Immunogenicity of pneumococcal vaccines in comorbid autoimmune and chronic respiratory diseases
Immunogenicity of pneumococcal vaccines in comorbid autoimmune and chronic respiratory diseases
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肺炎球菌疫苗在合并自身免疫性疾病和慢性呼吸道疾病中的免疫原性
DOI：
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发表时间：
2019
影响因子：
4.8
通讯作者：
Hiroki Takahashi
中科院分区：
文献类型：
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作者：
K. Kuronuma;Hiroki Takahashi
肺炎链球菌可引起肺炎、脑膜炎、中耳炎和菌血症。侵袭性肺炎球菌病的死亡率和发病率在65岁的成年人或有潜在的慢性或免疫抑制情况的人中很高。最近的一项系统综述显示，与健康受试者相比，接受免疫抑制剂治疗的患者对肺炎球菌结合疫苗(PCV)和肺炎球菌多糖疫苗的免疫反应减弱。与其他免疫抑制剂相比，使用肿瘤坏死因子-α阻滞剂治疗的患者有更好的疗效。全身低剂量皮质类固醇激素不会影响肺炎球菌疫苗的反应。接受免疫抑制治疗的人类免疫缺陷病毒和特发性肺纤维化患者对肺炎球菌疫苗的免疫原性降低。在某些疾病条件下，依赖T细胞的PCV的作用可能依赖于宿主记忆B细胞。几种免疫抑制治疗类型和疾病状况可能会影响对肺炎球菌疫苗的反应。只要有可能，免疫接种应在免疫抑制药物开始前实施。
ABSTRACT Streptococcus pneumoniae causes pneumonia, meningitis, otitis media, and bacteremia. The mortality and morbidity of invasive pneumococcal disease are high among adults aged >65 years or those with underlying chronic or immunosuppressive conditions. A recent systematic review showed that patients treated with immunosuppressive agents have impaired immune responses to pneumococcal conjugate vaccine (PCV) and pneumococcal polysaccharide vaccine compared with healthy subjects. A more favorable response is observed in patients treated with tumor necrosis factor-alpha-blocking agents compared with those treated with other immunosuppressive agents. Low systemic corticosteroid doses do not affect the responses to pneumococcal vaccines. Patients with human immunodeficiency virus and idiopathic pulmonary fibrosis receiving immunosuppressive therapy exhibit decreased immunogenicity to pneumococcal vaccines. The effects of T-cell-dependent PCV possibly depend on host memory B cells in some disease conditions. Several immunosuppressive therapy types and disease conditions may affect the responses to pneumococcal vaccines. Immunization should be administered before immunosuppressive medication initiation whenever possible.