Powers D C, Sears S D, Murphy B R, Thumar B, Clements M L
Gerontology Research Center, National Institute on Aging, Baltimore, Maryland.
J Clin Microbiol. 1989 Dec;27(12):2666-71. doi: 10.1128/jcm.27.12.2666-2671.1989.
Intranasal live attenuated cold-adapted (ca) influenza A/Kawasaki/9/86 (H1N1) reassortant virus and parenteral inactivated influenza A/Taiwan/1/86 (H1N1) virus were given alone or in combination to 80 ambulatory elderly subjects. An enzyme-linked immunosorbent assay was used to measure hemagglutinin-specific (HA) antibodies in serum and nasal wash specimens collected before vaccination and 1 and 3 months later. Serum immunoglobulin G (IgG) and nasal wash IgA HA responses were elicited in 56 and 20%, respectively, of 25 inactivated-virus vaccinees and in 67 and 48%, respectively, of 27 recipients of both vaccines but in only 36 and 25%, respectively, of 28 vaccinees given live virus alone. Inactivated virus, administered alone or with live virus vaccine, induced higher titers of serum antibody than did the live virus alone. In contrast, nasal IgA HA antibody was elicited more often and in greater quantity by the vaccine combination than by either vaccine alone. Despite these differences, the peak titers of local antibody mounted by each group of vaccinees were similar. By 3 months postvaccination, serum IgG and nasal IgA HA antibody titers remained elevated above prevaccination levels in 50 and 17%, respectively, of the inactivated-virus vaccinees and in 46 and 23%, respectively, of recipients of both vaccines but in only 19 and 7%, respectively, of the live-virus and systemic antibodies, if vaccinees. The finding that live ca influenza A virus induced short-lived local and systemic antibodies, if confirmed, suggests that live virus vaccination may not be a suitable alternative or adjunct to inactivated virus vaccination for the elderly.
将鼻内接种减毒活冷适应（ca）甲型流感病毒A/川崎/9/86（H1N1）重配病毒和胃肠外接种甲型流感病毒A/台湾/1/86（H1N1）灭活病毒单独或联合给予80名门诊老年受试者。采用酶联免疫吸附测定法检测接种疫苗前、接种后1个月和3个月采集的血清和鼻腔冲洗液标本中的血凝素特异性（HA）抗体。在25名接种灭活病毒疫苗的受试者中，分别有56%和20%的人产生了血清免疫球蛋白G（IgG）和鼻腔冲洗液IgA HA反应；在27名同时接种两种疫苗的受试者中，分别有67%和48%的人产生了上述反应；而在28名单独接种活病毒疫苗的受试者中，分别只有36%和25%的人产生了上述反应。单独接种或与活病毒疫苗联合接种灭活病毒所诱导的血清抗体滴度高于单独接种活病毒。相比之下，联合疫苗诱导鼻腔IgA HA抗体的频率和数量均高于单独使用任何一种疫苗。尽管存在这些差异，但每组接种疫苗者产生的局部抗体峰值滴度相似。接种疫苗后3个月时，灭活病毒疫苗接种者中分别有50%和17%的人血清IgG和鼻腔IgA HA抗体滴度仍高于接种前水平；两种疫苗都接种的受试者中，这一比例分别为46%和23%；而单独接种活病毒疫苗的受试者中，这一比例分别仅为19%和7%。如果活ca甲型流感病毒诱导的局部和全身抗体持续时间短这一发现得到证实，那么对于老年人来说，活病毒疫苗接种可能不是灭活病毒疫苗接种的合适替代方法或辅助方法。
