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Abdeen S, Abed Alah M, Al-Zaidan M, Mohamed Ibrahim MI, Abdulmajeed J, Al-Nuaimi AA, Al-Kuwari MG. Short-term side effects of BNT162b2 vaccine in primary care settings in Qatar: a retrospective study. Front Public Health 2024; 12:1384327. [PMID: 38660363 PMCID: PMC11039914 DOI: 10.3389/fpubh.2024.1384327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 03/20/2024] [Indexed: 04/26/2024] Open
Abstract
Background Despite the established effectiveness of the BNT162b2 Vaccine, the novel technology demands careful safety monitoring. While global studies have explored its safety, local data remains limited and exhibits some variability. This study investigated short-term side effects among BNT162b2 vaccinated individuals in Qatar. Methods A retrospective analysis was conducted using data extracted from the electronic health records of individuals aged 18 or older across 8 primary health centers who received either the first or second dose of the BNT162b2 vaccine during the period from December 23, 2020, to April 24, 2021. The proportions of individuals experiencing short-term side effects after each dose were calculated. Logistic regression and log binomial regression analyses were used to explore associations with the side effects. Results Among 7,764 participants, 5,489 received the first dose and 2,275 the second, with similar demographics between the groups. After the first dose, 5.5% reported at least one local side effect, compared to 3.9% after the second, with a 1.4 times higher incidence after the first dose (RR 1.4, 95% CI 1.14-1.75) compared to the second. Systemic side effects after the second dose were 2.6 times more common than after the first (RR 2.6, 95% CI 2.15-3.14). Gender, nationality, history of prior COVID-19 infection, and obesity were significantly associated with side effects after the first dose, while age, gender, and nationality, were significant factors after the second dose. Conclusion The rates of side effects following the BNT162b2 vaccine in Qatar were relatively low, with age, gender, nationality, previous infection, and obesity identified as significant predictors. These results emphasize the need for tailored vaccination strategies and contributes valuable insights for evidence-based decision-making in ongoing and future vaccination campaigns.
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Affiliation(s)
- Sami Abdeen
- Community Medicine Department, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Muna Abed Alah
- Community Medicine Department, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Manal Al-Zaidan
- Department of Pharmacy and Therapeutics Supply, Primary Health Care Corporation, Doha, Qatar
| | | | - Jazeel Abdulmajeed
- Strategy and Health Intelligence Department, Primary Health Care Corporation, Doha, Qatar
| | - Asma Ali Al-Nuaimi
- Strategy and Health Intelligence Department, Primary Health Care Corporation, Doha, Qatar
| | - Mohamed Ghaith Al-Kuwari
- Strategy and Health Intelligence Department, Primary Health Care Corporation, Doha, Qatar
- Collège of Medicine, Qatar University, Doha, Qatar
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Xu W, Ren W, Wu T, Wang Q, Luo M, Yi Y, Li J. Real-World Safety of COVID-19 mRNA Vaccines: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:1118. [PMID: 37376508 DOI: 10.3390/vaccines11061118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
With the mass vaccination program for COVID-19 mRNA vaccines, there has been sufficient real-world study (RWS) on the topic to summarize their safety in the total population and in immunocompromised (IC) patients who were excluded from phase 3 clinical trials. We conducted a systematic review and meta-analysis to evaluate the safety of COVID-19 mRNA vaccines, with a total of 5,132,799 subjects from 122 articles. In the case of the total population vaccinated with first, second, and third doses, the pooled incidence of any adverse events (AEs) was 62.20%, 70.39%, and 58.60%; that of any local AEs was 52.03%, 47.99%, and 65.00%; that of any systemic AEs was 29.07%, 47.86%, and 32.71%. Among the immunocompromised patients, the pooled odds ratio of any AEs, any local AEs, and systemic AEs were slightly lower than or similar to those of the healthy controls at 0.60 (95% CI: 0.33-1.11), 0.19 (95% CI: 0.10-0.37), and 0.36 (95% CI: 0.25-0.54), with pooled incidences of 51.95%, 38.82%, and 31.00%, respectively. The spectrum of AEs associated with the vaccines was broad, but most AEs were transient, self-limiting, and mild to moderate. Moreover, younger adults, women, and people with prior SARS-CoV-2 infection were more likely to experience AEs.
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Affiliation(s)
- Wanqian Xu
- School of Public Health, The Second Hospital of Nanjing, Nanjing Medical University, Nanjing 211166, China
- The Clinical Infectious Disease Center of Nanjing, Nanjing 210003, China
| | - Weigang Ren
- The Clinical Infectious Disease Center of Nanjing, Nanjing 210003, China
- Department of Infectious Diseases, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, China
| | - Tongxin Wu
- The Clinical Infectious Disease Center of Nanjing, Nanjing 210003, China
- Department of Infectious Diseases, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, China
| | - Qin Wang
- The Clinical Infectious Disease Center of Nanjing, Nanjing 210003, China
- Department of Infectious Diseases, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, China
| | - Mi Luo
- School of Public Health, The Second Hospital of Nanjing, Nanjing Medical University, Nanjing 211166, China
- The Clinical Infectious Disease Center of Nanjing, Nanjing 210003, China
| | - Yongxiang Yi
- School of Public Health, The Second Hospital of Nanjing, Nanjing Medical University, Nanjing 211166, China
- The Clinical Infectious Disease Center of Nanjing, Nanjing 210003, China
- Department of Infectious Diseases, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, China
| | - Junwei Li
- The Clinical Infectious Disease Center of Nanjing, Nanjing 210003, China
- Department of Infectious Diseases, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, China
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3
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Chen M, Yuan Y, Zhou Y, Deng Z, Zhao J, Feng F, Zou H, Sun C. Safety of SARS-CoV-2 vaccines: a systematic review and meta-analysis of randomized controlled trials. Infect Dis Poverty 2021. [PMID: 34225791 DOI: 10.1186/s40249-021-00878-5.pmid:34225791;pmcid:pmc8256217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND Various modalities of vaccines against coronavirus disease 2019 (COVID-19), based on different platforms and immunization procedures, have been successively approved for marketing worldwide. A comprehensive review for clinical trials assessing the safety of COVID-19 vaccines is urgently needed to make an accurate judgment for mass vaccination. MAIN TEXT A systematic review and meta-analysis was conducted to determine the safety of COVID-19 vaccine candidates in randomized controlled trials (RCTs). Data search was performed in PubMed, Embase, Cochrane library, Scopus, Web of Science, and MedRxiv. Included articles were limited to RCTs on COVID-19 vaccines. A total of 73,633 subjects from 14 articles were included to compare the risks of adverse events following immunization (AEFI) after vaccinating different COVID-19 vaccines. Pooled risk ratios (RR) of total AEFI for inactivated vaccine, viral-vectored vaccine, and mRNA vaccine were 1.34 [95% confidence interval (CI) 1.11-1.61, P < 0.001], 1.65 (95% CI 1.31-2.07, P < 0.001), and 2.01 (95% CI 1.78-2.26, P < 0.001), respectively. No significant differences on local and systemic AEFI were found between the first dose and second dose. In addition, people aged ≤ 55 years were at significantly higher risk of AEFI than people aged ≥ 56 years, with a pooled RR of 1.25 (95% CI 1.15-1.35, P < 0.001). CONCLUSIONS The safety and tolerance of current COVID-19 vaccine candidates are acceptable for mass vaccination, with inactivated COVID-19 vaccines candidates having the lowest reported AEFI. Long-term surveillance of vaccine safety is required, especially among elderly people with underlying medical conditions.
