Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY, USA.
Department of Cancer Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Int Rev Immunol. 2022;41(4):448-463. doi: 10.1080/08830185.2021.1925267. Epub 2021 May 12.
The impact of SARS-CoV-2 and COVID-19 disease susceptibility varies depending on the age and health status of an individual. Currently, there are more than 140 COVID-19 vaccines under development. However, the challenge will be to induce an effective immune response in the elderly population. Analysis of B cell epitopes indicates the minor role of the stalk domain of spike protein in viral neutralization due to low surface accessibility. Nevertheless, the accumulation of mutations in the receptor-binding domain (RBD) might reduce the vaccine efficacy in all age groups. We also propose the concept of chimeric vaccines based on the co-expression of SARS-CoV-2 spike and influenza hemagglutinin (HA) and matrix protein 1 (M1) proteins to generate chimeric virus-like particles (VLP). This review discusses the possible approaches by which influenza-specific memory repertoire developed during the lifetime of the elderly populations can converge to mount an effective immune response against the SARS-CoV-2 spike protein with the possibilities of designing single vaccines for COVID-19 and influenza. HighlightsImmunosenescence aggravates COVID-19 symptoms in elderly individuals.Low immunogenicity of SARS-CoV-2 vaccines in elderly population.Tapping the memory T and B cell repertoire in elderly can enhance vaccine efficiency.Chimeric vaccines can mount effective immune response against COVID-19 in elderly.Chimeric vaccines co-express SARS-CoV-2 spike and influenza HA and M1 proteins.
SARS-CoV-2 和 COVID-19 疾病易感性的影响因个体的年龄和健康状况而异。目前,有超过 140 种 COVID-19 疫苗正在开发中。然而,挑战将是在老年人群中诱导有效的免疫反应。B 细胞表位分析表明,由于刺突蛋白茎部的表面不可及性低,其在病毒中和中的作用较小。然而,受体结合域(RBD)中的突变积累可能会降低所有年龄段的疫苗效力。我们还提出了基于 SARS-CoV-2 刺突蛋白和流感血凝素(HA)和基质蛋白 1(M1)蛋白共表达的嵌合疫苗的概念,以产生嵌合病毒样颗粒(VLP)。这篇综述讨论了可能的方法,即通过开发老年人一生中产生的针对流感的特异性记忆库,可以收敛为针对 SARS-CoV-2 刺突蛋白产生有效的免疫反应,并有可能为 COVID-19 和流感设计单一疫苗。
亮点
免疫衰老加剧了老年人 COVID-19 的症状。
老年人对 SARS-CoV-2 疫苗的免疫原性低。
利用老年人群的记忆 T 和 B 细胞库可以提高疫苗效率。
嵌合疫苗可以在老年人中对 COVID-19 产生有效的免疫反应。
嵌合疫苗共表达 SARS-CoV-2 刺突蛋白和流感 HA 和 M1 蛋白。