Rationale for two influenza B lineages in seasonal vaccines: A meta-regression study on immunogenicity and controlled field trials
Rationale for two influenza B lineages in seasonal vaccines: A meta-regression study on immunogenicity and controlled field trials
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DOI：
10.1016/j.vaccine.2017.06.038
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发表时间：
2017-07-24
期刊：
影响因子：
5.5
通讯作者：
Osterhaus, A. D. M. E.
中科院分区：
文献类型：
--
作者：
Beyer, W. E. P.;Palache, A. M.;Osterhaus, A. D. M. E.
B谱系错配促使引入具有代表不同抗原谱系的两种流感B病毒的四价流感疫苗（QIV）。为了探索抗体（VEab）对抗体诱导和疫苗有效性预测的影响，我们对免疫原性研究进行了系统性文献检索，以评估QIV相对于三价流感疫苗（TIV）的抗体优效性。13篇相关文章描述了2007年至2013年的31项试验。将对数转换的GMT试验估计值及其方差转换为根据抗体（PRab）预测的临床保护率。根据接种前和接种后PRab计算VEab估计值。在没有特异性疫苗接种前免疫的情况下，匹配的平均VEab为69%，谱系错配的平均VEab为-4%。随着接种前血清阳性率的增加，错配影响下降至2%。我们还对TIV的随机对照试验和试验阴性病例对照试验进行了文献检索，并估计了疫苗对实验室确认的B型流感（VEf）的有效性。68篇符合条件的临床文章描述了1965年至2012年的110项季节性试验，涵盖了B谱系匹配（n = 52）、谱系漂移（n = 15）和谱系不匹配（n = 43）的季节。由于未测定接种前抗体水平，我们使用既往暴露于B型流感（Ppe）的机会作为季节前免疫措施。当Ppe为0%时，匹配季节的平均VEf为67%，不匹配季节的平均VEf为35%，这表明不匹配对VEf有中度但显著的影响。随着Ppe的增加，失配影响下降到3%。因此，血清学和田间试验表明，B谱系错配影响与季节前免疫力呈负相关，并且QIV超过TIV的获得对尚未暴露于B型流感的婴儿和儿童最有益。(C)2017爱思唯尔有限公司版权所有
B lineage mismatch prompted introduction of quadri-valent influenza vaccines (QIV) with two influenza B viruses representing distinct antigenic lineages. To explore the impact on antibody induction and vaccine effectiveness predicted from antibody (VEab), we performed a systematic literature search on immunogenicity studies conducted to assess antibody superiority of QIV over trivalent influenza vaccine (TIV). Thirteen relevant articles described 31 trials from 2007 and 2013. Log-transformed GMT trial estimates and their variances were converted to clinical protection rates predicted from antibody (PRab). VEab estimates were calculated from pre- and post-vaccination PRab. Without specific pre-vaccination immunity, average VEab was 69% for match, and -4% for lineage mismatch. With increasing pre-vaccination seropositivity, mismatch impact declined to 2%. We also performed an umbrella literature search for randomised controlled trials and test-negative case-control trials with TIV, and estimated vaccine effectiveness against laboratory-confirmed influenza B (VEf). Sixty-eight eligible clinical articles described 110 season-trials from 1965 to 2012, covering seasons with B lineage match (n = 52), lineage drift (n = 15) and lineage mismatch (n = 43). With no pre-vaccination antibody levels determined, we used chance of previous exposure to influenza B (Ppe) as pre-seasonal immunity measure. When Ppe was 0%, average VEf for matched seasons was 67%, and for mismatched seasons 35%, indicating a moderate, yet significant mismatch impact on VEf. With increasing Ppe, mismatch impact declined to 3%. Thus serological and field trials indicate that B lineage mismatch impact is negatively related to pre-seasonal immunity and that the gain of QIV over TIV most benefits infants and children not yet exposed to influenza B. (C) 2017 Elsevier Ltd. All rights reserved.