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Affiliation(s)
- Musha Chen
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Yue Yuan
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Yiguo Zhou
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Zhaomin Deng
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Jin Zhao
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Fengling Feng
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China. .,Key Laboratory of Tropical Disease Control (Sun Yat-Sen University), Ministry of Education, Guangzhou, China.
| | - Caijun Sun
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China. .,Key Laboratory of Tropical Disease Control (Sun Yat-Sen University), Ministry of Education, Guangzhou, China.
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4
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Chen M, Yuan Y, Zhou Y, Deng Z, Zhao J, Feng F, Zou H, Sun C. Safety of SARS-CoV-2 vaccines: a systematic review and meta-analysis of randomized controlled trials. Infect Dis Poverty 2021; 10:94. [PMID: 34225791 PMCID: PMC8256217 DOI: 10.1186/s40249-021-00878-5] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 06/22/2021] [Indexed: 12/21/2022] Open
Abstract
Background Various modalities of vaccines against coronavirus disease 2019 (COVID-19), based on different platforms and immunization procedures, have been successively approved for marketing worldwide. A comprehensive review for clinical trials assessing the safety of COVID-19 vaccines is urgently needed to make an accurate judgment for mass vaccination. Main text A systematic review and meta-analysis was conducted to determine the safety of COVID-19 vaccine candidates in randomized controlled trials (RCTs). Data search was performed in PubMed, Embase, Cochrane library, Scopus, Web of Science, and MedRxiv. Included articles were limited to RCTs on COVID-19 vaccines. A total of 73,633 subjects from 14 articles were included to compare the risks of adverse events following immunization (AEFI) after vaccinating different COVID-19 vaccines. Pooled risk ratios (RR) of total AEFI for inactivated vaccine, viral-vectored vaccine, and mRNA vaccine were 1.34 [95% confidence interval (CI) 1.11–1.61, P < 0.001], 1.65 (95% CI 1.31–2.07, P < 0.001), and 2.01 (95% CI 1.78–2.26, P < 0.001), respectively. No significant differences on local and systemic AEFI were found between the first dose and second dose. In addition, people aged ≤ 55 years were at significantly higher risk of AEFI than people aged ≥ 56 years, with a pooled RR of 1.25 (95% CI 1.15–1.35, P < 0.001). Conclusions The safety and tolerance of current COVID-19 vaccine candidates are acceptable for mass vaccination, with inactivated COVID-19 vaccines candidates having the lowest reported AEFI. Long-term surveillance of vaccine safety is required, especially among elderly people with underlying medical conditions. Graphic Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-021-00878-5.
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Affiliation(s)
- Musha Chen
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Yue Yuan
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Yiguo Zhou
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Zhaomin Deng
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Jin Zhao
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Fengling Feng
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China. .,Key Laboratory of Tropical Disease Control (Sun Yat-Sen University), Ministry of Education, Guangzhou, China.
| | - Caijun Sun
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China. .,Key Laboratory of Tropical Disease Control (Sun Yat-Sen University), Ministry of Education, Guangzhou, China.
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5
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Vlot JA, Vive MGD, Brockhoff HJ, van Genderen PJJ, Trompenaars MCE, van Steenbergen JE, Visser LG. Predicting morbidity in older travellers during a short-term stay in the tropics: the ELDEST study. J Travel Med 2021; 28:5991862. [PMID: 33225347 PMCID: PMC7788562 DOI: 10.1093/jtm/taaa216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/19/2020] [Accepted: 11/06/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND Older persons may suffer more from travel-related health problems because of ageing and underlying chronic disorders. Knowledge on who is more likely to have these health problems helps to tailor travel health advice more specifically. This study aimed to determine predictors of travel-related morbidity in older travellers by assessing their pre-travel characteristics and performance using physical and cognitive functioning tests. METHODS Multicentre prospective cohort study among older travellers (≥60 years) who consulted one of the participating Dutch travel clinics. Handgrip strength and cognitive performance were measured pre-travel. Participants completed questionnaires before departure and 1 and 4 weeks after return. A diary recorded health complaints during travel until 2-week post-travel. RESULTS In total, 477 travellers completed the study (follow-up rate of 97%). Participants' median age was 66 years. The most visited regions were South-East Asia (34%) and South Asia (14%). Median travel duration was 19 days. Polypharmacy (≥5 medications per day) was not uncommon (16%). The median Charlson Comorbidity Index (CCI) score was 0. Self-reported travel-related infectious diseases concerned primarily respiratory tract infections (21%) and gastroenteritis (10%) whereas non-infectious complaints were injuries (13%), peripheral edema (12%) and dehydration (3%). Medical assistance was sought by 18%, mostly post-travel from their general practitioner (87%). Self-reported physical and mental health-related quality of life significantly improved during and after travel. Predictors for an increased risk of travel-related morbidity were higher CCI score, more travel experience, longer travel duration, higher number of daily medications, visiting northern Africa or South-East and East Asia, and phone and social media use. CONCLUSION Older Dutch travellers are generally fit, well-prepared and suffer not only from common infectious health problems, but also from injuries. Travel improved their self-perceived health. The predictors could be used to identify the more at-risk older traveller and to decrease travel-related morbidity by optimizing pre-travel advice.
