Studio sull'efficacia della timomodulina nel potenziamento della risposta anticorpale dopo vaccinazione antiinfluenzale in pazienti affetti da broncopneumopatia cronica ostruttiva

Influenza remains a major cause of illness and death in patients affected by Chronic Obstructive Lung Disease (COLD) despite current vaccination programs. One factor is the immunization failure in COLD patients, that may be as high as 50% and is probably related to aging and immune disregulation. Conflicting results have been reported concerning the immune disregulation in COLD patients. With the aim of assesing whether administration of a Biological Response Modifier (BRM) (thymomodulin, Leucotrofina -Ellm) would result in greater antibody production, we enrolled 72 volunteer patients affected with COLD in an open randomized trial; 28 of them were submitted to vaccination with 1991 tri-valent influenza vaccine and to treatment with thymomodulin (60 mg b.i.d. for 30 days) and 34 received only the vaccine. No toxicity was observed in randomized trial. No toxicity was observed in either group. The hemagglutination inhibiting antibody (HIA) response has been enhanced with notable differences in the Thymomodulin group either after 10 (short-term response) or 30 days. In particular, among patients with unprotective preimmunization HIA titles (≤ 1:20), the rate of responders to H3N2 strain, that was responsable of 1991-1992 influenza epidemic wave, was statistically significant in the group of patients treated wit Thymomodulin (100% vs. 68% respectively, p < 0.01). The ability of Thymomodulin to enhance the serologic response to influenza vaccine in BPCO patients may be of clinical relevance.