Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden.
Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden.
Hum Vaccin Immunother. 2022 Nov 30;18(5):2088971. doi: 10.1080/21645515.2022.2088971. Epub 2022 Jun 15.
After trauma and central nervous system (CNS) injury, trauma-induced immune deficiency syndrome (TIDS) and CNS injury-induced immune deficiency syndrome (CIDS) may negatively affect responses to T-cell-dependent vaccines, such as pneumococcal conjugate vaccine (PCV) recommended after basilar fracture. This study (NCT02806284) aimed to investigate whether there after neurotrauma is a correlation between T-cell-dependent and independent vaccine responses and, thus, if B-cell activity is similarly depressed and whether the T-cell-dependent response is possible to predict.
Adult patients with basilar fracture (n = 33) and those undergoing pituitary gland surgery (n = 23) were within 10 days vaccinated with a T-cell-dependent vaccine against Haemophilus influenzae type b (Hib) and a T-cell-independent pneumococcal polysaccharide vaccine (PPSV). Samples reflecting the systemic inflammatory response and pre- and post-vaccination antibody levels after 3-6 weeks against Hib and PPSV were collected and determined by enzyme immunoassays.
High and significant correlations were detected in the responses to different pneumococcal serotypes, but none between the Hib and PPSV responses. No differences in trauma scores, C-reactive protein, IL-6, IL-10, pentraxin 3, fractalkine or calprotectin plasma concentrations or in ex vivo TNF-α, IL-6 or IL-10 responses to endotoxin were found between Hib vaccination responders and non-responders.
There was no correlation between the pneumococcal responses and that to Hib, indicating that B-cell function is not similarly depressed as T-cell function. Grading of the trauma or parameters reflecting the innate immune response could not predict the T-cell-dependent vaccine response. There is a need of further studies evaluating the vaccine response after neurotrauma.
创伤和中枢神经系统 (CNS) 损伤后，创伤诱导的免疫缺陷综合征 (TIDS) 和 CNS 损伤诱导的免疫缺陷综合征 (CIDS) 可能会对 T 细胞依赖性疫苗（如基底骨折后推荐使用的肺炎球菌结合疫苗 [PCV]）的反应产生负面影响。本研究（NCT02806284）旨在探讨神经外伤后 T 细胞依赖性和非依赖性疫苗反应之间是否存在相关性，以及 B 细胞活性是否同样受到抑制，以及 T 细胞依赖性反应是否可能预测。
在 10 天内，基底骨折患者（n=33）和接受垂体手术患者（n=23）接种了针对乙型流感嗜血杆菌（Hib）的 T 细胞依赖性疫苗和 T 细胞非依赖性肺炎球菌多糖疫苗（PPSV）。采集并通过酶免疫分析测定反映全身性炎症反应和接种前及接种后 3-6 周针对 Hib 和 PPSV 的抗体水平。
检测到针对不同肺炎球菌血清型的反应存在高度显著相关性，但 Hib 和 PPSV 之间无相关性。Hib 疫苗接种者和未接种者之间的创伤评分、C 反应蛋白、IL-6、IL-10、五聚素 3、 fractalkine 或钙卫蛋白血浆浓度或内毒素刺激后 TNF-α、IL-6 或 IL-10 的体外反应无差异。
肺炎球菌反应与 Hib 反应之间无相关性，表明 B 细胞功能未像 T 细胞功能那样受到抑制。创伤分级或反映固有免疫反应的参数不能预测 T 细胞依赖性疫苗反应。需要进一步研究评估神经外伤后的疫苗反应。
