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Bile Acids Impair Vaccine Response in Children With Biliary Atresia

Jinchuan Liu1, Yi Fei2, Tao Zhou1

  • 1Department of Liver Surgery and Liver Transplantation, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Frontiers in Immunology
|May 3, 2021
PubMed

Insights

Children with biliary atresia (BA) have low routine vaccination rates. High bile acid levels are linked to poor hepatitis B vaccine response, potentially by affecting memory B cells.

Area of Science:

  • Pediatric Hepatology
  • Immunology
  • Vaccinology

Background:

  • Children with biliary atresia (BA), a common pediatric liver disease, are susceptible to infections.
  • Vaccination is crucial for protecting young children, but coverage and immune responses in BA patients are poorly understood.

Purpose of the Study:

  • To assess vaccination coverage in children with BA.
  • To identify factors influencing immune responses to the hepatitis B vaccine in this vulnerable population.

Main Methods:

  • Evaluated vaccination status in 288 BA children (median age 7 months) before liver transplantation.
  • Assessed immune cell subsets (CD4+ T cells, CD19+ B cells) and correlated them with bile acid levels in 49 BA children (median age 4 months).

Main Results:

  • Routine vaccination rates for vaccines like Men AC, MMR, and DTP were low (10.8-41.2%).
  • Hepatitis B vaccine coverage was high (96.2%), but 19.8% had HBV infection.
  • Elevated bile acid levels independently predicted poor hepatitis B vaccine response (OR=0.394) and were negatively correlated with CD19+CD27+IgG+ memory B cells.

Conclusions:

  • Chinese children with BA exhibit very low uptake of routine immunizations.
  • Bile acids may impair hepatitis B vaccine efficacy by inhibiting post-class-switched memory B cell responses in BA patients.
Abstract

Keywords:
B cellsbile acidsbiliary atresiachildrenvaccine response

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