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Affiliation(s)
- Jessica A Vlot
- Department of Infectious Diseases, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Marissa G D Vive
- Department of Infectious Diseases, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Henricus J Brockhoff
- Department of Infectious Diseases, Municipal Health Service, Westeinde 128, 2512 HE The Hague, The Netherlands
| | - Pieter J J van Genderen
- Harbour Hospital and Institute for Tropical Diseases, currently working on Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | | | - James E van Steenbergen
- Department of Infectious Diseases, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.,Centre for Infectious Disease Control, Netherlands Institute for Public Health and Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
| | - Leonardus G Visser
- Department of Infectious Diseases, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
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6
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Xu Y, Liu Y, Du J, Zheng W, Liu S, Zhang X, Zhang X, Wang J, Che X, Gu W, Jiang W. Seroepidemiology of tetanus in Hangzhou from 2009 to 2018. Hum Vaccin Immunother 2020; 16:2670-2676. [DOI: 10.1080/21645515.2020.1738170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Yuyang Xu
- Imunoprevention institute, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Yan Liu
- Imunoprevention institute, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Jian Du
- Imunoprevention institute, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Wei Zheng
- Imunoprevention institute, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Shijun Liu
- Imunoprevention institute, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Xuechao Zhang
- Imunoprevention institute, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Xiaoping Zhang
- Imunoprevention institute, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Jun Wang
- Imunoprevention institute, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Xinren Che
- Imunoprevention institute, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Wenwen Gu
- Imunoprevention institute, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Wei Jiang
- Imunoprevention institute, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
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7
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Patel NP, Vukmanovic-Stejic M, Suarez-Farinas M, Chambers ES, Sandhu D, Fuentes-Duculan J, Mabbott NA, Rustin MHA, Krueger J, Akbar AN. Impact of Zostavax Vaccination on T-Cell Accumulation and Cutaneous Gene Expression in the Skin of Older Humans After Varicella Zoster Virus Antigen-Specific Challenge. J Infect Dis 2019; 218:S88-S98. [PMID: 30247603 PMCID: PMC6151076 DOI: 10.1093/infdis/jiy420] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background The live attenuated vaccine Zostavax was developed to prevent varicella zoster virus (VZV) reactivation that causes herpes zoster (shingles) in older humans. However, the impact of vaccination on the cutaneous response to VZV is not known. Methods We investigated the response to intradermal VZV antigen challenge before and after Zostavax vaccination in participants >70 years of age by immunohistological and transcriptomic analyses of skin biopsy specimens collected from the challenge site. Results Vaccination increased the proportion of VZV-specific CD4+ T cells in the blood and promoted the accumulation of both CD4+ and CD8+ T cells in the skin after VZV antigen challenge. However, Zostavax did not alter the proportion of resident memory T cells (CD4+ and CD8+) or CD4+Foxp3+ regulatory T cells in unchallenged skin. After vaccination, there was increased cutaneous T-cell proliferation at the challenge site and also increased recruitment of T cells from the blood, as indicated by an elevated T-cell migratory gene signature. CD8+ T-cell–associated functional genes were also highly induced in the skin after vaccination. Conclusion Zostavax vaccination does not alter the abundance of cutaneous resident memory T cells but instead increases the recruitment of VZV-specific T cells from the blood and enhances T-cell activation, particularly cells of the CD8+ subset, in the skin after VZV antigen challenge.
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Affiliation(s)
- Neil P Patel
- Division of Infection and Immunity, University College London.,Department of Dermatology, Royal Free Hospital, London
| | | | - Mayte Suarez-Farinas
- Laboratory for Investigative Dermatology, Rockefeller University, New York, New York
| | - Emma S Chambers
- Division of Infection and Immunity, University College London
| | - Daisy Sandhu
- Division of Infection and Immunity, University College London.,Department of Dermatology, Royal Free Hospital, London
| | | | - Neil A Mabbott
- Roslin Institute, University of Edinburgh, Midlothian, United Kingdom.,Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, United Kingdom
| | | | - James Krueger
- Laboratory for Investigative Dermatology, Rockefeller University, New York, New York
| | - Arne N Akbar
- Division of Infection and Immunity, University College London
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8
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Age-specific changes in the molecular phenotype of patients with moderate-to-severe atopic dermatitis. J Allergy Clin Immunol 2019; 144:144-156. [DOI: 10.1016/j.jaci.2019.01.015] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 01/04/2019] [Accepted: 01/17/2019] [Indexed: 12/31/2022]
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9
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Fujiwara A, Minakuchi H, Uehara J, Miki H, Inoue‐Minakuchi M, Kimura‐Ono A, Nawachi K, Maekawa K, Kuboki T. Loss of oral self‐care ability results in a higher risk of pneumonia in older inpatients: A prospective cohort study in a Japanese rural hospital. Gerodontology 2019; 36:236-243. [DOI: 10.1111/ger.12402] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 02/01/2019] [Accepted: 02/16/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Aya Fujiwara
- Department of Oral Rehabilitation and Regenerative Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Hajime Minakuchi
- Department of Oral Rehabilitation and Regenerative Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | | | - Haruna Miki
- Department of Oral Rehabilitation and Regenerative Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Mami Inoue‐Minakuchi
- Department of Oral Rehabilitation and Regenerative Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Aya Kimura‐Ono
- Center for Innovative Clinical Medicine Okayama University Hospital Okayama Japan
| | - Kumiko Nawachi
- Department of Oral Rehabilitation and Regenerative Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Kenji Maekawa
- Department of Oral Rehabilitation and Regenerative Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Takuo Kuboki
- Department of Oral Rehabilitation and Regenerative Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
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10
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Vukmanovic-Stejic M, Chambers ES, Suárez-Fariñas M, Sandhu D, Fuentes-Duculan J, Patel N, Agius E, Lacy KE, Turner CT, Larbi A, Birault V, Noursadeghi M, Mabbott NA, Rustin MHA, Krueger JG, Akbar AN. Enhancement of cutaneous immunity during aging by blocking p38 mitogen-activated protein (MAP) kinase-induced inflammation. J Allergy Clin Immunol 2017; 142:844-856. [PMID: 29155150 PMCID: PMC6127037 DOI: 10.1016/j.jaci.2017.10.032] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/13/2017] [Accepted: 10/23/2017] [Indexed: 01/09/2023]
Abstract
Background Immunity decreases with age, which leads to reactivation of varicella zoster virus (VZV). In human subjects age-associated immune changes are usually measured in blood leukocytes; however, this might not reflect alterations in tissue-specific immunity. Objectives We used a VZV antigen challenge system in the skin to investigate changes in tissue-specific mechanisms involved in the decreased response to this virus during aging. Methods We assessed cutaneous immunity based on the extent of erythema and induration after intradermal VZV antigen injection. We also performed immune histology and transcriptomic analyses on skin biopsy specimens taken from the challenge site in young (<40 years) and old (>65 years) subjects. Results Old human subjects exhibited decreased erythema and induration, CD4+ and CD8+ T-cell infiltration, and attenuated global gene activation at the site of cutaneous VZV antigen challenge compared with young subjects. This was associated with increased sterile inflammation in the skin in the same subjects related to p38 mitogen-activated protein kinase–related proinflammatory cytokine production (P < .0007). We inhibited systemic inflammation in old subjects by means of pretreatment with an oral small-molecule p38 mitogen-activated protein kinase inhibitor (Losmapimod; GlaxoSmithKline, Brentford, United Kingdom), which reduced both serum C-reactive protein levels and peripheral blood monocyte secretion of IL-6 and TNF-α. In contrast, cutaneous responses to VZV antigen challenge were increased significantly in the same subjects (P < .0003). Conclusion Excessive inflammation in the skin early after antigen challenge retards antigen-specific immunity. However, this can be reversed by inhibition of inflammatory cytokine production that can be used to promote vaccine efficacy and the treatment of infections and malignancy during aging.
