{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:01:26Z","timestamp":1790085686715,"version":"4.0.1"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,3,22]],"date-time":"2013-03-22T00:00:00Z","timestamp":1363910400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Vaccination against infection becomes important in patients with neuromyelitis optica spectrum disorder (<jats:styled-content style=\"fixed-case\">NMOSD<\/jats:styled-content>) because they are at an increased risk of infection due to long\u2010term immunosuppressive therapy. However, it is unclear whether <jats:styled-content style=\"fixed-case\">NMOSD<\/jats:styled-content> patients under immunosuppression therapy show proper antibody formation after vaccination. Thus the antibody formation after influenza A (H1N1) vaccination in patients with <jats:styled-content style=\"fixed-case\">NMOSD<\/jats:styled-content> receiving rituximab was evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study enrolled 26 patients with <jats:styled-content style=\"fixed-case\">NMOSD<\/jats:styled-content>, nine with multiple sclerosis and eight healthy controls. The enrolled patients had been treated with rituximab (<jats:italic>n<\/jats:italic>\u00a0=\u00a016), mycophenolate mofetil (<jats:italic>n<\/jats:italic>\u00a0=\u00a05), azathioprine (<jats:italic>n<\/jats:italic>\u00a0=\u00a06) and interferon\u2010\u03b2 (<jats:styled-content style=\"fixed-case\">IFN\u2010<\/jats:styled-content>\u03b2) (<jats:italic>n<\/jats:italic>\u00a0=\u00a08). Antibodies against the H1N1 influenza virus were measured in the serum drawn just before (T0) and between 3 and 5\u00a0weeks after (T1) vaccination. The immunization states for hepatitis B virus surface antigen, measles and tetanus during the treatment period were also tested.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The rituximab group showed significantly lower geometric mean titer, seroprotection rate and mean fold increase than the azathioprine group, <jats:styled-content style=\"fixed-case\">IFN\u2010<\/jats:styled-content>\u03b2 group and healthy controls, and a lower seroconversion rate than the <jats:styled-content style=\"fixed-case\">IFN\u2010<\/jats:styled-content>\u03b2 group. This decrease in vaccination efficacy was also shown in patients receiving mycophenolate mofetil. The immunization state for hepatitis B virus surface antigen, measles and tetanus remained the same during the treatment period with each drug, suggesting that these treatments do not affect previously formed immunity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study shows a severely hampered humoral immune response to H1N1 influenza vaccine in patients with <jats:styled-content style=\"fixed-case\">NMOSD<\/jats:styled-content> treated with rituximab, although the vaccination itself is safe in these patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.12132","type":"journal-article","created":{"date-parts":[[2013,3,23]],"date-time":"2013-03-23T06:47:25Z","timestamp":1364021245000},"page":"975-980","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":57,"title":["Reduced antibody formation after influenza vaccination in patients with neuromyelitis optica spectrum disorder treated with rituximab"],"prefix":"10.1111","volume":"20","author":[{"given":"W.","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Neurology The Catholic University of Korea Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.\u2010H.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology Research Institute and Hospital of National Cancer Center Goyang Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.\u2010Y.","family":"Huh","sequence":"additional","affiliation":[{"name":"Department of Neurology Research Institute and Hospital of National Cancer Center Goyang Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.\u2010Y.","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Research Institute and Hospital of National Cancer Center Goyang Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y. 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