Transcutaneous yellow fever vaccination of subjects with or without atopic dermatitis
Transcutaneous yellow fever vaccination of subjects with or without atopic dermatitis
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DOI：
10.1016/j.jaci.2013.10.037
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发表时间：
2014-02-01
影响因子：
14.2
通讯作者：
Hanifin, Jon
中科院分区：
文献类型：
--
作者：
Slifka, Mark K.;Leung, Donald Y. M.;Hanifin, Jon
背景：特应性皮炎（AD）是一种常见的炎症性皮肤病，全球患病率为3%-20%。AD患者在病毒感染后并发症的风险增加（如单纯疱疹病毒），而接种活牛痘病毒的AD患者是禁忌的，因为湿疹牛痘，一种罕见的，但可能致命的并发症与天花vaccination.Objective：我们试图发展一个更好的了解免疫力皮肤病毒感染的AD患者。在一项双盲随机研究中，我们研究了非特应性受试者和AD患者在标准皮下接种或经皮接种后使用分叉针接种减毒黄热病病毒（YFV）活疫苗的安全性和免疫原性。病毒血症，中和抗体，和抗病毒T细胞反应进行了分析，长达30天后vaccination.Results：YFV疫苗接种管理通过任一途径是耐受性良好。皮下疫苗接种比经皮疫苗接种产生更高的血清转化率，但在非特应性和AD组中引起相似的抗病毒抗体水平和T细胞反应。经皮接种疫苗后，两组均产生了相似的中和抗体应答，但AD患者在接种疫苗后30天表现出较低的抗病毒T细胞应答。经皮接种疫苗的受试者中，基线IgE水平和抗病毒抗体和CD 4（+）T细胞应答的幅度之间存在显着的负相关性observed.Conclusions：通过经皮途径接种YFV疫苗的AD患者显示，高基线IgE水平提供了一个潜在的生物标志物，用于预测经皮感染活病毒后减少的病毒特异性免疫记忆。
Background: Atopic dermatitis (AD) is a common inflammatory skin disease with a global prevalence ranging from 3% to 20%. Patients with AD have an increased risk for complications after viral infection (eg, herpes simplex virus), and vaccination of patients with AD with live vaccinia virus is contraindicated because of a heightened risk of eczema vaccinatum, a rare but potentially lethal complication associated with smallpox vaccination.Objective: We sought to develop a better understanding of immunity to cutaneous viral infection in patients with AD.Methods: In a double-blind randomized study we investigated the safety and immunogenicity of live attenuated yellow fever virus (YFV) vaccination of nonatopic subjects and patients with AD after standard subcutaneous inoculation or transcutaneous vaccination administered with a bifurcated needle. Viremia, neutralizing antibody, and antiviral T-cell responses were analyzed for up to 30 days after vaccination.Results: YFV vaccination administered through either route was well tolerated. Subcutaneous vaccination resulted in higher seroconversion rates than transcutaneous vaccination but elicited similar antiviral antibody levels and T-cell responses in both the nonatopic and AD groups. After transcutaneous vaccination, both groups mounted similar neutralizing antibody responses, but patients with AD demonstrated lower antiviral T-cell responses by 30 days after vaccination. Among transcutaneously vaccinated subjects, a significant inverse correlation between baseline IgE levels and the magnitude of antiviral antibody and CD4(+) T-cell responses was observed.Conclusions: YFV vaccination of patients with AD through the transcutaneous route revealed that high baseline IgE levels provide a potential biomarker for predicting reduced virus-specific immune memory after transcutaneous infection with a live virus.