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Affiliation(s)
| | - Emma S Chambers
- Division of Infection and Immunity, University College London, London, United Kingdom
| | | | - Daisy Sandhu
- Division of Infection and Immunity, University College London, London, United Kingdom; Department of Dermatology, Royal Free Hospital, London, United Kingdom
| | | | - Neil Patel
- Division of Infection and Immunity, University College London, London, United Kingdom; Department of Dermatology, Royal Free Hospital, London, United Kingdom
| | - Elaine Agius
- Division of Infection and Immunity, University College London, London, United Kingdom; Department of Dermatology, Royal Free Hospital, London, United Kingdom
| | - Katie E Lacy
- Division of Infection and Immunity, University College London, London, United Kingdom; Department of Dermatology, Royal Free Hospital, London, United Kingdom; NIHR Biomedical Research Centre at Guy's and St Thomas's Hospitals and King's College London, Cutaneous Medicine and Immunotherapy, St John's Institute of Dermatology, Division of Genetics and Molecular Medicine, King's College London School of Medicine, Guy's Hospital, King's College London, London, United Kingdom
| | - Carolin T Turner
- Division of Infection and Immunity, University College London, London, United Kingdom
| | - Anis Larbi
- Biomedical Sciences Institutes: Agency for Science, Technology and Research (A*STAR), Singapore
| | | | - Mahdad Noursadeghi
- Division of Infection and Immunity, University College London, London, United Kingdom
| | - Neil A Mabbott
- Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, United Kingdom
| | | | - James G Krueger
- Laboratory for Investigative Dermatology, Rockefeller University, New York, NY
| | - Arne N Akbar
- Division of Infection and Immunity, University College London, London, United Kingdom.
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11
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Dirmesropian S, Wood JG, MacIntyre CR, Beutels P, Newall AT. Economic Evaluation of Vaccination Programmes in Older Adults and the Elderly: Important Issues and Challenges. PHARMACOECONOMICS 2016; 34:723-731. [PMID: 26914091 DOI: 10.1007/s40273-016-0393-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
High-income countries are undergoing demographic transitions towards populations with substantial larger proportions of older adults. Due to the increased susceptibility of older adults to infectious diseases and their consequences, vaccination programmes are an important health intervention to help maintain healthy ageing. While much of the existing literature suggests that current vaccination programmes targeted at older adults and the elderly are likely to be cost effective in high-income countries, we argue that it is important to more fully consider some important issues and challenges. Since the majority of vaccines have been developed for children, economic evaluations of vaccination programmes have consequentially tended to focus on this age group and on how to incorporate herd-immunity effects. While programmes targeted at older adults and the elderly may also induce some herd effects, there are other important challenges to consider in these economic evaluations. For example, age and time effects in relation to vaccine efficacy and duration of immunity, as well as heterogeneity between targeted individuals in terms of risk of infection, severity of disease and response to vaccination. For some pathogens, there is also the potential for interactions with childhood programmes in the form of herd-immunity effects.
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Affiliation(s)
- Sevan Dirmesropian
- Samuels Building, School of Public Health and Community Medicine, UNSW Australia, Sydney, NSW, 2052, Australia
| | - James G Wood
- Samuels Building, School of Public Health and Community Medicine, UNSW Australia, Sydney, NSW, 2052, Australia
| | - C Raina MacIntyre
- Samuels Building, School of Public Health and Community Medicine, UNSW Australia, Sydney, NSW, 2052, Australia
| | - Philippe Beutels
- Samuels Building, School of Public Health and Community Medicine, UNSW Australia, Sydney, NSW, 2052, Australia
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID) and Centre for the Evaluation of Vaccination (CEV), Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Anthony T Newall
- Samuels Building, School of Public Health and Community Medicine, UNSW Australia, Sydney, NSW, 2052, Australia.
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Akuzawa N, Naito H. Nutritional parameters affecting severity of pneumonia and length of hospital stay in patients with pneumococcal pneumonia: a retrospective cross-sectional study. BMC Pulm Med 2015; 15:149. [PMID: 26608261 PMCID: PMC4658754 DOI: 10.1186/s12890-015-0143-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 11/18/2015] [Indexed: 12/02/2022] Open
Abstract
Background Pneumococcal pneumonia is the most common form of community-acquired pneumonia (CAP). Although a pneumococcal conjugate vaccine has contributed to a reduction in the incidence of pneumococcal pneumonia among older children and adults, no significant decrease in the incidence has been observed among persons aged ≥65 years. A low body mass index and hypoalbuminemia are common in Japanese patients with CAP, but the association of other nutritional parameters with the severity of pneumonia or length of hospital stay in patients with pneumococcal pneumonia is unclear. Methods Fifty-seven previously healthy inpatients who presented with pneumococcal pneumonia were divided into two groups: those aged ≥65 years (n = 36) and those aged <65 years (n = 21). Patients’ characteristics (the Confusion, Urea, Respiratory rate, Blood pressure, age >65 years (CURB-65) score), the pneumonia severity index (PSI), and inflammatory and metabolic nutritional parameters were compared between the two groups. Results The older group showed significantly lower serum albumin and cholinesterase (ChE) levels. Multivariate linear regression analysis revealed that the PSI was positively correlated with age in both groups. In the younger age group, both the CURB-65 score and PSI showed significant negative correlations with the serum ChE level, and there was a significant negative correlation between the length of stay and serum total cholesterol (T-cho) level. In the older group, the fasting period, lymphocyte count, and age showed significant positive correlations with the length of stay. There was a significant negative correlation between the length of stay and serum albumin level, but no correlation with the serum ChE or T-cho levels, in the older patients. Conclusions Our findings suggest that in patients aged <65 years, age and serum ChE and T-cho levels were associated with both the severity of pneumococcal pneumonia and length of stay. In contrast, the length of stay in older patients was associated with multiple factors that differed from those in younger patients. These differences may reflect age-related immunosenescence in older patients and a greater effect of serum ChE and T-cho levels on immunity in younger patients.
