Bernstein E D, Gardner E M, Abrutyn E, Gross P, Murasko D M
Vaccine. 1998 Nov;16(18):1722-31. doi: 10.1016/s0264-410x(98)00140-6.
Influenza vaccination is less efficacious in the elderly than in the young. To characterize this age-related decrease in immune response to influenza vaccination, antibody and cell-mediated responses to influenza vaccine were assessed before immunization and 4 weeks after vaccination of a population of 270 healthy elderly individuals (mean age: 80.2 years) living in eight local continuing care retirement communities (CCRCs) and 30 young individuals (mean age: 27.8 years). The antibody titres produced against all three influenza strains increased significantly after vaccination in both the young and elderly (p < 0.0005); however, the young demonstrated significantly higher titres to all three strains than did the elderly (p < 0.03). Peripheral blood mononuclear cells (PBMC) cultured with influenza vaccine demonstrated significantly increased proliferation (elderly: p < 0.00005; young: p < 0.001) after vaccination, with proliferative responses in the young significantly higher than the elderly both before (p < 0.04) and after (p < 0.0005) vaccination. Similarly, IFN gamma production in these PBMC cultures increased significantly pre- to postvaccination in both young and elderly (young: p < 0.006; elderly: p < 0.00005), but the young produced more than the elderly both pre- and postvaccination (p < 0.0001). Following vaccination, PBMC production of IL-10 was higher in the young than in the elderly (p < 0.0015), while IL-6 production was comparable in both young and elderly individuals. Greater than 13% of the elderly population did not produce detectable IL-6, IL-10, or IFN gamma either before or after vaccination. The data show that the decreased cell-mediated and humoral responses to influenza vaccination of this healthy elderly population are accompanied by the production of lower levels of cytokines. A unique finding in this population of 270 healthy elderly was the association between a TH0 cytokine profile and intact immune responses to influenza vaccine. A similar relationship was not seen in the young.
流感疫苗接种在老年人中的效果不如在年轻人中显著。为了描述这种与年龄相关的对流感疫苗免疫反应的下降，我们评估了270名居住在八个当地持续护理退休社区（CCRCs）的健康老年人（平均年龄：80.2岁）和30名年轻人（平均年龄：27.8岁）在免疫接种前和接种疫苗4周后的抗体及细胞介导反应。在年轻人和老年人中，接种疫苗后针对所有三种流感毒株产生的抗体滴度均显著增加（p < 0.0005）；然而，年轻人针对所有三种毒株产生的滴度显著高于老年人（p < 0.03）。用流感疫苗培养的外周血单核细胞（PBMC）在接种疫苗后增殖显著增加（老年人：p < 0.00005；年轻人：p < 0.001），接种疫苗前（p < 0.04）和接种疫苗后（p < 0.0005）年轻人的增殖反应均显著高于老年人。同样，这些PBMC培养物中IFNγ的产生在年轻人和老年人接种疫苗前后均显著增加（年轻人：p < 0.006；老年人：p < 0.00005），但接种疫苗前后年轻人产生的IFNγ均多于老年人（p < 0.0001）。接种疫苗后，年轻人PBMC产生的IL - 10高于老年人（p < 0.0015），而年轻人和老年人中IL - 6的产生相当。超过13%的老年人群在接种疫苗前后均未产生可检测到的IL - 6、IL - 10或IFNγ。数据表明，这群健康老年人对流感疫苗接种的细胞介导和体液反应降低伴随着细胞因子水平的降低。在这270名健康老年人中一个独特的发现是TH0细胞因子谱与对流感疫苗的完整免疫反应之间的关联。在年轻人中未观察到类似关系。
