Karasartova Djursun, Gazi Umut, Tosun Ozgur, Gureser Ayse S, Sahiner Ibrahim T, Dolapci Mete, Ozkan Aysegul T
Department of Medical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey.
Department of Medical Microbiology and Clinic Microbiology, Faculty of Medicine, Near East University, Near East Boulevard, Nicosia, Cyprus.
J Clin Immunol. 2017 May;37(4):388-396. doi: 10.1007/s10875-017-0397-3. Epub 2017 May 9.
Splenectomy is associated with increased risk of overwhelming post-splenectomy infections despite proper anti-pneumococcal vaccination. As most studies concentrated on vaccination-induced humoral immunity, the cellular immune responses triggered in splenectomized patients are not yet well studied. The present study aims to investigate this area as it can contribute to the development of more effective vaccination strategies.
Five healthy and 14 splenectomized patients were vaccinated with pneumococcal conjugate polysaccharide vaccine (PCV) followed by pneumococcal polysaccharide vaccine according to the guidelines established by Advisory Committee on Immunization Practices. PBMC samples collected 0, 8, and 12 weeks after PCV immunization were in vitro stimulated with PCV. Levels of lymphoproliferation, T cell differentiation, and cytokine release were assessed by carboxyfluorescein succinimidyl ester labeling, intracellular cytokine staining, and ELISA, respectively.
While T1-dominated immune response was detected in both groups, asplenic individuals generated significantly lower levels of T1 cells following in vitro stimulation. Similarly, levels of IFN-γ, IL-4, and IL-17 release and lymphoproliferation were significantly lower in asplenic patients.
According to our data, splenectomy negatively influences the levels of PCV-induced lymphoproliferation, T1 differentiation, and cytokine release. Besides, PCV failed to induce T17-dominant immune response which is crucial for protection against extracellular pathogens.
尽管进行了适当的抗肺炎球菌疫苗接种，但脾切除术后仍存在暴发性感染风险增加的情况。由于大多数研究集中在疫苗接种诱导的体液免疫上，脾切除患者触发的细胞免疫反应尚未得到充分研究。本研究旨在探讨这一领域，因为它有助于制定更有效的疫苗接种策略。
5名健康受试者和14名脾切除患者按照免疫实践咨询委员会制定的指南，先接种肺炎球菌结合多糖疫苗（PCV），随后接种肺炎球菌多糖疫苗。在PCV免疫后0、8和12周采集的外周血单个核细胞（PBMC）样本，用PCV进行体外刺激。分别通过羧基荧光素琥珀酰亚胺酯标记、细胞内细胞因子染色和酶联免疫吸附测定（ELISA）评估淋巴细胞增殖水平、T细胞分化和细胞因子释放情况。
两组均检测到以T1为主导的免疫反应，但脾切除个体在体外刺激后产生的T1细胞水平显著较低。同样，脾切除患者的γ干扰素（IFN-γ）、白细胞介素-4（IL-4）和白细胞介素-17（IL-17）释放水平及淋巴细胞增殖水平也显著较低。
根据我们的数据，脾切除对PCV诱导的淋巴细胞增殖、T1分化和细胞因子释放水平产生负面影响。此外，PCV未能诱导对抵御细胞外病原体至关重要的以T17为主导的免疫反应。
