Varicella-zoster virus-specific immune responses in elderly recipients of a herpes zoster vaccine
Varicella-zoster virus-specific immune responses in elderly recipients of a herpes zoster vaccine
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DOI：
10.1086/528696
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发表时间：
2008-03-15
影响因子：
6.4
通讯作者：
Weinberg, A.
中科院分区：
文献类型：
--
作者：
Levin, M. J.;Oxman, M. N.;Weinberg, A.
背景一项涉及38，546名≥ 60岁受试者的双盲、安慰剂对照试验证明了高效Oka/ Merck水痘-带状疱疹病毒（VZV）减毒活疫苗的有效性。该试验包括一项免疫学亚组研究，以确定VZV特异性免疫应答与疫苗接种和临床结果的关系。免疫学亚组研究在2个研究中心招募了1395名受试者，在疫苗接种前、疫苗接种后6周以及接种后1年、2年和3年采集血样，通过γ-干扰素ELISPOT和应答细胞频率测定法检测VZV特异性细胞介导免疫（VZV-CMI），并通过糖蛋白ELISA检测VZV抗体。疫苗接种后6周，接种者的VZV-CMI和VZV抗体显著增加。疫苗诱导的VZV-CMI增加在3年随访期间持续存在，尽管其幅度随时间推移而降低。这些VZV特异性免疫应答的幅度在60-69岁的受试者中比在≥ 70岁的受试者中更大。带状疱疹疫苗诱导VZV-CMI和VZV抗体显著增加。疫苗接种者中VZV-CMI增强的幅度和持续时间以及这种增强与年龄的关系证实了在有效性试验期间观察到的疫苗的临床效果。这些发现支持了这样的假设，即增强VZV-CMI可以保护老年人免受带状疱疹和带状疱疹后神经痛的影响。
Background. A double-blind, placebo-controlled trial that involved 38,546 subjects >= 60 years old demonstrated efficacy of a high-potency live-attenuated Oka/ Merck varicella-zoster virus (VZV) vaccine. The trial included an immunology substudy to determine the relationship of VZV-specific immune responses to vaccination and clinical outcome.Methods. The immunology substudy enrolled 1395 subjects at 2 sites where blood samples obtained prior to vaccination, at 6 weeks after vaccination, and at 1, 2, and 3 years thereafter were tested for VZV-specific cell-mediated immunity (VZV-CMI) by gamma-interferon ELISPOT and responder cell frequency assays and for VZV antibody by glycoprotein ELISA.Results. VZV-CMI and VZV antibodies were significantly increased in vaccine recipients at 6 weeks after vaccination. The vaccine-induced increases in VZV-CMI persisted during the 3 years of follow-up, although their magnitude decreased over time. The magnitude of these VZV-specific immune responses was greater in subjects 60-69 years old than in subjects >= 70 years old.Conclusions. The zoster vaccine induced a significant increase in VZV-CMI and VZV antibody. The magnitude and duration of the boost in VZV-CMI in vaccine recipients and the relationship of this boost to age paralleled the clinical effects of the vaccine observed during the efficacy trial. These findings support the hypothesis that boosting VZV-CMI protects older adults against herpes zoster and postherpetic neuralgia.