[Autoantibodies after vaccination against pneumococcal and influenza infections in children and adolescents with type I diabetes mellitus].

Aim: To study the influence of vaccination against pneumococcal and influenza infections on the levels of autoantibodies to DNA, pancreatic and adrenal tissues as well as on populations of lymphocytes and levels of immunoglobulins in children and adolescents with type I diabetes mellitus (DM1).

Materials And Methods: One hundred and thirty children and adolescents 2 - 18 years of age were followed during 12 months. One hundred participants were vaccinated against pneumococcal infection with Pneumo 23 vaccine. Twenty-eight of them (28%) were also vaccinated against influenza with subunit vaccine Grippol. Vaccination was performed during intensified insulin treatment. Unvaccinated group consisted from 30 children of the same age. During vaccination 59 (59%) children were in phase of diabetes compensation and 41 (41%)--in phase of subcompensation.

Results: In 5 out of 10 participants with high level of antibodies (Abs) to native DNA (n-DNA) before vaccination with Pneumo 23, normalization of this level 1 year after vaccination was noted. Normalization of level of Abs to denaturated DNA (d-DNA) was observed in 2 out of 7 patients with high levels to d-DNA before vaccination. Normalization of level of Abs to n-DNA was observed in 2 out of 3 patients after combined vaccination. It is important to note that vaccination of children in subcompensation phase of DM1 did not result in changes of levels of autoantibodies. One year after vaccination decrease of IgG, IgA, and IgM levels to normal range was noted. Absence of increase of HLA-DR and CD16 levels in postimmunization period in children with DM1 vaccinated even in subcompensation phase is also an indirect evidence of absence of autoimmune process activation.

Conclusion: Use of Pneumo 23 vaccine or its combination with Grippol vaccine in patients with DM1 did not result in increase of levels of autoantibodies to n-DNA, d-DNA and pancreatic tissue, was not able to initiate or lead to disease progression as well as positively influenced on the immune response with tendency to normalization of the several arms of the immune system and, at the same time, did not result in activation of autoimmune process.