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Affiliation(s)
- Nobuhiro Akuzawa
- Nutrition Support Team, Gunma Chuo Hospital, 1-7-13 Koun-cho, Maebashi, Gunma, 371-0025, Japan.
| | - Hiroshi Naito
- Nutrition Support Team, Gunma Chuo Hospital, 1-7-13 Koun-cho, Maebashi, Gunma, 371-0025, Japan.
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Impaired immune response to vaccination against infection with human respiratory syncytial virus at advanced age. J Virol 2014; 88:9744-50. [PMID: 24920795 DOI: 10.1128/jvi.01101-14] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
UNLABELLED Elderly humans are prone to severe infection with human respiratory syncytial virus (HRSV). The aging of today's human population warrants the development of protective vaccination strategies aimed specifically at the elderly. This may require special approaches due to deteriorating immune function. To design and test vaccination strategies tailored to the elderly population, we need to understand the host response to HRSV vaccination and infection at old age. Moreover, the preclinical need for testing of candidate vaccines requires translational models resembling susceptibility to the (unadapted) human pathogen. Here, we explored the effects of aging on immunity and protection induced by a model HRSV vaccine candidate in a translational aging model in cotton rats (Sigmodon hispidus) and examined possibilities to optimize vaccination concepts for the elderly. We immunized young and aged cotton rats with a live-attenuated recombinant HRSV vaccine candidate and analyzed the induced immune response to and protection against challenge with HRSV. In old cotton rats, HRSV infection persisted longer, and vaccination induced less protection against infection. Aged animals developed lower levels of vaccine-induced IgG, virus-neutralizing serum antibodies, and IgA in lungs. Moreover, booster responses to HRSV challenge were impaired in animals vaccinated at an older age. However, increased dose and reduced attenuation of vaccine improved protection even in old animals. This study shows that cotton rats provide a model for studying the effects of aging on the immune response to the human respiratory pathogen HRSV and possibilities to optimize vaccine concepts for the elderly. IMPORTANCE HRSV infection poses a risk for severe disease in the elderly. The aging of the population warrants increased efforts to prevent disease at old age, whereas HRSV vaccines are only in the developmental phase. The preclinical need for testing of candidate human vaccines requires translational models resembling susceptibility to the natural human virus. Moreover, we need to gain insight into waning immunity at old age, as this is a special concern in vaccine development. In this study, we explored the effect of age on protection and immunity against an experimental HRSV vaccine in aged cotton rats (Sigmodon hispidus), a rodent species that provides a model representing natural susceptibility to human viruses. Older animals generate fewer antibodies upon vaccination and require a higher vaccine dose for protection. Notably, during the early secondary immune response to subsequent HRSV infection, older animals showed less protection and a slower increase of the virus-neutralizing antibody titer.
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Baldon EJ, Marengo EB, de Franco M, Starobinas N, Bueno V, Sant’Anna OA. Mycobacterium leprae Hsp65 administration reduces the lifespan of aged high antibody producer mice. Immun Ageing 2014; 11:6. [PMID: 24669842 PMCID: PMC3986931 DOI: 10.1186/1742-4933-11-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 03/22/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Aging process may result in immune modifications that lead to disruption of innate and acquired immunity mechanisms that may induce chronic-degenerative events. The heat shock proteins (Hsp), phylogeneticaly conserved among organisms, present as main function the ability of folding and refolding proteins, but they also are associated with chronic-degenerative disorders. Here were evaluated the role of M. leprae native Hsp65 (WT) and its point-mutated (K409A) on survival and anti-DNA and anti-Hsp65 antibody production of aged genetically selected mice for high (HIII) and low (LIII) antibody production; data from 120- and 270-days old mice (named "adult" or "aged", respectively) were compared. RESULTS WT Hsp65 administration induces reduction in the mean survival time of adult and aged female HIII mice, this effect being stronger in aged individuals. Surprisingly, the native protein administration increased the survival of aged female LIII when compared to K409A and control groups. No survival differences were observed in aged male mice after Hsp65 proteins inoculation. We observed increase in IgG1 anti-Hsp65 in WT and K409A aged HIII female mice groups and no marked changes in the anti-DNA (adult and aged HIII) and anti-Hsp65 IgG1 or IgG2a isotypes production in adult HIII female and aged male mice. LIII male mice presented increased anti-DNA and anti-Hsp65 IgG2a isotype production after WT or K409A injection, and LIII female groups showed no alterations. CONCLUSIONS The results revealed that the WT Hsp65 interferes with survival of aged HIII female mice without involvement of a remarkable IgG1 and IgG2a anti-DNA and anti-Hsp65 antibodies production. The deleterious effects of Hsp65 on survival time in aged HIII female mice could be linked to a gender-effect and are in agreement with those previously reported in lupus-prone mice.
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Affiliation(s)
- Estevam José Baldon
- Laboratório de Imunoquímica, Instituto Butantan, Avenida Vital Brazil 1500, 05530-900 São Paulo, Brasil
| | - Eliana Blini Marengo
- Hospital Israelita Albert Einstein, Avenida Albert Einstein, 627/701, 05652-000 São Paul, Brasil
| | - Marcelo de Franco
- Laboratório de Imunogenética, Instituto Butantan, Avenida Vital Brazil 1500, 05530-900 São Paulo, Brasil
| | - Nancy Starobinas
- Laboratório de Imunogenética, Instituto Butantan, Avenida Vital Brazil 1500, 05530-900 São Paulo, Brasil
| | - Valquiria Bueno
- Departamento de Microbiologia, Imunologia e Parasitologia, UNIFESP, Rua Botucatu 862, 04023-062 São Paulo, Brasil
| | - Osvaldo Augusto Sant’Anna
- Laboratório de Imunoquímica, Instituto Butantan, Avenida Vital Brazil 1500, 05530-900 São Paulo, Brasil
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Hakim FT, Gress RE. Immunosenescence: immune deficits in the elderly and therapeutic strategies to enhance immune competence. Expert Rev Clin Immunol 2014; 1:443-58. [DOI: 10.1586/1744666x.1.3.443] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Takahashi K, Moyo P, Chigweshe L, Chang WC, White MR, Hartshorn KL. Efficacy of recombinant chimeric lectins, consisting of mannose binding lectin and L-ficolin, against influenza A viral infection in mouse model study. Virus Res 2013; 178:495-501. [PMID: 24140629 PMCID: PMC3885334 DOI: 10.1016/j.virusres.2013.10.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 09/23/2013] [Accepted: 10/02/2013] [Indexed: 12/22/2022]
Abstract
Influenza A virus infection could result in fatal complications. Although immunization is the most effective prevention it is not effective to pandemic infection and is less effective or not approved for certain age groups. Some influenza virus strains have developed resistance to antiviral agents. Thus, new therapeutic agents are urgently needed. We focused on innate immune molecules, including mannose-binding lectin (MBL). In order to optimize its antiviral activities, we have previously generated three recombinant chimeric lectins (RCL), by introducing portions of L-ficolin, another innate immune lectin. Our in vitro characterizations previously selected RCL2 and RCL3 for further investigations against viruses, including influenza viruses. Here, we examined efficacy of these lectins against infection with PR8 (H1N1) influenza A virus using mouse model studies and a human tracheal epithelial cell system. Our results provide in vivo evidence that RCL3 is effective agent against influenza virus infection. The therapeutic mechanisms are in part by providing host protective responses mediated by cytokines. We conclude that RCL3 is a potential new innate immune anti-influenza virus therapeutic agent.
