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Zhou F, Wang Z, Zhang G, Wu Y, Xiong Y. Immunosenescence and inflammaging: Conspiracies against alveolar bone turnover. Oral Dis 2024; 30:1806-1817. [PMID: 37288702 DOI: 10.1111/odi.14642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/11/2023] [Accepted: 05/27/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Inflammaging and immunosenescence are characteristics of senescent immune system alterations. This review provides insights into inflammaging and immunosenescence in periodontitis and focuses on the innerlink of inflammaging and immunosenescence in alveolar bone turnover from a perspective of cell-cell interaction. METHODS This review is conducted by a narrative approach to discuss the effect of inflammaging and immunosenescence in aging-related alveolar bone loss. A comprehensive literature research in PubMed and Google was applied to identify reports in English. RESULTS Inflammaging is concerned with abnormal M1 polarization and increasing circulating inflammatory cytokines, while immunosenescence involves reduced infection and vaccine responses, depressed antimicrobial function, and infiltration of aged B cells and memory T cells. TLR-mediated inflammaging and altered adaptive immunity significantly affect alveolar bone turnover and aggravate aging-related alveolar bone loss. Besides, energy consumption also plays a vital role in aged immune and skeletal system of periodontitis. CONCLUSIONS Senescent immune system exerts a significant function in aging-related alveolar bone loss. Inflammaging and immunosenescence interact functionally and mechanistically, which affects alveolar bone turnover. Therefore, further clinical treatment strategies targeting alveolar bone loss could be based on the specific molecular mechanism connecting inflammaging, immunosenescence, and alveolar bone turnover.
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Affiliation(s)
- Feng Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhanqi Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Guorui Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yingying Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yi Xiong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Knight H, Jia R, Ayling K, Blake H, Morling JR, Villalon AM, Corner J, Denning C, Ball J, Bolton K, Figueredo G, Morris D, Tighe P, Vedhara K. The changing vaccine landscape: rates of COVID-19 vaccine acceptance and hesitancy in young adults during vaccine rollout. Perspect Public Health 2023; 143:220-224. [PMID: 35575215 PMCID: PMC10467000 DOI: 10.1177/17579139221094750] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS Development and rollout of vaccines offers the best opportunity for population protection against the SARS-CoV-2 (COVID-19) virus. However, hesitancy towards the vaccines might impede successful uptake in the United Kingdom, particularly in young adults who demonstrate the highest rates of hesitancy. This prospective study explored COVID-19 vaccine hesitancy in young adults and whether the reasons behind these attitudes changed during the initial stages of the United Kingdom's vaccine rollout. METHOD Data on vaccination intention were collected from a British university student cohort at three time points: October 2020, February 2021, and March 2021. This online survey included items on intention to receive a vaccine and a free-text response for the reasons behind this intention. Cochran's Q tests examined changes in rates of hesitancy and acceptance over time and free-text responses were analysed thematically. RESULTS At baseline, 893 students provided data, with 476 participants completing all three time points. Hesitancy declined over time, with 29.4% of participants expressing hesitancy at baseline, reducing to 9.1% at wave 2 and 5.9% at wave 3. The most commonly endorsed themes for those willing to accept a vaccine were self-protection against COVID-19 and pro-social reasons, including protecting the population or unspecific others, and ending the pandemic/returning to normal life. The most commonly endorsed hesitancy themes related to 'confidence' in the vaccines and potential personal risk, including insufficient testing/scientific evidence, concern about side effects, and long-term effects. These reasons remained the most commonly endorsed at both waves 2 and 3. CONCLUSIONS While a decline in hesitancy was observed over time, the key reasons behind both vaccine acceptance and hesitancy remained consistent. Reasons behind hesitancy aligned with those of the general public, providing support for the use of generalist interventions. Pro-social reasons frequently underpinned vaccine acceptance, so cohort-specific interventions targeting those factors may be of benefit.
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Affiliation(s)
- H Knight
- School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| | - R Jia
- School of Medicine, University of Nottingham, Nottingham, UK
| | - K Ayling
- School of Medicine, University of Nottingham, UK
| | - H Blake
- School of Health Sciences, University of Nottingham, Nottingham, UK; NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - JR Morling
- School of Medicine, University of Nottingham, Nottingham, UK; NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - AM Villalon
- Faculty of Engineering, University of Nottingham, Nottingham, UK
| | - J Corner
- University Executive Board, University of Nottingham, Nottingham, UK
| | - C Denning
- Biodiscovery Institute, University Park, University of Nottingham, Nottingham, UK
| | - J Ball
- Biodiscovery Institute, University Park, University of Nottingham, Nottingham, UK
| | - K Bolton
- School of Mathematical Sciences, University of Nottingham, Nottingham, UK
| | - G Figueredo
- School of Computer Sciences, University of Nottingham, Nottingham, UK
| | - D Morris
- Faculty of Engineering, University of Nottingham, Nottingham, UK
| | - P Tighe
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - K Vedhara
- School of Medicine, University of Nottingham, Nottingham, UK
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3
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Du Y, Jin C, Jit M, Chantler T, Lin L, Larson HJ, Li J, Gong W, Yang F, Ren N, Cheng W, Zhou Y, Tang W, Tucker JD, Wu D. Influenza vaccine uptake among children and older adults in China: a secondary analysis of a quasi-experimental study. BMC Infect Dis 2023; 23:225. [PMID: 37055738 PMCID: PMC10098986 DOI: 10.1186/s12879-023-08145-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 03/09/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Influenza vaccination is the key to prevent influenza-related disease, especially among high-risk populations. However, influenza vaccine uptake in China is low. This secondary analysis of a quasi-experimental trial aimed to understand factors associated with influenza vaccine uptake among children and older people stratified by funding context. METHODS A total of 225 children (aged 0.5-8 years) and 225 older people (aged 60 years or above) were recruited from three clinics (rural, suburban and urban) in Guangdong Province. Participants were allocated into two groups based on funding contexts: a self-paid group (N = 150, 75 children and 75 older adults) in which participants paid full price for their vaccination; and a subsidized group (N = 300, 150 children and 150 older adults) in which varying levels of financial support was provided. Univariate and multivariable logistic regressions were conducted stratified by funding contexts. RESULTS Overall, 75.0% (225/300) of participants in the subsidized group and 36.7% (55/150) in the self-paid group got vaccinated. Older adults had lower vaccination rates than children in both funding groups, while both age groups showed much higher uptake in the subsidized group than in the self-paid group (aOR = 5.96, 95% CI: 3.77-9.42, p = 0.001). In the self-paid group, having prior influenza vaccination history of children (aOR:2.61, 95%CI: 1.06-6.42) or older people (aOR:4.76, 95%CI: 1.08-20.90) was associated with increased influenza vaccine uptake compared to those who had no prior vaccination experiences in the family. While in the subsidized group, participants who got married or lived with partners (aOR = 0.32, 0.10-0.98) had lower vaccination uptake than single ones. Trust in providers' advice (aOR = 4.95, 95%CI:1.99, 12.43), perceived effectiveness of the vaccine (aOR: 12.18, 95%CI: 5.21-28.50), and experienced influenza-like illnesses in the family in the past year (aOR = 46.52, 4.10, 533.78) were associated with higher vaccine uptake. CONCLUSIONS Older people had suboptimal vaccine uptake compared to children in both contexts and need more attention to enhance influenza vaccination. Tailoring interventions to different vaccine funding contexts may help improve influenza vaccination: In self-paid context, motivating people to accept their first ever influenza vaccination may be a promising strategy. In subsidized context, improving public confidence in vaccine effectiveness and providers' advice would be useful.
