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[使用水痘疫苗预防带状疱疹的可能性]

[Possibility of prevention of herpes zoster by use of varicella vaccine].

作者信息

Kawano S, Terada K, Yagi Y, Kataoka N

机构信息

Department of Pediatrics, Kawasaki Medical School.

出版信息

Kansenshogaku Zasshi. 1998 Jul;72(7):714-9. doi: 10.11150/kansenshogakuzasshi1970.72.714.

Abstract

It has been considered that a decline in specific cell-mediated immunity (CMI) for the varicella-zoster virus (VZV) could be responsible for a high incidence of herpes zoster in the elderly. If the strength of CMI for VZV could be increased by immunization of the elderly with a varicella vaccine, herpes zoster might be preventable. We compared the CMI for VZV (using a lymphoproliferative assay and a varicella skin test) and VZV-IgG antibodies in serum before and after 2-3 months of vaccination in 15 subjects more than 40 years old. When the CMI for VZV was measured by the lymphoproliferative assay, a stimulation index (SI) of more than 2.0 was estimated to be positive in this study. The SIs (mean +/- SD) before and after the vaccination were 2.7 +/- 1.8 and 2.7 +/- 1.9, respectively, and no significant difference was noted. On the other hand, the diameter of erythema in the varicella skin test after the vaccination became larger than that before the vaccination in the 10 of 13 subjects. In addition, serum VZV-IgG antibodies increased after vaccination in 6 of 14 subjects. There were no obvious reasons for the discrepancy in the results of the lymphoproliferative assay and the varicella skin test. However, because of the poor response indicated by the assay, only one vaccination for the elderly might not be enough to increase the CMI for VZV. The appropriate age for vaccination should also be considered. Lastly, further investigation of the CMI for VZV before and after vaccination on larger scale is required.

摘要

有人认为,针对水痘带状疱疹病毒(VZV)的特异性细胞介导免疫(CMI)下降可能是老年人带状疱疹高发的原因。如果通过给老年人接种水痘疫苗来增强其对VZV的CMI强度,带状疱疹或许是可以预防的。我们比较了15名40岁以上受试者在接种疫苗2 - 3个月前后的VZV特异性CMI(采用淋巴细胞增殖试验和水痘皮肤试验)以及血清中的VZV-IgG抗体。在本研究中,通过淋巴细胞增殖试验测量VZV特异性CMI时,刺激指数(SI)大于2.0被判定为阳性。接种疫苗前后的SI(均值±标准差)分别为2.7±1.8和2.7±1.9,未发现显著差异。另一方面,13名受试者中有10名接种疫苗后的水痘皮肤试验红斑直径比接种前更大。此外,14名受试者中有6名接种疫苗后血清VZV-IgG抗体增加。淋巴细胞增殖试验和水痘皮肤试验结果存在差异,原因尚不明确。然而,鉴于该试验显示的反应不佳,仅给老年人接种一剂疫苗可能不足以增强对VZV的CMI。还应考虑合适的接种年龄。最后,需要对更大规模人群接种疫苗前后的VZV特异性CMI进行进一步研究。

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