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健康及接受高效抗逆转录病毒治疗的HIV患者对大流行性流感疫苗的细胞免疫和体液免疫反应。

Cellular and humoral immune responses to pandemic influenza vaccine in healthy and in highly active antiretroviral therapy-treated HIV patients.

作者信息

Agrati Chiara, Gioia Cristiana, Castilletti Concetta, Lapa Daniele, Berno Giulia, Puro Vincenzo, Carletti Fabrizio, Cimini Eleonora, Nisii Carla, Castellino Flora, Martini Federico, Capobianchi Maria R

机构信息

National Institute for Infectious Diseases (INMI) Lazzaro Spallanzani, Rome, Italy.

出版信息

AIDS Res Hum Retroviruses. 2012 Dec;28(12):1606-16. doi: 10.1089/AID.2011.0371. Epub 2012 May 8.

Abstract

Influenza vaccination is recommended for HAART-treated HIV patients to prevent influenza illness and complications. Due to the known ability of T cells to mediate a broadly cross-reactive response, vaccination effectiveness in cell-mediated immune (CMI) response induction is a main objective in new influenza vaccination strategies. Nevertheless, data on CMI responses after pandemic vaccination in HIV subjects are still missing. In the present study, the ability of a single dose of adjuvanted pandemic influenza vaccine to induce humoral and CMI responses was compared in HAART-treated HIV patients and in healthcare workers. Healthcare workers (HCW, n=65) and HAART-treated HIV patients (HIV, n=67) receiving pandemic vaccination were enrolled and analyzed before (t0) and after (t1) vaccination. The analysis of strain-specific humoral response was performed by HAI assay; CMI against pandemic (A/H1N1/Cal/09) and seasonal (A/H1N1/Brisb/07 and A/H3N2/Brisb/07) strains was analyzed by ELISpot and intracellular staining followed by flow cytometry. Pandemic vaccination was effective in inducing both humoral and cell-mediated responses in HAART-treated HIV patients as well as in HCWs. A large fraction of both HCWs and HIV-infected patients showed a T cell response to the pandemic strain before vaccination, suggesting possible previous exposure to A/H1N1/pdm/09 and/or cross-reactive T cells. Notably, pandemic vaccine was also able to boost cross-reactive immune responses to seasonal strains. Finally, a weaker boost of both strain-specific and cross-reactive T cell immunity was found in individuals showing a higher baseline response. These data show the effectiveness of adjuvanted pandemic vaccine to induce both humoral and cellular (strain-specific and cross-reactive) immune responses in HIV patients similar to HCWs.

摘要

建议接受高效抗逆转录病毒治疗(HAART)的HIV患者接种流感疫苗,以预防流感疾病及其并发症。鉴于T细胞具有介导广泛交叉反应的能力,诱导细胞介导免疫(CMI)反应的疫苗接种效果是新型流感疫苗接种策略的主要目标。然而,关于HIV感染者接种大流行流感疫苗后的CMI反应数据仍然缺失。在本研究中,比较了单剂量佐剂大流行流感疫苗在接受HAART治疗的HIV患者和医护人员中诱导体液和CMI反应的能力。纳入接受大流行流感疫苗接种的医护人员(HCW,n = 65)和接受HAART治疗的HIV患者(HIV,n = 67),并在接种前(t0)和接种后(t1)进行分析。通过血凝抑制试验(HAI)分析毒株特异性体液反应;通过酶联免疫斑点试验(ELISpot)和细胞内染色后进行流式细胞术分析针对大流行毒株(A/H1N1/Cal/09)和季节性毒株(A/H1N1/Brisb/07和A/H3N2/Brisb/07)的CMI。大流行流感疫苗接种在接受HAART治疗的HIV患者以及医护人员中诱导体液和细胞介导反应均有效。很大一部分医护人员和HIV感染患者在接种疫苗前对大流行毒株表现出T细胞反应,提示可能既往接触过A/H1N1/pdm/09和/或交叉反应性T细胞 。值得注意的是,大流行流感疫苗还能够增强对季节性毒株的交叉反应性免疫反应。最后,在基线反应较高的个体中发现毒株特异性和交叉反应性T细胞免疫的增强较弱。这些数据表明,佐剂大流行流感疫苗在HIV患者中诱导体液和细胞(毒株特异性和交叉反应性)免疫反应的效果与医护人员相似。

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