医务人员接种 A(H1N1)pdm09 疫苗：再次接种后低应答者的免疫应答增强。
A(H1N1)pdm09 vaccination of health care workers: improved immune responses in low responders following revaccination.
机构信息
Influenza Centre, The Gade Institute, University of Bergen, Bergen, Norway.
出版信息
J Infect Dis. 2012 Dec 1;206(11):1660-9. doi: 10.1093/infdis/jis589. Epub 2012 Sep 11.
BACKGROUND
We conducted a clinical trial in October 2009 to evaluate the immunogenicity of the AS03-adjuvanted influenza vaccine (pH1N1 vaccine) in health care workers (HCWs). By 2 weeks after vaccination, 97% had protective hemagglutinin inhibition (HI) titers (≥ 40) however, 16% were low responders (LR) and failed to maintain a protective response 90 days after vaccination.
METHODS
We analyzed the humoral responses (HI, antibody-secreting cell [ASC], and serum immunoglobulin G [IgG]) in 15 LRs and 25 control HCWs. Twelve LRs were revaccinated with the pH1N1 vaccine, and 7 were subsequently vaccinated with the 2010 seasonal trivalent influenza vaccine. We conducted a long-term analysis of the humoral and CD4(+) T-helper (Th) 1 responses.
RESULTS
The LRs had a slower HI antibody response than the control HCWs, with protective antibody titers not reached until 2 weeks after vaccination in the majority of the participants. The LRs also had significantly lower IgG ASCs at day 7 and HA1-specific serum IgG responses at day 21, compared with the control HCWs. Revaccination with the pH1N1 vaccine elicited rapid HI antibody, ASC, memory B cell, and multifunctional CD4(+) Th1 cell responses.
CONCLUSION
This study shows that revaccination of low-responding HCWs with the pH1N1 vaccine is required for maintaining long-term protection.
CLINICAL TRIALS REGISTRATION
NCT01003288.
背景
我们于 2009 年 10 月开展了一项临床试验，旨在评估 AS03 佐剂流感疫苗（pH1N1 疫苗）在卫生保健工作者（HCWs）中的免疫原性。接种后 2 周，97%的人产生了保护性血凝抑制（HI）滴度（≥40），然而，有 16%的人是低应答者（LR），并且在接种后 90 天无法维持保护性反应。
方法
我们分析了 15 名 LR 和 25 名对照 HCWs 的体液反应（HI、抗体分泌细胞[ASC]和血清免疫球蛋白 G[IgG]）。12 名 LR 用 pH1N1 疫苗再次接种，随后 7 名 LR 用 2010 年季节性三价流感疫苗接种。我们对体液和 CD4(+)辅助性 T 细胞（Th）1 反应进行了长期分析。
结果
LR 的 HI 抗体反应比对照 HCWs 慢，大多数参与者直到接种后 2 周才达到保护性抗体滴度。LR 在第 7 天的 IgG ASC 和第 21 天的 HA1 特异性血清 IgG 反应也显著低于对照 HCWs。用 pH1N1 疫苗再次接种可迅速诱导 HI 抗体、ASC、记忆 B 细胞和多功能 CD4(+)Th1 细胞反应。
结论
本研究表明，需要对低应答的 HCWs 用 pH1N1 疫苗进行再次接种，以维持长期保护。
临床试验注册
NCT01003288。
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