Friedmann David, Goldacker Sigune, Peter Hans-Hartmut, Warnatz Klaus
Division of Immunodeficiency, Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Chronic Immunodeficiency (CCI), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Faculty of Biology, University of Freiburg, Schaenzlestrasse 1, Freiburg, Germany.
Division of Immunodeficiency, Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Chronic Immunodeficiency (CCI), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
J Allergy Clin Immunol Pract. 2020 Jul-Aug;8(7):2332-2340.e5. doi: 10.1016/j.jaip.2020.04.019. Epub 2020 Apr 21.
Vaccination against influenza is recommended for patients with common variable immunodeficiency (CVID), although humoral immune responses in these patients are impaired and the evidence of effective T-cell responses in CVID is not well established.
To determine plasmablast and T-cellular vaccination responses against influenza in patients with CVID.
Patients with CVID and healthy controls were vaccinated with the quadrivalent vaccine Influsplit Tetra 2018/2019. Before and 1 week after vaccination plasmablasts and circulating inducible costimulator-expressing T follicular helper cells were measured to determine positive vaccine responses in these patients. In addition, antigen-specific T cells were determined by their upregulation of CD25 and OX40 after in vitro restimulation with the vaccine.
Most healthy controls but only 1 patient with CVID mounted a positive humoral immune response, measured by an increase in plasmablasts 1 week after vaccination. In contrast, most patients with CVID showed an increase in inducible costimulator T follicular helper cells and/or an increase in antigen-specific CD25OX40 T cells 1 week after vaccination, demonstrating a positive T-cellular immune response.
Despite the remaining challenge of accurately assessing the complexity of T-cell responses, the recommendation of vaccinating patients with CVID against influenza is reasonable.
对于普通可变免疫缺陷（CVID）患者，建议接种流感疫苗，尽管这些患者的体液免疫反应受损，且CVID中有效T细胞反应的证据尚不充分。
确定CVID患者针对流感的浆母细胞和T细胞疫苗接种反应。
CVID患者和健康对照者接种四价疫苗Influsplit Tetra 2018/2019。在接种前和接种后1周，测量浆母细胞和循环中表达诱导性共刺激分子的T滤泡辅助细胞，以确定这些患者的疫苗阳性反应。此外，通过疫苗体外再刺激后CD25和OX40的上调来确定抗原特异性T细胞。
大多数健康对照者，但只有1例CVID患者产生了阳性体液免疫反应，通过接种后1周浆母细胞的增加来衡量。相比之下，大多数CVID患者在接种后1周显示诱导性共刺激分子T滤泡辅助细胞增加和/或抗原特异性CD25OX40 T细胞增加，表明T细胞免疫反应呈阳性。
尽管准确评估T细胞反应的复杂性仍然具有挑战性，但建议CVID患者接种流感疫苗是合理的。
