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Common Painkillers Blunt Immune Response, New Research Indicates

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Using a common painkiller such as aspirin or ibuprofen (Advil®, Motrin®, etc.) "might not be a good idea" around the time of a flu shot or other inoculation, according to a new report from vaccine researchers at the University of Rochester (New York). In particular, you probably should avoid taking one for pain at your injection site. These widely used drugs, known as NSAIDs (nonsteroidal anti-inflammatory drugs), appear to interfere with the body's immune response, and particularly with the intended production of antibodies after a vaccination.

The findings have "widespread implications," the researchers note, since from 50 to 70 percent of Americans use NSAIDs for pain and inflammation relief. (And usage is likely even higher among Fibromyalgia and Chronic Fatigue Syndrome patients.) The revelation may be particularly important for older people, who are often heavy users of NSAIDs, and tend to be poor responders to flu and other vaccinations, says lead researcher Richard P. Phipps, PhD, a professor of Microbiology and Immunology. "This study could help explain the immune response problem," he notes.

NSAIDs Inhibit More Than Cox-2
NSAIDs are also known as "cox-2 inhibitors." The cyclooxygenase-2 (cox-2) enzyme acts to support repair of damage done by infection, a process that involves some degree of fever and inflammation (potentially pain). And the cox-2 inhibiting drugs blunt this response.

However, in studying the blood of subjects vaccinated during testing of the new HPV (Human Papillomavirus) vaccine to prevent cervical cancer, the investigators discovered that the cox-2 enzyme also influences the activity of human B-lymphocytes (B-cells) – the type of white blood cell that springs into action to produce antibodies when we're vaccinated. These "B-cells" work both to neutralize invading viral agents and produce memories of them for future recognition and response. The blood of vaccinated subjects produced a rich supply of antibodies to the HPV virus. But when cox-2 inhibitors were introduced to the subjects' blood, the B-cells' ability to produce antibodies was severely reduced.

The researchers produced a similar finding by testing relationship between cox-2 expression and B-cell antibody production in animals. Two groups of mice were vaccinated – one group that had been engineered to be cox-2 deficient and one normal control group. The cox-2 deficient animals made 50 to 70 percent fewer antibodies than the normal control animals.

Implications for the Immune Compromised?
The scientists say they don't yet understand exactly how cox-2 influences immune response. And while they emphasize they're not questioning the HPV vaccine, which proved effective in many trials even though some subjects undoubtedly had taken NSAIDs, they believe the extent of immune response generally "may depend upon the dose and frequency of NSAID use." They suggest that "the negative effects of blocking cox-2 could be more pronounced in people with compromised immune systems," and in situations where lower-than-optimal doses are administered when vaccines are in short supply.

The study report, "Cyclooxygenase-2 Inhibition Attenuates Antibody Responses Against Human Papillomavirus-Like Particles," by EP Ryan, et al., was published in the December 1, 2006 issue of The Journal of Immunology http://www.jimmunol.org/cgi/content/abstract/177/11/7811

Note: This information has not been evaluated by the FDA and is not intended to diagnose, treat, cure, or prevent any disease. It is extremely important that you make no change in your health support plan or regimen without careful review and collaborative consideration with your professional healthcare team.

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