Role of humoral and cell-mediated immunity in protection from influenza disease after immunization of healthy elderly

被引:177
作者
Murasko, DM
Bernstein, ED
Gardner, EM
Gross, P
Munk, G
Dran, S
Abrutyn, E
机构
[1] Med Coll Penn & Hahnemann Univ, Sch Med & Publ Hlth, Dept Microbiol & Immunol, Philadelphia, PA 19129 USA
[2] Hackensack Univ, Med Ctr, Dept Internal Med, Hackensack, NJ 07601 USA
[3] Med Coll Penn & Hahnemann Univ, Sch Med, Dept Med, Philadelphia, PA 19129 USA
[4] Med Coll Penn & Hahnemann Univ, Sch Publ Hlth, Dept Med, Philadelphia, PA 19129 USA
关键词
influenza; immunization; aging; antibody; T cell; interferon;
D O I
10.1016/S0531-5565(01)00210-8
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
While influenza immunization significantly reduces the risk of pneumonia and associated deaths, vaccination of elderly only affords 30-50% protection against influenza disease. The purpose of this study was to: (1) evaluate the consistency of immune responses across multiple years in young and elderly; (2) determine the contribution of antibody and cell-mediated responses in protection after immunization with influenza vaccine. Independently living healthy elderly (>200/year; mean age 78.8-80.6/ year) were recruited yearly in this four year study. The results clearly demonstrate: (1) both young and elderly consistently produced significant antibody and T cell proliferative responses to influenza vaccine upon yearly immunization; however, both responses of elderly were significantly and consistently lower than young. (2) Percentages of both young and elderly demonstrating protective titers (i.e. HI greater than or equal to 40) increased post-immunization each year, but were consistently higher in young compared to elderly. (3) The risk of developing influenza disease after immunization was highest among elderly demonstrating neither antibody nor cell-mediated responses. Importantly, the risk of influenza disease was comparable in elderly demonstrating a cell-mediated response alone, an antibody response alone, or both cell-mediated and antibody responses. This suggests that cell-mediated responses play a significant role in protection in at least a subset of elderly from influenza disease after immunization. (C) 2002 Elsevier Science Inc. All rights reserved.
引用
收藏
页码:427 / 439
页数:13
相关论文
共 23 条
[1]  
Bennett N M, 1973, Med J Aust, V1, P19
[2]   Immune response to influenza vaccination in a large healthy elderly population [J].
Bernstein, E ;
Kaye, D ;
Abrutyn, E ;
Gross, P ;
Dorfman, M ;
Murasko, DM .
VACCINE, 1999, 17 (01) :82-94
[3]   Cytokine production after influenza vaccination in a healthy elderly population [J].
Bernstein, ED ;
Gardner, EM ;
Abrutyn, E ;
Gross, P ;
Murasko, DM .
VACCINE, 1998, 16 (18) :1722-1731
[4]   ANTIBODY INDUCTION BY INFLUENZA VACCINES IN THE ELDERLY - A REVIEW OF THE LITERATURE [J].
BEYER, WEP ;
PALACHE, AM ;
BALJET, M ;
MASUREL, N .
VACCINE, 1989, 7 (05) :385-394
[5]  
BRANDRISS MW, 1981, AM REV RESPIR DIS, V124, P681
[6]   SERUM AND NASAL WASH ANTIBODIES ASSOCIATED WITH RESISTANCE TO EXPERIMENTAL CHALLENGE WITH INFLUENZA-A WILD-TYPE VIRUS [J].
CLEMENTS, ML ;
BETTS, RF ;
TIERNEY, EL ;
MURPHY, BR .
JOURNAL OF CLINICAL MICROBIOLOGY, 1986, 24 (01) :157-160
[7]   A CONTROLLED TRIAL OF AMANTADINE AND RIMANTADINE IN THE PROPHYLAXIS OF INFLUENZA-A INFECTION [J].
DOLIN, R ;
REICHMAN, RC ;
MADORE, HP ;
MAYNARD, R ;
LINTON, PN ;
WEBBERJONES, J .
NEW ENGLAND JOURNAL OF MEDICINE, 1982, 307 (10) :580-584
[8]   A GRADED-DOSE STUDY OF INACTIVATED, SURFACE-ANTIGEN INFLUENZA-B VACCINE IN VOLUNTEERS - REACTOGENICITY, ANTIBODY-RESPONSE AND PROTECTION TO CHALLENGE VIRUS-INFECTION [J].
GOODEVE, A ;
POTTER, CW ;
CLARK, A ;
JENNINGS, R ;
SCHILD, GC ;
YETTS, R .
JOURNAL OF HYGIENE, 1983, 90 (01) :107-115
[9]   THE EFFICACY OF INFLUENZA VACCINATION IN ELDERLY INDIVIDUALS - A RANDOMIZED DOUBLE-BLIND PLACEBO-CONTROLLED TRIAL [J].
GOVAERT, TME ;
THIJS, CTMCN ;
MASUREL, N ;
SPRENGER, MJW ;
DINANT, GJ ;
KNOTTNERUS, JA .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1994, 272 (21) :1661-1665
[10]   EFFICACY OF AN INFLUENZA HEMAGGLUTININ DIPHTHERIA TOXOID CONJUGATE VACCINE IN ELDERLY NURSING-HOME SUBJECTS DURING AN INFLUENZA OUTBREAK [J].
GRAVENSTEIN, S ;
DRINKA, P ;
DUTHIE, EH ;
MILLER, BA ;
BROWN, CS ;
HENSLEY, M ;
CIRCO, R ;
LANGER, E ;
ERSHLER, WB .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 1994, 42 (03) :245-251