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Affiliation(s)
- Kazue Takahashi
- Program of Developmental Immunology, Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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Abstract
Given the "inborn" nature of the innate immune system, it is surprising to find that innate immune function does in fact change with age. Similar patterns of distinct Toll-like-receptor-mediated immune responses come to light when one contrasts innate immune development at the beginning of life with that toward the end of life. Importantly, these developmental patterns of innate cytokine responses correlate with clinical patterns of susceptibility to disease: A heightened risk of suffering from excessive inflammation is often detected in prematurely born infants, disappears over the first few months of life, and reappears toward the end of life. In addition, risk periods for particular infections in early life reemerge in older adults. The near-mirror-image patterns that emerge in contrasts of early versus late innate immune ontogeny emphasize changes in host-environment interactions as the underlying molecular and teleologic drivers.
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McShane PJ, Naureckas ET, Strek ME. Bronchiectasis in a diverse US population: effects of ethnicity on etiology and sputum culture. Chest 2012; 142:159-167. [PMID: 22267679 DOI: 10.1378/chest.11-1024] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Previous studies of patients with bronchiectasis have found that the cause is idiopathic in the majority of cases, but these studies were done in homogeneous populations. We hypothesized that the etiology of bronchiectasis can be determined in a higher percentage of patients in a diverse US population and will differ significantly based on ethnicity. METHODS One hundred twelve patients with bronchiectasis confirmed by chest CT scan entered the study. Data from 106 patients were available for full evaluation. Clinical questionnaire, pulmonary function tests, sputum microbiology, laboratory data, and immune function testing were done. Results were analyzed by ethnicity and etiology. RESULTS Patients were 61.6% European American (EA), 26.8% African American (AA), 8.9% Hispanic American (HA), and 2.7% Asian American. A cause of bronchiectasis was determined in 93.3% of patients. In 63.2% of patients, bronchiectasis was caused by immune dysregulation, including deficiency (n = 18 [17%]), autoimmune disease (n = 33 [31.1%]), hematologic malignancy (n = 15 [14.2%]), and allergic bronchopulmonary aspergillosis (n = 1 [0.9%]). Rheumatoid arthritis was the cause of bronchiectasis in 28.6% of AA patients vs 6.2% of EA patients (P < .05). Hematologic malignancy was the etiology in 20.0% of the EA patients vs none of the AA patients (P = .02). A significantly higher percentage of HA patients had Pseudomonas aeruginosa in their sputum compared with AA and EA patients (P = .01). CONCLUSIONS The etiology of bronchiectasis can be determined in the majority of patients in a heterogeneous US population and is most often due to immune dysregulation. Rheumatoid arthritis is more likely in AA patients than EA patients. HA patients are more likely to have P aeruginosa in their sputum.
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Affiliation(s)
- Pamela J McShane
- Section of Pulmonary and Critical Care, Department of Medicine, University of Chicago Medical Center, Chicago, IL.
| | - Edward T Naureckas
- Section of Pulmonary and Critical Care, Department of Medicine, University of Chicago Medical Center, Chicago, IL
| | - Mary E Strek
- Section of Pulmonary and Critical Care, Department of Medicine, University of Chicago Medical Center, Chicago, IL
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Visiting Relatives and Friends (VFR), Pregnant, and Other Vulnerable Travelers. Infect Dis Clin North Am 2012; 26:625-35. [DOI: 10.1016/j.idc.2012.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Weng NP. Telomeres and immune competency. Curr Opin Immunol 2012; 24:470-5. [PMID: 22626625 PMCID: PMC3423542 DOI: 10.1016/j.coi.2012.05.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 04/27/2012] [Accepted: 05/01/2012] [Indexed: 11/26/2022]
Abstract
Telomeres are essential for the integrity of chromosomes and for cellular replication. Attrition of telomeres occurs during DNA replication owing to the inability of conventional DNA polymerase to replicate chromosomal termini and the insufficient compensation for telomere loss by telomerase, an enzyme that synthesizes telomeric DNA. A number of genetic defects have been described in humans and in animal models that cause accelerated telomere attrition, in turn leading to severe phenotypes of hematopoietic and other proliferating cells. Telomere length, most frequently measured as an average value in heterogeneous peripheral blood leukocyte populations in humans, has been associated with a wide range of health conditions and diseases of immune and non-immune cells. Here, I review recent studies of telomere length dynamics with particular relevance to immune function.
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Affiliation(s)
- Nan-ping Weng
- Laboratory of Molecular Biology and Immunology, National Institute on Aging, National Institutes of Health, 251 Bayview Blvd., Suite 100, Baltimore, MD 21224, USA.
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Foster AD, Sivarapatna A, Gress RE. The aging immune system and its relationship with cancer. ACTA ACUST UNITED AC 2011; 7:707-718. [PMID: 22121388 DOI: 10.2217/ahe.11.56] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The incidence of most common cancers increases with age. This occurs in association with, and is possibly caused by a decline in immune function, termed immune senescence. Although the size of the T-cell compartment is quantitatively maintained into older age, several deleterious changes (including significant changes to T-cell subsets) occur over time that significantly impair immunity. This article highlights some of the recent findings regarding the aging immune system, with an emphasis on the T-cell compartment and its role in cancer.
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Affiliation(s)
- Anthony D Foster
- National Cancer Institute (NCI), Experimental Transplantation & Immunology Branch (ETIB), 10 Center Dr. 10 CRC, 3-3330 Bethesda, MD 20814, USA
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Chang WC, Hartshorn KL, White MR, Moyoa P, Michelow IC, Koziel H, Kinane BT, Schmidt EV, Fujita T, Takahashi K. Recombinant chimeric lectins consisting of mannose-binding lectin and L-ficolin are potent inhibitors of influenza A virus compared with mannose-binding lectin. Biochem Pharmacol 2011; 81:388-95. [PMID: 21035429 PMCID: PMC3053085 DOI: 10.1016/j.bcp.2010.10.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Revised: 10/18/2010] [Accepted: 10/19/2010] [Indexed: 11/21/2022]
Abstract
MBL structurally contains a type II-like collagenous domain and a carbohydrate recognition domain (CRD). We have recently generated three novel recombinant chimeric lectins (RCL), in which varying length of collagenous domain of mannose-binding lectin (MBL) is replaced with that of L-ficolin (L-FCN). CRD of MBL is used for target recognition because it has a broad spectrum in pathogen recognition compared with L-FCN. Results of our study demonstrate that these RCLs are potent inhibitors of influenza A virus (IAV). RCLs, against IAV, show dose-dependent activation of the lectin complement pathway, which is significantly higher than that of recombinant human MBL (rMBL). This activity is observed even without MBL-associated serine proteases (MASPs, provided by MBL deficient mouse sera), which have been thought to mediate complement activation. These observations suggest that RCLs are more efficient in associating with MASP-2, which predominantly mediates the activity. Yet, additional serum further increases the activity while RCL-mediated coagulation-like enzyme activities are diminished compared with rMBL, suggesting reduced association with MASP-1, which has been shown to mediate coagulation-like activity. These data suggest that RCLs may interfere less with host coagulation, which is advantageous to be a therapeutic drug. Importantly, these RCLs have surpassed rMBL for anti-viral activities, such as viral aggregation, reduction of viral hemagglutination (HA) and inhibition of virus-mediated HA and neuraminidase (NA) activities. These results are encouraging that novel RCLs could be used as anti-IAV agents with less side effect and that RCLs would be suitable candidates in developing a new anti-IAV therapy.
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Affiliation(s)
- Wei-Chuan Chang
- Program of Developmental Immunology, Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
| | - Kevan L. Hartshorn
- Department of Medicine, Boston University School of Medicine, Boston, MA02118
| | - Mitchell R. White
- Department of Medicine, Boston University School of Medicine, Boston, MA02118
| | | | - Ian C. Michelow
- Program of Developmental Immunology, Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
| | - Henry Koziel
- Division of Pulmonary, Critical Care, and Sleep Medicine; Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA02115
| | - Bernard T. Kinane
- Program of Developmental Immunology, Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
| | - Emmett V. Schmidt
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
| | - Teizo Fujita
- Department of Immunology, Fukushima Medical University School of Medicine, Fukushima 960-1295 Japan
| | - Kazue Takahashi
- Program of Developmental Immunology, Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
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Marchand-Janssen C, Loulergue P, Mouthon L, Mahr A, Blanche P, Deforges L, Lebon P, Cohen P, Pagnoux C, Le Guern V, Bienvenu B, Aouba A, Guillevin L, Launay O. Patients with systemic inflammatory and autoimmune diseases are at risk of vaccine-preventable illnesses. Rheumatology (Oxford) 2011; 50:1099-105. [DOI: 10.1093/rheumatology/keq422] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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McDonald KG, Leach MR, Huang C, Wang C, Newberry RD. Aging impacts isolated lymphoid follicle development and function. IMMUNITY & AGEING 2011; 8:1. [PMID: 21214915 PMCID: PMC3023758 DOI: 10.1186/1742-4933-8-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Accepted: 01/07/2011] [Indexed: 01/19/2023]
Abstract
BACKGROUND Immunosenescence is the age-related decline and dysfunction of protective immunity leading to a marked increase in the risk of infections, autoimmune disease, and cancer. The majority of studies have focused on immunosenescence in the systemic immune system; information concerning the effect of aging on intestinal immunity is limited. Isolated lymphoid follicles (ILFs) are newly appreciated dynamic intestinal lymphoid structures that arise from nascent lymphoid tissues, or cryptopatches (CP), in response to local inflammatory stimuli. ILFs promote "homeostatic" responses including the production of antigen-specific IgA, thus playing a key role in mucosal immune protection. ILF dysfunction with aging could contribute to immunosenescence of the mucosal system, and accordingly we examined phenotypic and functional aspects of ILFs from young (2 month old) and aged (2 year old) mice. RESULTS We observed that aged mice have increased numbers of ILFs and increased numbers of structures corresponding to an early stage of CPs transforming into ILFs. The cellular composition of ILFs in aged mice is altered with a smaller B-lymphocyte population and an increased T-lymphocyte population. The ILF T-lymphocyte population is notable by the presence of CD4+ CD8αα+ T-lymphocytes, which are absent from the systemic compartment. The smaller B-lymphocyte population in ILFs from aged mice is directly correlated with decreased mRNA and protein expression of CCL20 and CXCL13, two chemokines that play crucial roles in recruiting B-lymphocytes into ILFs. Aged mice had elevated levels of serum and fecal immunoglobulins and despite the decreased B-lymphocyte population, ILFs from aged mice displayed increased IgA production. The immunoglobulin repertoire was skewed in aged mice, and ILFs demonstrated a repertoire usage similar to that of the systemic pool in both young and aged mice. CONCLUSIONS Here we observed that ILF development, cellular composition, and immunoglobulin production are altered with aging suggesting that ILF dysfunction contributes to mucosal immunosenescence.
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Affiliation(s)
- Keely G McDonald
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA
| | - Matthew R Leach
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA
| | - Conway Huang
- University of Texas Southwestern Medical School, Austin Texas, 78701, USA
| | - Caihong Wang
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA
| | - Rodney D Newberry
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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Corsini E, Racchi M, Lucchi L, Donetti E, Bedoni M, Viviani B, Galli C, Marinovich M. Skin immunosenescence: decreased receptor for activated C kinase-1 expression correlates with defective tumour necrosis factor-α production in epidermal cells. Br J Dermatol 2009; 160:16-25. [DOI: 10.1111/j.1365-2133.2008.08885.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Enhancement of cytotoxic T-lymphocyte response in aged mice by a novel treatment with recombinant AdIL-12 and wild-type adenovirus in rapid succession. Mol Ther 2008; 16:1500-6. [PMID: 18545221 DOI: 10.1038/mt.2008.121] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
A decrease in the expression of Th1 cytokines has been associated with age-related decrease in cytotoxic T-lymphocyte (CTL) function. We utilized an E1-deleted adenovirus (Ad) vector to deliver the murine interleukin-12 (IL-12) gene in order to enhance the antivirus CTL response. Wild-type (WT) Ad was administered 3 days after AdIL-12 treatment, when IL-12 production was at its peak and the anti-Ad antibody response had not yet begun to develop. Before receiving AdIL-12 treatment, aged (18 month old) mice exhibited a 58% decrease in the number of virus-specific CTLs, and a 30% decrease in in vivo CTL activity as compared to young (2 month old) mice. After AdIL-12 treatment, aged mice displayed a greater increase in IL-12 expression and endogenous production of interferon-gamma than observed in young mice. When infected with WT Ad, these AdIL-12-treated aged mice exhibited an increased in vivo CTL response and an in vitro proliferative response that was similar to those in young mice. The frequencies of occurrence of D(b)-E1Bp(+)CD8(+) T cells in the spleen, liver, and lung in aged mice were higher than the corresponding values in young mice. These results indicate that IL-12 treatment significantly promotes the virus-specific CTL response in aged mice and, more importantly, specifically targets the virally infected organs, such as the liver and lung, promoting enhanced CTL activity against the virus.
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Kumar R, Burns EA. Age-related decline in immunity: implications for vaccine responsiveness. Expert Rev Vaccines 2008; 7:467-79. [PMID: 18444893 DOI: 10.1586/14760584.7.4.467] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Aging is associated with declines in immune system function, or 'immunosenescence', leading to progressive deterioration in both innate and adaptive immunity. These changes contribute to the decreased response to vaccines seen in many older adults, and morbidity and mortality from infection. Infections (e.g., influenza, pneumonia and septicemia) appear among the top ten most-common causes of death in adults in the USA aged 55 years and older. As immunosenescence has gathered more attention in the scientific and healthcare communities, investigators have demonstrated more links between immunosenescent changes and morbidity and mortality related to infections and declining vaccine responses. This review summarizes the recent literature on age-dependent defects in adaptive and innate immunity, data linking these defects to poor vaccine response and morbidity and mortality, current recommendations for vaccinations and potential strategies to improve vaccine efficacy in older adults.
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Affiliation(s)
- Rajesh Kumar
- Medical College of Wisconsin, 5000 W National Avenue, CC-G, Milwaukee, WI 53295, USA.
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Abstract
Aging is associated clinically with increases in the frequency and severity of infectious diseases and an increased incidence of cancer, chronic inflammatory disorders and autoimmunity. These age-associated immune dysfunctions are the consequence of declines in both the generation of new naïve T and B lymphocytes and the functional competence of memory populations. These alterations collectively are termed immunosenescence.
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Affiliation(s)
- F T Hakim
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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Hoshino A, Tamura J, Nakazawa M, Koyama H. Middle-aged and Elderly Outpatients Show Lower Body Temperature Responses than the Young, Even with the Same C-reactive Protein Levels. J Int Med Res 2007; 35:329-37. [PMID: 17593861 DOI: 10.1177/147323000703500307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The variation of body temperature response and C-reactive protein (CRP) levels with age was investigated. A cross-sectional study on new outpatients between January 2004 and June 2005 was carried out. Body temperature and serum CRP levels were examined for screening purposes in 1081 patients. Mean axillary body temperature was maintained at around 36.7°C in early adulthood, and gradually declined in middle age. Middle-aged and elderly outpatients tended to show a lower body temperature response than the young, even with the same CRP levels. The critical age (boundary age) was assumed to be when the relationship between body temperature response and CRP level changed. This study suggests that the boundary age is about 40 years old.
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Affiliation(s)
- A Hoshino
- Department of General Practice Medicine, Gunma University Graduate School of Medicine, Gunma, Japan
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The Efficacy of Vaccines to Prevent Infectious Diseases in the Elderly. IMMUNOSENESCENCE 2007. [PMCID: PMC7121339 DOI: 10.1007/978-0-387-76842-7_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Infectious diseases still represent a major challenge to human progress and survival. Especially elderly persons are more frequently and severely affected by infectious diseases and they display distinct features with respect to clinical presentation and treatment. Although vaccinations are considered a vital medical procedure for preventing morbidity and mortality caused by infectious diseases, the protective effect of vaccinations is abrogated in elderly persons. This is due to a decline in the functions of the immune system referred to as immunosenescence. The first part of this chapter will therefore summarize the status quo of the efficacy of vaccines in preventing morbidity and mortality caused by typical infectious diseases in the elderly, such as influenza, pneumonia and tuberculosis. The second part will then elucidate the underlying age-related mechanisms which may contribute to the decreased efficacy of vaccines. Based on the complex mechanisms involved in immunosenescence, strategies will be outlined which may be succesfful in enhancing protective immune responses following vaccination in elderly persons.
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Herndler-Brandstetter D, Cioca DP, Grubeck-Loebenstein B. Immunizations in the elderly: do they live up to their promise? Wien Med Wochenschr 2006; 156:130-41. [PMID: 16823527 PMCID: PMC7088340 DOI: 10.1007/s10354-006-0267-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2005] [Accepted: 11/11/2005] [Indexed: 12/30/2022]
Abstract
In the 21st century, public health is not only challenged by newly emerging and re-emerging infectious diseases but also by demographic developments that are taking place in many countries. Importantly, infections in the elderly are more frequent, more severe and have distinct features with respect to clinical presentation and treatment. This is due to a decline in the functions of the immune system referred to as immunosenescence. The most important age-related changes affect the T cell system. Although this derogates the protective effect of some vaccines, vaccinations are still considered the most cost-effective medical procedure for preventing morbidity and mortality caused by infectious diseases. The present article aims at outlining the impact of infectious diseases on the elderly and summarizing the progress made in the field of vaccinations of the elderly and how age-related changes within the immune system contribute to the decreased efficacy of vaccines.
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Affiliation(s)
| | - Daniel P. Cioca
- />Institute for Biomedical Aging Research, Austrian Academy of Sciences, Innsbruck, Austria
| | - Beatrix Grubeck-Loebenstein
- />Institute of Vaccination Immunology of the Austrian Green Cross Society for Preventive Medicine, Innsbruck, Austria
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Alp E, Yildiz O, Aygen B, Sumerkan B, Sari I, Koc K, Couble A, Laurent F, Boiron P, Doganay M. Disseminated nocardiosis due to unusual species: two case reports. ACTA ACUST UNITED AC 2006; 38:545-8. [PMID: 16798710 DOI: 10.1080/00365540500532860] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Pulmonary nocardiosis is the major clinical manifestation of human nocardiosis and disseminated infection can be seen in immunocompromised patients. N. asteroides is the predominant pathogen associated with disseminated diseases. We report 2 cases of pulmonary nocardiosis admitted with disseminated infection, caused by rare species of Nocardia: Nocardia transvalensis and Nocardia cyriacigeorgica.
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Affiliation(s)
- Emine Alp
- Department of Infectious Diseases, Erciyes University, Faculty of Medicine, Kayseri, Turkey.
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