School of Medicine and Health Sciences Poster Presentations

Title

Pilot Study of the Safety and Feasibility of Ultrasound-Guided Fine Needle Aspiration following Hepatitis B Vaccination of Healthy Adults

Document Type

Poster

Abstract Category

Immunology/Infectious Diseases

Keywords

vaccines, immunization, HIV/AIDS, immunology

Publication Date

Spring 5-1-2019

Abstract

Assessing adequate immune response after vaccination is a critical component in developing vaccines to prevent diseases. Researchers have devised techniques to help quantify immune responses and determine the efficacy of vaccines. However, research shows low frequencies of antigen-specific T helper follicular cells, immune response cells in blood, making it difficult to assess adequate induction of this important cell type after vaccination. To remedy this, it has been postulated that sampling lymph node centers directly may increase the likelihood of detecting these cells. This study serves as a preliminary model in assessing the efficacy of detecting T- follicular helper cells against the hepatitis B virus surface antigen in lymph nodes (LN) of human participants. If deemed effective, this technique will be implemented in a HIV vaccine trial. The primary purpose of this study was to assess the safety and feasibility of conducting ultrasound-guided axillary LN fine needle aspiration (FNA) following the second and third doses of the ENGERGIX-B hepatitis B vaccine. Additionally, we were interested in characterizing the cellular composition using flow cytometry after the second and third doses of the vaccine. Three volunteers were enrolled who were negative for HBsAg, HBsAb, HBcAb, HIV and HCV. They received the Hepatitis B Vaccine on a 0, 1, & 6-month schedule via intramuscular injections to the deltoid. Baseline screening axillary ultrasound was performed. LN aspirations were conducted 2 weeks post-2nd and 3rd doses of the vaccine. New nodes since baseline were sampled in each volunteer each time point. Aspirates transported to NIH within 1 hour of collection. In 2 of 3 volunteers, new post-vaccination axillary LNs were detected by ultrasound and successfully aspirated; the 3rd volunteer did not have LNs of sufficient size to be accessed. LN-FNA yielded significant numbers of detectable lymphocytes: 1.0 ‚úï 106 in participant 1 and 0.3 ‚úï 106 in participant 2. Using a labeled hepatitis B surface antigen probe, HBV++ germinal center B and T cells were detected in both volunteers, although these events were rare. These results suggest that antigen-specific T helper follicular cells can be detected in LNs after recent immunization. This reinforces the idea that ultrasound-guided axillary LN-FNA is a useful tool in assessing adequate immune response after vaccination. This studying is currently recruiting volunteers and additional data is expected.

Open Access

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Presented at Research Days 2019.

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Pilot Study of the Safety and Feasibility of Ultrasound-Guided Fine Needle Aspiration following Hepatitis B Vaccination of Healthy Adults

Assessing adequate immune response after vaccination is a critical component in developing vaccines to prevent diseases. Researchers have devised techniques to help quantify immune responses and determine the efficacy of vaccines. However, research shows low frequencies of antigen-specific T helper follicular cells, immune response cells in blood, making it difficult to assess adequate induction of this important cell type after vaccination. To remedy this, it has been postulated that sampling lymph node centers directly may increase the likelihood of detecting these cells. This study serves as a preliminary model in assessing the efficacy of detecting T- follicular helper cells against the hepatitis B virus surface antigen in lymph nodes (LN) of human participants. If deemed effective, this technique will be implemented in a HIV vaccine trial. The primary purpose of this study was to assess the safety and feasibility of conducting ultrasound-guided axillary LN fine needle aspiration (FNA) following the second and third doses of the ENGERGIX-B hepatitis B vaccine. Additionally, we were interested in characterizing the cellular composition using flow cytometry after the second and third doses of the vaccine. Three volunteers were enrolled who were negative for HBsAg, HBsAb, HBcAb, HIV and HCV. They received the Hepatitis B Vaccine on a 0, 1, & 6-month schedule via intramuscular injections to the deltoid. Baseline screening axillary ultrasound was performed. LN aspirations were conducted 2 weeks post-2nd and 3rd doses of the vaccine. New nodes since baseline were sampled in each volunteer each time point. Aspirates transported to NIH within 1 hour of collection. In 2 of 3 volunteers, new post-vaccination axillary LNs were detected by ultrasound and successfully aspirated; the 3rd volunteer did not have LNs of sufficient size to be accessed. LN-FNA yielded significant numbers of detectable lymphocytes: 1.0 ‚úï 106 in participant 1 and 0.3 ‚úï 106 in participant 2. Using a labeled hepatitis B surface antigen probe, HBV++ germinal center B and T cells were detected in both volunteers, although these events were rare. These results suggest that antigen-specific T helper follicular cells can be detected in LNs after recent immunization. This reinforces the idea that ultrasound-guided axillary LN-FNA is a useful tool in assessing adequate immune response after vaccination. This studying is currently recruiting volunteers and additional data is expected.