Gustafson Claire E, Kim Chulwoo, Weyand Cornelia M, Goronzy Jörg J
Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, Calif; Department of Medicine, Veterans Administration Healthcare System, Palo Alto, Calif.
Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, Calif; Department of Medicine, Veterans Administration Healthcare System, Palo Alto, Calif.
J Allergy Clin Immunol. 2020 May;145(5):1309-1321. doi: 10.1016/j.jaci.2020.03.017.
Impaired vaccine responses in older individuals are associated with alterations in both the quantity and quality of the T-cell compartment with age. As reviewed herein, the T-cell response to vaccination requires a fine balance between the generation of inflammatory effector T cells versus follicular helper T (T) cells that mediate high-affinity antibody production in tandem with the induction of long-lived memory cells for effective recall immunity. During aging, we find that this balance is tipped where T cells favor short-lived effector but not memory or T responses. Consistently, vaccine-induced antibodies commonly display a lower protective capacity. Mechanistically, multiple, potentially targetable, changes in T cells have been identified that contribute to these age-related defects, including posttranscription regulation, T-cell receptor signaling, and metabolic function. Although research into the induction of tissue-specific immunity by vaccines and with age is still limited, current mechanistic insights provide a framework for improved design of age-specific vaccination strategies that require further evaluation in a clinical setting.
随着年龄增长,老年人疫苗反应受损与T细胞区室的数量和质量改变有关。如本文所述,T细胞对疫苗接种的反应需要在炎性效应T细胞与滤泡辅助性T(Th)细胞的生成之间达到精细平衡,Th细胞介导高亲和力抗体的产生,并诱导长寿记忆细胞以实现有效的回忆免疫。在衰老过程中,我们发现这种平衡被打破,T细胞倾向于产生短期效应细胞而非记忆细胞或Th细胞。一致地,疫苗诱导的抗体通常表现出较低的保护能力。从机制上讲,已确定T细胞中多种可能可靶向的变化导致了这些与年龄相关的缺陷,包括转录后调控、T细胞受体信号传导和代谢功能。尽管关于疫苗诱导组织特异性免疫及其与年龄关系的研究仍然有限,但目前的机制见解为改进针对特定年龄的疫苗接种策略设计提供了一个框架,这些策略需要在临床环境中进一步评估。