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A Prospective Study of Humoral and Cellular Immune Responses to Hepatitis B Vaccination in Habitual Marijuana Smokers

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Abstract

Exposure to Δ9-tetrahydrocannabinol (THC) in vitro and in animal models can significantly impair the differentiation, activation and function of dendritic cells, T cells and B cells. However, studies directly assessing the impact of marijuana smoking on human immunity are lacking. A prospective study of immune responses to a standard hepatitis B vaccination was therefore carried out in a matched cohort of 9 marijuana smokers (MS) and 9 nonsmokers (NS). In addition to their regular marijuana use, MS smoked four marijuana cigarettes in a monitored setting on the day of each vaccination. Blood samples were collected over time to assess the development of hepatitis B-specific immunity. The majority of subjects from both the NS (8) and MS (6) groups developed positive hepatitis B surface antibody titers (>10 IU/L) and of these 6 NS and 5 MS were classified as high antibody (good) responders (>100 IU/L). The development of a good response correlated with the presence of hepatitis B-specific T cell proliferation and cytokine production, resulting in a clear distinction regarding the immune status of good responders versus non-responders. However, even though there were slighter more non-responders in the MS cohort, there were no significant differences between MS and NS with respect to peripheral blood cell phenotypes or vaccination-related changes in hepatitis B responses. While a larger cohort may be required to rule out a small suppressive effect, our findings do not suggest that habitual marijuana smoking exerts a major impact on the development of systemic immunity to hepatitis B vaccination.

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Fig. 1: Dendritic cells (DC) that have been exposed to Δ9-tetrahydrocannabinol (THC) in vitro are impaired in their capacity to stimulate hepatitis B surface antigen (HBsAg)-specific T cell responses.
Fig. 2: A clinical protocol for evaluating the impact of habitual marijuana (MJ) use on humoral and cellular immune responses to hepatitis B vaccination.
Fig. 3: Both marijuana smokers (MS) and non-smokers (NS) are capable of developing humoral immunity in response to vaccination.
Fig. 4: Development of anti-HBsAg cellular immune responses to vaccination.
Fig. 5: Marijuana smokers (MS) and non-smokers (NS) demonstrate similar antibody and T cell immune responses to the hepatitis B vaccination.

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Acknowledgements

We are grateful to Dr. David M. Andrenyak, under the direction of Dr. David E. Moody, for determining serum THC and metabolite levels at the University of Utah Center for Human Toxicology. This research was supported by the National Institute on Drug Abuse at the National Institutes of Health (grants R01 DA-003018, DA-021813). Flow cytometry was performed in the UCLA Jonsson Comprehensive Cancer Center (JCCC) and Center for AIDS Research Flow Cytometry Core Facility, which is supported by the National Institutes of Health (grants CA-16042, AI-28697), the JCCC, the UCLA AIDS Institute, and the David Geffen School of Medicine at UCLA.

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Correspondence to Michael D. Roth.

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The authors have no commercial or financial conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Kiertscher, S.M., Gangalum, P.R., Ibrahim, G. et al. A Prospective Study of Humoral and Cellular Immune Responses to Hepatitis B Vaccination in Habitual Marijuana Smokers. J Neuroimmune Pharmacol 13, 219–229 (2018). https://doi.org/10.1007/s11481-018-9776-7

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  • DOI: https://doi.org/10.1007/s11481-018-9776-7

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