Couch R B, Kasel J A
Annu Rev Microbiol. 1983;37:529-49. doi: 10.1146/annurev.mi.37.100183.002525.
The observations summarized in this review indicate immunity to infection with type A influenza viruses is subtype specific since little or none is conveyed to subtypes possessing immunologically distinct HA and NA proteins. However, within a subtype, a prior antigenic experience with one variant may prevent or modify illness to another. The resulting degree of subtype immunity depends on the extent of relatedness between variants. Observations with H3N2 viruses indicate that homotypic resistance to subsequent infection and illness with the same virus is potent and of relatively long duration. The long lasting durability of such immunity was indicated by the epidemiologic pattern following the reappearance of H1N1 virus. Knowledge of the duration and specificity of immunity aids considerably in assessing mechanisms that account for host resistance to influenza. Recovery from influenza virus infection must involve a variety of humoral and cell-mediated immune mechanisms, and conclusions regarding the relative importance of each one are not possible at present. To prevent infection, involved immune mechanism(s) must account for: (a) subtype specificity, (b) reduced cross-reactivity of immunity for succeeding antigenic variants, (c) a long duration of immunity, and (d) immunity at the mucosal surface. Only antibody directed toward the HA molecule presently satisfies these properties and thus should be considered the major mediator of resistance to infection. Study of naturally occurring infection is needed for determining the duration and specificity of secretory IgA in nasal and lower respiratory secretions so as to establish its relative importance as a mediator of immunity. However, the described duration, specificity, and consistent relationship to immunity suggest that IgG antibody in respiratory secretions, derived entirely or partly from serum, is the most likely mediator of resistance to natural influenza.
本综述中总结的观察结果表明，对甲型流感病毒感染的免疫力具有亚型特异性，因为很少或几乎没有免疫力会传递给具有免疫上不同的血凝素（HA）和神经氨酸酶（NA）蛋白的亚型。然而，在一个亚型内，先前对一种变体的抗原接触可能会预防或改变对另一种变体的疾病反应。由此产生的亚型免疫程度取决于变体之间的相关程度。对H3N2病毒的观察表明，对同一病毒随后感染和发病的同型抗性很强且持续时间相对较长。H1N1病毒再次出现后的流行病学模式表明了这种免疫力的持久耐久性。了解免疫力的持续时间和特异性在很大程度上有助于评估宿主对流感抵抗力的机制。从流感病毒感染中恢复必然涉及多种体液免疫和细胞介导的免疫机制，目前还无法就每种机制的相对重要性得出结论。为了预防感染，涉及的免疫机制必须解释：（a）亚型特异性，（b）对后续抗原变体的免疫交叉反应性降低，（c）免疫力的持续时间长，以及（d）黏膜表面的免疫力。目前只有针对HA分子的抗体满足这些特性，因此应被视为抵抗感染的主要介质。需要对自然发生的感染进行研究，以确定鼻腔和下呼吸道分泌物中分泌型IgA的持续时间和特异性，从而确定其作为免疫介质的相对重要性。然而，所描述的持续时间、特异性以及与免疫力的一致关系表明，呼吸道分泌物中的IgG抗体，全部或部分源自血清，是抵抗自然流感最可能的介质。