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Affiliation(s)
- Yumeng Du
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Guangzhou, China
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China
| | - Chenqi Jin
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China
- Dermatology Hospital of South Medical University, Guangzhou, China
| | - Mark Jit
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, New Territories, Hong Kong, China
| | - Tracey Chantler
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Leesa Lin
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, New Territories, Hong Kong, China
| | - Heidi J Larson
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Jing Li
- Department of Occupational and Environmental Health, West China School of Public Health, Sichuan University, Chengdu, China
| | - Wenfeng Gong
- China Country Office, Bill & Melinda Gates Foundation, Beijing, China
| | - Fan Yang
- Institute of Population Research, Peking University, Beijing, China
| | - Nina Ren
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Weibin Cheng
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yi Zhou
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Weiming Tang
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Guangzhou, China
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China
- Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joseph D Tucker
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China
- Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dan Wu
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China.
- Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, Room 360, Keppel St, London, WC1E 7HT, UK.
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Jiang L, Jing H, Lan L, Liu X, Wang S, Xu Y, Meng N. Effects of Acupuncture Combined with Exercise on Expression of Immune Factors in Aging Rats and Its Significance in Antiaging Intervention. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:6833196. [PMID: 36017145 PMCID: PMC9398838 DOI: 10.1155/2022/6833196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 12/04/2022]
Abstract
Background With the improvement of people's living standards, how to maintain health and delay aging to improve the quality of life and achieve longevity has become a hot topic of concern. objective. To investigate the effect of acupuncture combined with exercise on the expression of immune factors in aging rats and its significance in antiaging intervention. Materials and Methods Forty-three SD rats included 12 rats in the control group, and the remaining rats were injected intraperitoneally with D-galactose 500 mg/kg to prepare a subacute aging rat model. The 24 rats that were successfully modeled were divided into acupuncture exercise groups and exercise groups according to the random number table method, with 12 rats in each group. After the modeling, the comparison group did not do any intervention, the exercise group was given aerobic exercise intervention, and the acupuncture exercise group was given acupuncture combined with exercise intervention. The effect of immune factor expression in rats was compared. Results The levels of IgM, IgA, and IgG in the acupuncture exercise group were significantly higher than those in the exercise group (P < 0.05). The IL-10 content in the acupuncture exercise group was significantly higher than that in the exercise group (P < 0.05) and was significantly reduced in the acupuncture exercise group compared with the comparison group (P < 0.05). The level of IL-6 in the acupuncture exercise group was significantly lower than that in the exercise group, and the level of IL-6 in the acupuncture exercise group was significantly increased compared with the comparison group (P < 0.05). The C3 and C4 levels in the acupuncture exercise group were significantly higher than those in the exercise group (P < 0.05). The levels of IFN-γ and TNP-α were significantly lower in the acupuncture exercise group than in the exercise group and significantly increased in the acupuncture exercise group compared with the comparison group (P < 0.05). Conclusion Ling turtle eight method acupuncture combined with exercise promoted the development of immune organ spleen, enhances the body's immune function and complement system, inhibits the immune inflammatory response and regulates immune balance, reduces the inflammatory response caused by the aging of D-type galactose, and achieves the effect of delaying aging.
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Affiliation(s)
- Lulu Jiang
- College of Sports and Human Sciences, Harbin Sport University, Harbin, China 150008
| | - Hongying Jing
- College of Sports and Human Sciences, Harbin Sport University, Harbin, China 150008
| | - Lan Lan
- College of Sport Humanistic Sociology, Harbin Sport University, Harbin, China 150008
| | - Xia Liu
- College of Sports and Human Sciences, Harbin Sport University, Harbin, China 150008
| | - Su Wang
- College of Sports and Human Sciences, Harbin Sport University, Harbin, China 150008
| | - Yan Xu
- College of Sports and Human Sciences, Harbin Sport University, Harbin, China 150008
| | - Nijia Meng
- College of Sports and Human Sciences, Harbin Sport University, Harbin, China 150008
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5
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Tormo N, Navalpotro D, Martínez-Serrano M, Moreno M, Grosson F, Tur I, Guna MR, Soriano P, Tornero A, Gimeno C. Commercial Interferon-gamma release assay to assess the immune response to first and second doses of mRNA vaccine in previously COVID-19 infected versus uninfected individuals. Diagn Microbiol Infect Dis 2022; 102:115573. [PMID: 35121268 PMCID: PMC8502494 DOI: 10.1016/j.diagmicrobio.2021.115573] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/29/2021] [Accepted: 10/04/2021] [Indexed: 01/01/2023]
Abstract
We analysed immunological response during vaccination by using quantitative anti-spike IgG antibodies (qAbs) and Interferon-gamma (IFNγ) production by SARS-CoV-2-specific CD4+ and CD8+ T cells (QuantiFERON® assay). Blood samples were collected at four time points: a day before the reception of first (T0) and second (T1) BNT162b2 doses, 14 (T2) and 28 days (T3) after second dose. Fifty individuals were included: 34 previously infected by SARS-CoV-2 (CoV2+) and 16 that were not (CoV2-). Among CoV2+, we only observed significant differences after the first dose in both qAbs and IFNγ+ T cells. CoV2- showed differences after each dose, and the response was lower than CoV2+. Older people presented a higher response in CoV2+, while in CoV2, young people responded best. Our results suggest that the second BNT162b2 vaccine dose is not a priority in people with previous COVID-19. QuantiFERON® is a good option to monitor T-cell immunity to SARS-CoV-2.
