Shelter from the cytokine storm: pitfalls and prospects in the development of SARS-CoV-2 vaccines for an elderly population.
Shelter from the cytokine storm: pitfalls and prospects in the development of SARS-CoV-2 vaccines for an elderly population.
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DOI：
10.1007/s00281-020-00821-0
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发表时间：
2020-10
影响因子：
9
通讯作者：
Medaglini D
中科院分区：
文献类型：
--
作者：
Ciabattini A;Garagnani P;Santoro F;Rappuoli R;Franceschi C;Medaglini D
SARS-CoV-2大流行迫切需要开发有效的预防工具。COVID-19严重打击了老年人和更脆弱的人群，推动了老年人接种疫苗的万年青问题。为老年人群量身定制的SARS-CoV-2疫苗的开发面临着老年人群由于免疫衰老、合并症和药物治疗而导致的免疫反应性差的挑战。此外，与年龄相关的炎症表型可能既影响疫苗接种效果，又加剧COVID-19相关的“细胞因子风暴综合征”的风险，影响疫苗接种效果的因素与增强SARS-CoV-2感染毒力和恶化预后的因素之间存在重叠。SARS-CoV-2感染的免疫病理学机制复杂且尚不清楚，加上免疫应答与年龄相关的进行性下降，以及缺乏明确的保护相关性，使得为老年人设计疫苗接种策略极具挑战性。在疫苗开发的持续努力中，已经开发了不同的SARS-CoV-2候选疫苗，在临床前和临床研究中进行了测试，并正在进行临床测试，但目前只有一小部分正在老年人群中进行测试。系统生物学的最新进展整合了临床、免疫学和组学数据，有助于确定稳定和稳健的疫苗反应标志物，并有助于更好地了解老年人对SARS-CoV-2疫苗的反应。
The SARS-CoV-2 pandemic urgently calls for the development of effective preventive tools. COVID-19 hits greatly the elder and more fragile fraction of the population boosting the evergreen issue of the vaccination of older people. The development of a vaccine against SARS-CoV-2 tailored for the elderly population faces the challenge of the poor immune responsiveness of the older population due to immunosenescence, comorbidities, and pharmacological treatments. Moreover, it is likely that the inflammaging phenotype associated with age could both influence vaccination efficacy and exacerbate the risk of COVID-19-related “cytokine storm syndrome” with an overlap between the factors which impact vaccination effectiveness and those that boost virulence and worsen the prognosis of SARS-CoV-2 infection. The complex and still unclear immunopathological mechanisms of SARS-CoV-2 infection, together with the progressive age-related decline of immune responses, and the lack of clear correlates of protection, make the design of vaccination strategies for older people extremely challenging. In the ongoing effort in vaccine development, different SARS-CoV-2 vaccine candidates have been developed, tested in pre-clinical and clinical studies and are undergoing clinical testing, but only a small fraction of these are currently being tested in the older fraction of the population. Recent advances in systems biology integrating clinical, immunologic, and omics data can help to identify stable and robust markers of vaccine response and move towards a better understanding of SARS-CoV-2 vaccine responses in the elderly.