Kostinov Mikhail, Chuchalin Alexander, Chebykina Anna, Khrapunova Isabella, Cherdantsev Alexander, Solov'eva Irina, Akhmatova Nelli, Polishchuk Valentina, Kryukova Nadezhda, Kostinova Aristitsa, Vlasenko Anna, Loktionova Marina, Albahansa Yvette, Shmit'ko Anna, Shogenova Lyudmila
I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, Russian Federation.
I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
PLoS One. 2025 Feb 12;20(2):e0313539. doi: 10.1371/journal.pone.0313539. eCollection 2025.
Influenza vaccine is a tool for preventing infection and reducing exacerbations in patients with asthma and chronic obstructive pulmonary disease (COPD). However, the associations between clinical outcomes and changes in the levels of inflammation markers have not been fully delineated. The purpose of this study was to investigate the clinical course and the changes in the levels of inflammation markers in patients with asthma or chronic obstructive pulmonary disease for one year after vaccination against influenza.
The prospective study for one year included 34 patients with asthma, 20 patients with COPD vaccinated against influenza, both groups being under a basic maintenance therapy, and 26 healthy individuals vaccinated with the trivalent polymer-subunit (adjuvanted) vaccine, containing 5 μg of influenza virus strains and 500 μg of azoximer bromide. The levels of C-reactive protein (CRP) and serum cytokines (IL-2, IL-6, IL-10, and IL-17) were measured by enzyme-linked immunosorbent assay (ELISA) at baseline and 6 and 12 months after vaccination.
Over a year after vaccination against influenza, the frequency and duration of bronchopulmonary exacerbations significantly decreased both in patients with asthma and those with COPD: by 1.9-2 and 2.2-2.5 times, respectively. There was also a significant reduction in the frequency and duration of hospitalization (by 2.0-2.5 and 2.3-3 times, respectively). Other changes observed over the one-year follow-up period included a 1.6-fold reduction (р<0.01) in the need for outpatient care and a reduction in the number of courses of systemic corticosteroids (by 16.7%; р<0.05) in asthma patients; and a 3.6-fold decrease (р<0.05) in the number of courses of antibiotics in COPD patients. Twelve months after vaccination against influenza, the study participants had significantly lower IL-6 levels, and COPD patients, additionally, showed a reduction in IL-10 levels compared to baseline. Our study identified certain correlations between positive clinical outcomes of vaccination and levels of inflammation markers.
Analysis of the immunological, clinical and functional parameters in asthma and COPD patients showed that vaccination not only reduces the risk of influenza and other respiratory infections due to activation of non-specific protection, but also improves the clinical course of asthma and COPD.
流感疫苗是预防哮喘和慢性阻塞性肺疾病（COPD）患者感染并减少病情加重的一种手段。然而，临床结局与炎症标志物水平变化之间的关联尚未完全阐明。本研究的目的是调查哮喘或慢性阻塞性肺疾病患者接种流感疫苗后一年的临床病程及炎症标志物水平的变化。
这项为期一年的前瞻性研究纳入了34例哮喘患者、20例接种流感疫苗的COPD患者（两组均接受基础维持治疗）以及26例接种含5μg流感病毒株和500μg氮氧喹啉溴化物的三价聚合物亚单位（佐剂）疫苗的健康个体。在基线、接种疫苗后6个月和12个月时，采用酶联免疫吸附测定（ELISA）法检测C反应蛋白（CRP）和血清细胞因子（IL-2、IL-6、IL-10和IL-17）水平。
接种流感疫苗一年后，哮喘患者和COPD患者的支气管肺病情加重频率和持续时间均显著降低：分别降低了1.9至2倍和2.2至2.5倍。住院频率和持续时间也显著降低（分别降低了2.0至2.5倍和2.3至3倍）。在一年的随访期内观察到的其他变化包括：哮喘患者的门诊护理需求降低了1.6倍（р<0.01），全身用皮质类固醇疗程数减少（减少了16.7%；р<0.05）；COPD患者的抗生素疗程数减少了3.6倍（р<0.05）。接种流感疫苗12个月后，研究参与者的IL-6水平显著降低，此外，COPD患者的IL-10水平与基线相比也有所降低。我们的研究确定了疫苗接种的积极临床结局与炎症标志物水平之间的某些相关性。
对哮喘和COPD患者的免疫学、临床和功能参数分析表明，接种疫苗不仅通过激活非特异性保护降低了流感和其他呼吸道感染的风险，还改善了哮喘和COPD的临床病程。