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Affiliation(s)
- Nuria Tormo
- Microbiology Department, Consorcio Hospital General Universitario, Valencia, Spain.
| | - David Navalpotro
- Microbiology Department, Consorcio Hospital General Universitario, Valencia, Spain
| | | | - Marta Moreno
- Microbiology Department, Consorcio Hospital General Universitario, Valencia, Spain
| | - Fernando Grosson
- Microbiology Department, Consorcio Hospital General Universitario, Valencia, Spain
| | - Irene Tur
- Microbiology Department, Consorcio Hospital General Universitario, Valencia, Spain
| | - Maria Remedios Guna
- Microbiology Department, Consorcio Hospital General Universitario, Valencia, Spain
| | - Pepa Soriano
- Control Commission of Nursing Homes, Consorcio Hospital General Universitario, Valencia, Spain
| | - Ana Tornero
- Control Commission of Nursing Homes, Consorcio Hospital General Universitario, Valencia, Spain
| | - Concepción Gimeno
- Microbiology Department, Consorcio Hospital General Universitario, Valencia, Spain
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6
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The Implications of Vaccines in Older Populations. Vaccines (Basel) 2022; 10:vaccines10030431. [PMID: 35335063 PMCID: PMC8955469 DOI: 10.3390/vaccines10030431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/05/2022] [Accepted: 03/09/2022] [Indexed: 11/17/2022] Open
Abstract
Mean longevity is increasing worldwide, with major consequences for public health worldwide, as the global population of adults aged over 65 years now exceeds the number of children under 5 for the first time in history. The ageing process over the life course is extremely heterogeneous, and it will be important to promote and enhance healthy ageing worldwide. Vaccination is a key player in the healthy ageing process, both at the individual and the community level. We review here the contribution of vaccines to individual and community health. At an individual level, we highlight the prevention of infectious diseases, as well as other, less well-known benefits of vaccination, such as modulation of the inflammatory process. We then underline the importance of vaccination in achieving herd immunity and reducing the transmission of pathogens in the community. Finally, at a community level, another important benefit of vaccination is the reduction in antimicrobial resistance. Taken together, these effects contribute to ensuring the best health, for the greatest number, for the longest time possible.
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7
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Michel JP, Ecarnot F. Healthy Ageing and Vaccines: Application of the P4 Medicine Concept to Immunizations. Gerontology 2021; 68:481-487. [PMID: 34247174 DOI: 10.1159/000517211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/15/2021] [Indexed: 11/19/2022] Open
Abstract
In today's tormented world, it appears useful to take advantage of communication channels to promote life-course immunization and affirm its major role in healthy ageing. Instead of developing the argument of chronological age, we demonstrate the life-course principle here based on the P4 medicine concept. Are vaccines "preventive, personalized, predictive, and participatory?" Based on detailed analysis of research findings, we successively demonstrate the seminal role of vaccines on preventable infectious diseases, post-sepsis functional decline, non-communicable diseases (cardio-neuro-vascular, respiratory, and renal diseases), community protection, antimicrobial resistance, and perhaps even old-age dementia. Healthy ageing and the promotion of immunization are closely dependent on health literacy and provision of information by skilled health-care professionals. However, personal autonomy and individual freedom are influenced by psycho-cognitive hurdles (cultural approaches, beliefs, emotions, and behaviours), the opinions of the public/family/friends, and the increasing role of social media, which challenges scientific evidence. A similar phenomenon exists when dealing with the issue of healthy ageing, whose success depends greatly on life-course immunization.
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Affiliation(s)
- Jean-Pierre Michel
- Department of Rehabilitation and Geriatrics, Medical University of Geneva, Geneva, Switzerland
| | - Fiona Ecarnot
- Department of Cardiology, University Hospital Besancon, Besancon, France.,EA3920, University of Franche-Comté, Besancon, France
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8
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Chou YH, Chen YM. Aging and Renal Disease: Old Questions for New Challenges. Aging Dis 2021; 12:515-528. [PMID: 33815880 PMCID: PMC7990354 DOI: 10.14336/ad.2020.0703] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/03/2020] [Indexed: 12/15/2022] Open
Abstract
Chronic kidney disease (CKD) is a growing problem among aging population, and the number of individuals at risk of end stage renal disease is rising. Part of the reason lies in incomplete understanding of the pathways underlying renal aging and kidney disease, as well as insufficient delivery of evidence-based treatment to elderly patients with CKD. This review aims to address these unsolved issues by delineating updated mechanisms of renal senescence and summarizing recent findings on key clinical aspects of CKD in the elderly. Challenges and obstacles in caring for older people with CKD are discussed, with an emphasis on modification of risk factors, prevention of acute kidney injury, stabilization of progression and decision on dialysis initiation.
