Relationship between the response to influenza vaccination and the nutritional status in institutionalized elderly subjects
Relationship between the response to influenza vaccination and the nutritional status in institutionalized elderly subjects
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DOI：
10.1093/gerona/54.2.m59
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发表时间：
1999-02-01
影响因子：
5.1
通讯作者：
Payette, H
中科院分区：
文献类型：
--
作者：
Fulop, T;Wagner, JR;Payette, H
背景流感是工业化国家老年人的主要健康问题。疗养院可能是流感爆发的特别好的环境。因此，本研究的目的是评估机构老年受试者的营养状况的一些方面，他们对流感疫苗接种的反应。还研究了细胞免疫应答的某些方面。23名患者参加了这项横断面研究。所有患者在第0天接种FluviralR，1994-95制剂：A/Shangdon/09/93、A/Texas/36/91、B/Panama/45/90。同时对免疫前抗体效价、简易营养评价法营养状况、生化指标、淋巴细胞增殖反应进行评价。在第28天，测定接种后抗体滴度。通过血凝抑制试验测定接种前和接种后针对各种流感抗原的抗体滴度。任何病毒抗原增加4倍均视为血清转化。接种前滴度高于40被认为是保护性的。11名老年受试者有反应，12名无反应。我们已经表明，营养参数，如血红蛋白，红细胞压积，总蛋白，铁和维生素E水平，以及DHEA水平和细胞免疫反应显着低于无反应组相比，响应组。因此，他们可能与流感疫苗的反应性机构老年人。这些结果将有助于设计干预研究，通过实现最佳营养状态来改善免疫反应，主要是在体弱的老年人群中，这可能会对公共卫生产生重大影响。
Background. Influenza is a major health problem among elderly people in industrialized countries. Nursing homes may be a particularly good setting for outbreaks of influenza. Thus, the aim of the present study was to evaluate some aspects of the nutritional status of institutionalized elderly subjects in relation to their response to influenza vaccination. Certain aspects of the cellular immune response were also investigated.Methods. Twenty-three patients participated in this cross-sectional study. All patients were vaccinated on day 0 with FluviralR, 1994-95 preparation: A/Shangdon/09/93, A/Texas/36/91, B/Panama/45/90. At the same time the prevaccination antibody titer, the nutritional status by the Mini Nutritional Assessment, biochemical parameters, and lymphocyte proliferation were assessed. On day 28, the postvaccination antibody titer was determined. The determination of pre- and postvaccination antibody titers against the various influenza antigens was carried out by the hemagglutination inhibition test. An increase of 4x for any of the virus antigens was considered as a seroconversion. A titer higher than 40 at the prevaccination period was considered as protective.Results. Eleven elderly subjects were responsive and 12 were not. We have shown that the nutritional parameters such as hemoglobin, hematocrit, total protein, iron and vitamin E levels, as well as the DHEA level and the cellular immune response were significantly lower in the nonresponsive group as compared to the responsive group. Thus, they might be associated with the influenza vaccine responsiveness of institutionalized elderly subjects.Conclusions. These results will help design intervention studies for improving the immune response by achieving an optimal nutritional status, mainly in the frail elderly population, that could have a great public health impact.