhibition Tests
  • Humans
  • Immunologic Memory / immunology
  • Inflammation / immunology
  • Influenza Vaccines / administration & dosage
  • Influenza Vaccines / immunology*
  • Influenza, Human / immunology*
  • Influenza, Human / prevention & control
  • Male
  • Middle Aged
  • RNA, Messenger / biosynthesis
  • Tumor Necrosis Factor-alpha / blood
  • Young Adult


  • Antibodies, Viral
  • Biomarkers
  • Influenza Vaccines
  • RNA, Messenger
  • Tumor Necrosis Factor-alpha
  • AICDA (activation-induced cytidine deaminase)
  • Cytidine Deaminase