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Affiliation(s)
- Yu-Hsiang Chou
- 1Department of Internal Medicine, National Taiwan University Hospital Jin-Shan Branch, New Taipei City 20844, Taiwan.,2Renal Division, Department of Internal Medicine, and
| | - Yung-Ming Chen
- 2Renal Division, Department of Internal Medicine, and.,3Department of Geriatrics and Gerontology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taiwan
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9
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Clemente-Suárez VJ, Hormeño-Holgado A, Jiménez M, Benitez-Agudelo JC, Navarro-Jiménez E, Perez-Palencia N, Maestre-Serrano R, Laborde-Cárdenas CC, Tornero-Aguilera JF. Dynamics of Population Immunity Due to the Herd Effect in the COVID-19 Pandemic. Vaccines (Basel) 2020; 8:E236. [PMID: 32438622 PMCID: PMC7349986 DOI: 10.3390/vaccines8020236] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 02/07/2023] Open
Abstract
The novel Coronavirus 2 Severe Acute Respiratory Syndrome (SARS-Cov-2) has led to the Coronavirus Disease 2019 (COVID-19) pandemic, which has surprised health authorities around the world, quickly producing a global health crisis. Different actions to cope with this situation are being developed, including confinement, different treatments to improve symptoms, and the creation of the first vaccines. In epidemiology, herd immunity is presented as an area that could also solve this new global threat. In this review, we present the basis of herd immunology, the dynamics of infection transmission that induces specific immunity, and how the application of immunoepidemiology and herd immunology could be used to control the actual COVID-19 pandemic, along with a discussion of its effectiveness, limitations, and applications.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain;
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
- Studies Centre in Applied Combat (CESCA), Toledo 45007, Spain;
| | | | - Manuel Jiménez
- Departamento de Didáctica de la Educación Física y Salud, Universidad Internacional de La Rioja, Logroño 26006, Spain;
| | | | - Eduardo Navarro-Jiménez
- Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (E.N.-J.); (R.M.-S.)
| | | | - Ronald Maestre-Serrano
- Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla 080005, Colombia; (E.N.-J.); (R.M.-S.)
| | | | - Jose Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain;
- Studies Centre in Applied Combat (CESCA), Toledo 45007, Spain;
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10
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Lang PO, Aspinall R. The Burden of Chikungunya Virus Infection: The Need for Systematic and Geriatric-Specific Epidemiological Monitoring. J Am Geriatr Soc 2018; 66:635-636. [DOI: 10.1111/jgs.15267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Pierre-Olivier Lang
- Health and Wellbeing Academy; Anglia Ruskin University; Cambridge, UK
- Geriatric and Geriatric Rehabilitation Division, Department of Medicine, University Hospital of Lausanne; Lausanne, Switzerland
| | - Richard Aspinall
- Health and Wellbeing Academy; Anglia Ruskin University; Cambridge, UK
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11
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van den Berg SPH, Wong A, Hendriks M, Jacobi RHJ, van Baarle D, van Beek J. Negative Effect of Age, but Not of Latent Cytomegalovirus Infection on the Antibody Response to a Novel Influenza Vaccine Strain in Healthy Adults. Front Immunol 2018; 9:82. [PMID: 29434600 PMCID: PMC5796903 DOI: 10.3389/fimmu.2018.00082] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 01/11/2018] [Indexed: 01/15/2023] Open
Abstract
Older adults are more vulnerable to influenza virus infection and at higher risk for severe complications and influenza-related death compared to younger adults. Unfortunately, influenza vaccine responses tend to be impaired in older adults due to aging of the immune system (immunosenescence). Latent infection with cytomegalovirus (CMV) is assumed to enhance age-associated deleterious changes of the immune system. Although lower responses to influenza vaccination were reported in CMV-seropositive compared to CMV-seronegative adults and elderly, beneficial effects of CMV infection were observed as well. The lack of consensus in literature on the effect of latent CMV infection on influenza vaccination may be due to the presence of pre-existing immunity to influenza in these studies influencing the subsequent influenza vaccine response. We had the unique opportunity to evaluate the effect of age and latent CMV infection on the antibody response to the novel influenza H1N1pdm vaccine strain during the pandemic of 2009, thereby reducing the effect of pre-existing immunity on the vaccine-induced antibody response. This analysis was performed in a large study population (n = 263) in adults (18–52 years old). As a control, memory responses to the seasonal vaccination, including the same H1N1pdm and an H3N2 strain, were investigated in the subsequent season 2010–2011. With higher age, we found decreased antibody responses to the pandemic vaccination even within this age range, indicating signs of immunosenescence to this novel antigen in the study population. Using a generalized estimation equation regression model, adjusted for age, sex, and previous influenza vaccinations, we observed that CMV infection in contrast did not influence the influenza virus-specific antibody titer after H1N1pdm vaccination. Yet, we found higher residual protection rates (antibody level ≥40 hemagglutinin units (HAU)) in CMV-seropositive individuals than in CMV-seronegative individuals 6 months and 1 year after pandemic vaccination. In the subsequent season, no effect of age or CMV infection on seasonal influenza vaccine response was observed. In conclusion, we observed no evidence for CMV-induced impairment of antibody responses to a novel influenza strain vaccine in adults. If anything, our data suggest that there might be a beneficial effect of latent CMV infection on the protection rate after novel influenza vaccination.
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Affiliation(s)
- Sara P H van den Berg
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands.,Laboratory of Translational Immunology, Department of Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Albert Wong
- Department of Statistics, Informatics and Mathematical Modelling, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Marion Hendriks
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Ronald H J Jacobi
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Debbie van Baarle
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands.,Laboratory of Translational Immunology, Department of Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Josine van Beek
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
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van der Heiden M, Berbers GAM, Fuentes S, van Zelm MC, Boots AMH, Buisman AM. An Explorative Biomarker Study for Vaccine Responsiveness after a Primary Meningococcal Vaccination in Middle-Aged Adults. Front Immunol 2018; 8:1962. [PMID: 29375578 PMCID: PMC5768620 DOI: 10.3389/fimmu.2017.01962] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 12/19/2017] [Indexed: 01/08/2023] Open
Abstract
Introduction Prevention of infectious diseases in the elderly is essential to establish healthy aging. Yet, immunological aging impairs successful vaccination of the elderly. Predictive biomarkers for vaccine responsiveness in middle-aged adults may help to identify responders and non-responders before reaching old age. Therefore, we aimed to determine biomarkers associated with low and high responsiveness toward a primary vaccination in middle-aged adults, for which a tetravalent meningococcal vaccine was used as a model. Methods Middle-aged adults (50–65 years of age, N = 100), receiving a tetravalent meningococcal vaccination, were divided into low and high responders using the functional antibody titers at 28 days postvaccination. A total of 48 parameters, including absolute numbers of immune cells and serum levels of cytokines and biochemical markers, were determined prevaccination in all participants. Heat maps and multivariate redundancy analysis (RDA) were used to reveal immune phenotype characteristics and associations of the low and high responders. Results Several significant differences in prevaccination immune markers were observed between the low and high vaccine responders. Moreover, RDA analysis revealed a significant association between the prevaccination immune phenotype and vaccine responsiveness. In particular, our analysis pointed at high numbers of CD4 T cells, especially naïve CD4 and regulatory T subsets, to be associated with low vaccine responsiveness. In addition, low responders showed lower prevaccination IL-1Ra levels than high responders. Conclusion This explorative biomarker study shows associations between the prevaccination immune phenotype and vaccine responsiveness after a primary meningococcal vaccination in middle-aged adults. Consequently, these results provide a basis for predictive biomarker discovery for vaccine responsiveness that will require validation in larger cohort studies.
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Affiliation(s)
- Marieke van der Heiden
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands.,Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
| | - Guy A M Berbers
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Susana Fuentes
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Menno C van Zelm
- Department of Immunology, Erasmus MC, Rotterdam, Netherlands.,Department of Immunology and Pathology, Monash University and Alfred Hospital, Melbourne, VIC, Australia
| | - Annemieke M H Boots
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
| | - Anne-Marie Buisman
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
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13
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van der Heiden M, van Ravenhorst MB, Bogaard M, Boots AMH, Berbers GAM, Buisman AM. Lower antibody functionality in middle-aged adults compared to adolescents after primary meningococcal vaccination: Role of IgM. Exp Gerontol 2017; 105:101-108. [PMID: 29287771 DOI: 10.1016/j.exger.2017.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 12/18/2017] [Accepted: 12/19/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Successful vaccination of elderly persons is often hampered by immunological ageing, leaving part of the elderly population vulnerable for infectious diseases. As an alternative, timely vaccinations might be administered at middle-age, before reaching old age. Studies evaluating the immunological fitness of middle-aged adults are warranted. In this study we compared the immunogenicity of a primary meningococcal vaccination in Dutch middle-aged adults with that in adolescents, in order to gain knowledge on the early signs of immune ageing. METHODS In this study, we compared the antibody responses after a primary meningococcal vaccination between middle-aged adults (50-65years of age, N=204) and adolescents (10-15years of age, N=225). Blood samples were taken pre-, as well as 28days and 1year post-vaccination. Functional antibody titers were measured with the serum bactericidal killing assay using baby rabbit complement (rSBA). Meningococcal polysaccharide (PS) specific IgG and IgM concentrations were determined with a fluorescent bead-based multiplex immunoassay. RESULTS Lower post-vaccination functional antibody titers against meningococcal group W and Y were observed in the middle-aged adults compared to the adolescents. One year post-vaccination, also a significantly higher proportion of the middle-aged adults possessed an rSBA titer below protection level. A large reduction in post-vaccination IgM concentrations was observed in the middle-aged adults, whereas IgG concentrations were only marginally different between the two age groups. Strong correlations between the post-vaccination rSBA titers and IgM concentrations were found both in the middle-aged adults and the adolescents. CONCLUSION Although protective antibody titers were initiated after primary meningococcal vaccination in middle-aged adults, antibody functionality was significantly lower as compared to that in adolescents. This difference was mainly caused by lower IgM responses. Our results indicate early signs of immune ageing in middle-aged adults, which is important knowledge for the development of future vaccine strategies to better protect elderly persons against infectious diseases.
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Affiliation(s)
- Marieke van der Heiden
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
| | - Mariette B van Ravenhorst
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Department of Pediatric Immunology and Infectious Disease, Wilhelmina Children's Hospital Medical Centre Utrecht, Utrecht, The Netherlands
| | - Marjan Bogaard
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Annemieke M H Boots
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Guy A M Berbers
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Anne-Marie Buisman
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
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Aspinall R, Lang PO. Vaccination choices for older people, looking beyond age specific approaches. Expert Rev Vaccines 2017; 17:23-30. [DOI: 10.1080/14760584.2018.1411197] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
| | - Pierre Olivier Lang
- Anglia Ruskin University, Cambridge, UK
- Geriatric and Geriatric Rehabilitation Division, Department of Medicine, University Hospital of Lausanne, Lausanne, Switzerland
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15
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Tetanus Toxoid carrier protein induced T-helper cell responses upon vaccination of middle-aged adults. Vaccine 2017; 35:5581-5588. [DOI: 10.1016/j.vaccine.2017.08.056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 08/15/2017] [Accepted: 08/27/2017] [Indexed: 01/19/2023]
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16
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van der Heiden M, Boots AMH, Bonacic Marinovic AA, de Rond LGH, van Maurik M, Tcherniaeva I, Berbers GAM, Buisman AM. Novel Intervention in the Aging Population: A Primary Meningococcal Vaccine Inducing Protective IgM Responses in Middle-Aged Adults. Front Immunol 2017; 8:817. [PMID: 28769927 PMCID: PMC5515833 DOI: 10.3389/fimmu.2017.00817] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 06/27/2017] [Indexed: 12/14/2022] Open
Abstract
Introduction Vaccine responses are often reduced in the elderly, leaving part of the elderly population vulnerable to infectious diseases. Timely vaccination may offer a solution for strengthening memory immunity before reaching old age, which classifies middle-aged persons as a target age group for vaccine interventions. However, knowledge regarding the immunogenicity of primary immunizations in middle-aged adults is lacking. We determined the immunogenicity of a primary meningococcal vaccine towards which no or (very) low pre-vaccination immunity exists in middle-aged adults (NTR4636). Methods A vaccine containing multiple meningococcal groups (tetravalent) conjugated to tetanus toxoid (MenACWY-TT) was administered to middle-aged adults (50–65 years of age, N = 204) in a phase IV single-center and open-label study. Blood samples were taken pre-, 7 days, 28 days, and 1 year post-vaccination. Functional antibody titers were measured with the serum bactericidal assay (SBA). Meningococcal- and tetanus-specific antibody responses were determined with a fluorescent bead-based multiplex immunoassay. A bi-exponential decay model was used to estimate long-term protection. Results In the majority of the participants, the meningococcal vaccine clearly induced naïve responses to meningococci W (MenW) and meningococci Y (MenY) as compared to a booster response to meningococci C (MenC). After 28 days, 94, 99, and 97% of the participants possessed a protective SBA titer for MenC, MenW, and MenY, respectively, which was maintained in 76, 94, and 86% 1 year post-vaccination. At this 1-year time point, significantly lower SBA titers were found in participants without a pre-vaccination SBA titer. Overall, protective antibody titers were predicted to persist after 10 years in 40–60% of the participants. The SBA titers correlated well with the meningococcal-specific IgM responses, especially for MenW and MenY. Interestingly, these IgM responses were negatively correlated with age. Conclusion Primary immunization with a tetravalent meningococcal vaccine was highly immunogenic in middle-aged adults, inducing protective antibody titers in the vast majority of the participants lasting for at least 1 year. The age-related decrease in highly functional IgM responses argues in favor of vaccination against de novo antigens before reaching old age and, hence, middle-aged persons are an age group of interest for future vaccine interventions to protect the aging population.
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Affiliation(s)
- Marieke van der Heiden
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands.,Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
| | - Annemieke M H Boots
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
| | - Axel A Bonacic Marinovic
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Lia G H de Rond
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Marjan van Maurik
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Irina Tcherniaeva
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Guy A M Berbers
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Anne-Marie Buisman
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
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17
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Bouaziz W, Lang PO, Schmitt E, Kaltenbach G, Geny B, Vogel T. Health benefits of multicomponent training programmes in seniors: a systematic review. Int J Clin Pract 2016; 70:520-36. [PMID: 27291143 DOI: 10.1111/ijcp.12822] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The ageing process is intrinsically associated with decline in physical endurance, muscle strength and gait ability and balance, which all contribute to functional disability. Regular physical training, and more particularly multicomponent training (MCT), has demonstrated many health benefits. OBJECTIVE To evaluate the evidence of the health benefits of MCT including endurance training, muscle strengthening, balance exercises, and/or stretching (i.e. flexibility training) and/or coordination training in adults aged 65 years or over. METHODS A comprehensive, systematic database search for manuscripts was performed in CINAHL Plus, Embase, Medline, PubMed Central, ScienceDirect, Scopus, Sport Discus and Web of Science using key words. For potential inclusion, two reviewers independently assessed all intervention studies published in English language from 1 January 2000 to 30 April 2015. RESULTS Of 2525 articles initially identified, 27 studies were finally included in this systematic review. They were all divided into five categories according to their main outcome measurements (cardio-respiratory fitness, metabolic outcomes, functional and cognitive functions and quality of life, QoL). These studies reported that MCT has a significant beneficial effect on cardio-respiratory fitness and on metabolic outcomes. Substantial improvement in functional and cognitive performance was also measured and a slighter but positive effect on QoL. CONCLUSION Overall, this review demonstrates a positive effect of MCT with functional benefits and positive health outcomes for seniors. Based on this evidence, clinicians should encourage all adults aged 65 or over to engage in MCT programmes to favour healthy ageing and keeping older members of our society autonomous and independent.
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Affiliation(s)
- W Bouaziz
- Geriatric Department, University Hospital, Strasbourg, France
- Department of Physiology and EA-3072, Faculty of Medicine, Strasbourg University, Strasbourg, France
| | - P O Lang
- Health and Wellbeing Academy, Anglia Ruskin University, Cambridge, UK
- Geriatric and Rehabilitation Geriatric Division, University Hospital of Lausanne, Lausanne, Switzerland
| | - E Schmitt
- Geriatric Department, University Hospital, Strasbourg, France
- Department of Physiology and EA-3072, Faculty of Medicine, Strasbourg University, Strasbourg, France
| | - G Kaltenbach
- Geriatric Department, University Hospital, Strasbourg, France
| | - B Geny
- Department of Physiology and EA-3072, Faculty of Medicine, Strasbourg University, Strasbourg, France
- Functional Explorations Department, University Hospital, Strasbourg, France
| | - T Vogel
- Geriatric Department, University Hospital, Strasbourg, France
- Department of Physiology and EA-3072, Faculty of Medicine, Strasbourg University, Strasbourg, France
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Michel JP, Dreux C, Vacheron A. Healthy ageing: Evidence that improvement is possible at every age. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2016.04.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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19
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van der Heiden M, van Zelm MC, Bartol SJW, de Rond LGH, Berbers GAM, Boots AMH, Buisman AM. Differential effects of Cytomegalovirus carriage on the immune phenotype of middle-aged males and females. Sci Rep 2016; 6:26892. [PMID: 27243552 PMCID: PMC4886678 DOI: 10.1038/srep26892] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 05/10/2016] [Indexed: 12/16/2022] Open
Abstract
The elderly population is more susceptible to infections as a result of an altered immune response, commonly referred to as immunosenescence. Cytomegalovirus (CMV)-infection associated changes in blood lymphocytes are known to impact this process, but the interaction with gender remains unclear. Therefore, we analysed the effects and interaction of gender and CMV on the absolute numbers of a comprehensive set of naive and memory T- and B-cell subsets in people between 50 and 65 years of age. Enumeration and characterisation of lymphocyte subsets by flow cytometry was performed on fresh whole blood samples from 255 middle-aged persons. CMV-IgG serostatus was determined by ELISA. Gender was a major factor affecting immune cell numbers. CMV infection was mainly associated with an expansion of late-differentiated T-cell subsets. CMV+ males carried lower numbers of total CD4+, CD4+ central memory (CM) and follicular helper T-cells than females and CMV- males. Moreover, CMV+ males had significantly lower numbers of regulatory T (Treg)-cells and memory B-cells than CMV+ females. We here demonstrate an interaction between the effects of CMV infection and gender on T- and B-cells in middle-aged individuals. These differential effects on adaptive immunity between males and females may have implications for vaccination strategies at middle-age.
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Affiliation(s)
- Marieke van der Heiden
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven 3720 BA, The Netherlands
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen 9700 RB, The Netherlands
| | - Menno C. van Zelm
- Department of Immunology, Erasmus MC, Rotterdam 3000 CA, The Netherlands
- Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, Victoria 3004, Australia
| | | | - Lia G. H. de Rond
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven 3720 BA, The Netherlands
| | - Guy A. M. Berbers
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven 3720 BA, The Netherlands
| | - Annemieke M. H. Boots
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen 9700 RB, The Netherlands
| | - Anne-Marie Buisman
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven 3720 BA, The Netherlands
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A Molecular Host Response Assay to Discriminate Between Sepsis and Infection-Negative Systemic Inflammation in Critically Ill Patients: Discovery and Validation in Independent Cohorts. PLoS Med 2015; 12:e1001916. [PMID: 26645559 PMCID: PMC4672921 DOI: 10.1371/journal.pmed.1001916] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 10/29/2015] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Systemic inflammation is a whole body reaction having an infection-positive (i.e., sepsis) or infection-negative origin. It is important to distinguish between these two etiologies early and accurately because this has significant therapeutic implications for critically ill patients. We hypothesized that a molecular classifier based on peripheral blood RNAs could be discovered that would (1) determine which patients with systemic inflammation had sepsis, (2) be robust across independent patient cohorts, (3) be insensitive to disease severity, and (4) provide diagnostic utility. The goal of this study was to identify and validate such a molecular classifier. METHODS AND FINDINGS We conducted an observational, non-interventional study of adult patients recruited from tertiary intensive care units (ICUs). Biomarker discovery utilized an Australian cohort (n = 105) consisting of 74 cases (sepsis patients) and 31 controls (post-surgical patients with infection-negative systemic inflammation) recruited at five tertiary care settings in Brisbane, Australia, from June 3, 2008, to December 22, 2011. A four-gene classifier combining CEACAM4, LAMP1, PLA2G7, and PLAC8 RNA biomarkers was identified. This classifier, designated SeptiCyte Lab, was validated using reverse transcription quantitative PCR and receiver operating characteristic (ROC) curve analysis in five cohorts (n = 345) from the Netherlands. Patients for validation were selected from the Molecular Diagnosis and Risk Stratification of Sepsis study (ClinicalTrials.gov, NCT01905033), which recruited ICU patients from the Academic Medical Center in Amsterdam and the University Medical Center Utrecht. Patients recruited from November 30, 2012, to August 5, 2013, were eligible for inclusion in the present study. Validation cohort 1 (n = 59) consisted entirely of unambiguous cases and controls; SeptiCyte Lab gave an area under curve (AUC) of 0.95 (95% CI 0.91-1.00) in this cohort. ROC curve analysis of an independent, more heterogeneous group of patients (validation cohorts 2-5; 249 patients after excluding 37 patients with an infection likelihood of "possible") gave an AUC of 0.89 (95% CI 0.85-0.93). Disease severity, as measured by Sequential Organ Failure Assessment (SOFA) score or Acute Physiology and Chronic Health Evaluation (APACHE) IV score, was not a significant confounding variable. The diagnostic utility of SeptiCyte Lab was evaluated by comparison to various clinical and laboratory parameters available to a clinician within 24 h of ICU admission. SeptiCyte Lab was significantly better at differentiating cases from controls than all tested parameters, both singly and in various logistic combinations, and more than halved the diagnostic error rate compared to procalcitonin in all tested cohorts and cohort combinations. Limitations of this study relate to (1) cohort compositions that do not perfectly reflect the composition of the intended use population, (2) potential biases that could be introduced as a result of the current lack of a gold standard for diagnosing sepsis, and (3) lack of a complete, unbiased comparison to C-reactive protein. CONCLUSIONS SeptiCyte Lab is a rapid molecular assay that may be clinically useful in managing ICU patients with systemic inflammation. Further study in population-based cohorts is needed to validate this assay for clinical use.
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Baratali L, Lang PO. [Pneumococcal infections: Appraisal and perspectives in terms of adult vaccination]. Presse Med 2015; 44:1155-61. [PMID: 26363530 DOI: 10.1016/j.lpm.2015.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 04/02/2015] [Accepted: 04/16/2015] [Indexed: 11/26/2022] Open
Abstract
Pneumococcal diseases are the first cause of bacterial infections in adult and in the aged adult. While its considerable morbi-mortality is potentially preventable through vaccination, the interest of anti-pneumococcal vaccination in these populations is still debated. Effectiveness appraisal of current anti-pneumococcal vaccines and the perspectives in terms of preventive strategies against Streptococcus pneumoniae infections in the adult population are presented.
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Affiliation(s)
- Laila Baratali
- CHUV, service de médecine interne, 46, rue du Bugnon, 1011 Lausanne, Suisse
| | - Pierre Olivier Lang
- CHUV, service de médecine interne, 46, rue du Bugnon, 1011 Lausanne, Suisse; CHUV, service de gériatrie et de réhabilitation gériatrique, Mont Paisible 16 (MP16/04/414), 1011 Lausanne, Suisse; Anglia Ruskin University, Health and wellbeing academy, Cambridge, Royaume-Uni.
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Borba RCN, Vidal VM, Moreira LO. The re-emergency and persistence of vaccine preventable diseases. AN ACAD BRAS CIENC 2015; 87:1311-22. [PMID: 26312431 DOI: 10.1590/0001-3765201520140663] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The introduction of vaccination worldwide dramatically reduced the incidence of pathogenic bacterial and viral diseases. Despite the highly successful vaccination strategies, the number of cases among vaccine preventable diseases has increased in the last decade and several of those diseases are still endemic in different countries. Here we discuss some epidemiological aspects and possible arguments that may explain why ancient diseases such as, measles, polio, pertussis, diphtheria and tuberculosis are still with us.
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Affiliation(s)
- Rodrigo C N Borba
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Vinícius M Vidal
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Lilian O Moreira
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR
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Abstract
The age-associated increased susceptibility to infectious disease would suggest that vaccination should be a route to promote healthy aging and keep our seniors autonomous and independent. While vaccination represents a cost-effective and efficient strategy at community level, the ability of the immune system to mount a protective immune response is still unpredictable at the level of the individual. Thus, at a similar age, some individuals, including the elderly, might still be 'good' responders while some other, even younger, would definitely fail to mount a protective response. In this review, the current burden of vaccine-preventable diseases in the aging and aged population will be detailed with the aim to identify the ideal vaccine candidates over the age of 50 years. This article will conclude with potential strategies to reduce, as best as possible, this burden and the imperative need to overcome barriers in extending current vaccine coverage towards to a lifelong vaccine schedule.
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Affiliation(s)
- Pierre-Olivier Lang
- Translational Medicine Research group, Cranfield Health, Cranfield University, Cranfield, England,
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Vogel T, Lang PO, Schmitt E, Lepretre PM, Kaltenbach G, Goette-Di Marco P, Talha S, Lonsdorfer J, Geny B. Effects of a personalized nine weeks intermittent exercise working program on left ventricle filling function in middle-aged women with mild diastolic dysfunction. Eur Geriatr Med 2014. [DOI: 10.1016/j.eurger.2014.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Prior contacts with the 2000–2003 seasonal vaccines extends the 2009 pandemic A/H1N1 vaccine-specific immune protection to non-humoral compartments. Eur Geriatr Med 2014. [DOI: 10.1016/j.eurger.2014.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Lang PO. Why Influenza Viruses Continue to Pose a Significant Threat to Aging and Aged Populations Worldwide. CURRENT GERIATRICS REPORTS 2013. [DOI: 10.1007/s13670-013-0070-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Lang P. Vaccine policies and standards for older subjects in Switzerland. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2012.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Aspinall R, Govind S, Lapenna A, Lang PO. Dose response kinetics of CD8 lymphocytes from young animals transfused into old animals and challenged with influenza. IMMUNITY & AGEING 2013; 10:34. [PMID: 23947636 PMCID: PMC3765176 DOI: 10.1186/1742-4933-10-34] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 08/10/2013] [Indexed: 11/10/2022]
Abstract
Transfusion of autologous leukocytes after prolonged storage has been proposed as a means of rejuvenating the immune system of older individuals. The rationale for this approach is that age related immune decline is associated with a diminished pool of naïve T cells following atrophy of the thymus and reduction in thymic output. The presence of high levels of naïve T cells within the blood of young individuals could provide a boost to the immune system of an older “self” through a rejuvenation of the naïve T cell pool. However what remains unresolved is whether the cells could be incorporated effectively into the T cell pool of the host and whether effectors could be generated. Using CD45 congenic mice in our experiments we show that the transfusion of young donor cells into older congenic host animals leads to their successful incorporation into the peripheral T cell pool. When the recipients were challenged with influenza virus, specific effector CD8 cells were generated which were of both host and donor origin. We found no relationship between the number of responder cells of donor origin at the time of assay and the number of cells injected.
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Aspinall R, Lang PO. The Avalanche is Coming … And Just Now It's Starting to Snow. Front Immunol 2013; 4:165. [PMID: 23805142 PMCID: PMC3691508 DOI: 10.3389/fimmu.2013.00165] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 06/11/2013] [Indexed: 11/13/2022] Open
Affiliation(s)
- Richard Aspinall
- Translational Medicine Research Group, Cranfield Health, Cranfield University Cranfield, UK
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Lang PO, Govind S, Aspinall R. Reversing T cell immunosenescence: why, who, and how. AGE (DORDRECHT, NETHERLANDS) 2013; 35:609-20. [PMID: 22367580 PMCID: PMC3636382 DOI: 10.1007/s11357-012-9393-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 02/08/2012] [Indexed: 05/03/2023]
Abstract
Immunosenescence is the term commonly used to describe the multifaceted phenomenon encompassing all changes occurring in the immune system during aging. It contributes to render older adults more prone to develop infectious disease and main age-related diseases. While age clearly imposes drastic changes in immune physiology, older adults have heterogeneous health and immune phenotypes. This confronts scientists and researcher to develop more age-specific interventions rather than simply adopting intervention regimes used in younger people and this in order to maintain immune protection in older adults. Thus, this review provides evidences of the central role played by cell-mediated immunity in the immunosenescence process and explores the means by which senescent state of the cell-mediated immune function could be identified and predicted using biomarkers. Furthermore considerations are given to recent advances made in the field of age-specific immune interventions that could contribute to maintain immune protection, to improve quality of life, and/or to promote healthy aging of the growing part of the population.
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Affiliation(s)
- Pierre Olivier Lang
- Department of Internal Medicine, Rehabilitation and Geriatrics, Medical School and University Hospitals of Geneva, Hospital of Trois-Chêne, Chemin du Pont-Bochet 3, CH-1226, Thônex, Geneva, Switzerland.
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31
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Does vitamin D deficiency contribute to further impinge the state of vulnerability to infections of aging and aged adults? Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2012.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Lang PO, Samaras D, Samaras N. Testosterone Replacement Therapy in Reversing “Andropause”: What Is the Proof-of-Principle? Rejuvenation Res 2012; 15:453-65. [DOI: 10.1089/rej.2012.1316] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Pierre Olivier Lang
- Medical School and University Hospitals of Geneva, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva, Switzerland
- Translational Medicine Research Group, Cranfield Health, Cranfield University, Cranfield, United Kingdom
| | - Dimitrios Samaras
- