Baldo V, Baldovin T, Floreani A, Fragapane E, Trivello R
Department of Environmental Medicine and Public Health, Institute of Hygiene, University of Padua, Padua, Italy.
J Clin Immunol. 2007 Sep;27(5):542-7. doi: 10.1007/s10875-007-9100-4. Epub 2007 May 21.
The ability of influenza vaccination to provide cross-protection against heterovariant influenza strains was evaluated in a double-blind, randomized, trial in north-east Italy during the winter of 2005-2006. Of 238 adult subjects with underlying chronic diseases, 120 received MF59-adjuvanted subunit vaccine (Sub/MF59) and 118 received a conventional subunit vaccine (Subunit). Immunogenicity was measured for A/H3N2 and B influenza strains against both the homologous vaccine strains (A/New York/55/2004 and B/Jiangsu/10/2003), and the heterovariant strains recommended for the 2006-2007 season (A/Wisconsin/67/2005 and B/Malaysia/2506/2004). Although both vaccines conferred serological protection against the homologous vaccine strains and the 2006-2007 heterovariant A/H3N2 strain for a majority of subjects, the antibody response was highest in the Sub/MF59 vaccine group. For example, MF59-adjuvanted vaccination conferred significantly greater (P = 0.002) protection against the heterovariant A/H3N2 strain than the conventional subunit vaccine (79.2% vs. 61.0% of subjects, respectively). In conclusion, these results demonstrate that protection provided by influenza vaccination in adults affected by chronic diseases is lower against heterovariant strains than for homologous strains. However, addition of MF59 adjuvant to a subunit vaccine enhances immunogenicity against the A/H3N2 heterovariant strain, conferring broader protection than a conventional subunit vaccine in this population, who are at higher risk of influenza-related complications.
2005 - 2006年冬季，在意大利东北部进行了一项双盲随机试验，评估流感疫苗接种对异源流感毒株提供交叉保护的能力。在238名患有慢性基础疾病的成年受试者中，120人接种了含MF59佐剂的亚单位疫苗（亚单位/MF59），118人接种了传统亚单位疫苗（亚单位疫苗）。针对甲型H3N2和乙型流感毒株，检测了针对同源疫苗毒株（A/纽约/55/2004和B/江苏/10/2003）以及2006 - 2007季节推荐的异源毒株（A/威斯康星/67/2005和B/马来西亚/2506/2004）的免疫原性。虽然两种疫苗都为大多数受试者提供了针对同源疫苗毒株和2006 - 2007异源甲型H3N2毒株的血清学保护，但亚单位/MF59疫苗组的抗体反应最高。例如，含MF59佐剂的疫苗接种对异源甲型H3N2毒株的保护作用显著高于传统亚单位疫苗（P = 0.002）（分别为79.2%和61.0%的受试者）。总之，这些结果表明，流感疫苗接种对患有慢性疾病的成年人提供的针对异源毒株的保护低于同源毒株。然而，在亚单位疫苗中添加MF59佐剂可增强对甲型H3N2异源毒株的免疫原性，在该流感相关并发症风险较高的人群中提供比传统亚单位疫苗更广泛的保护。
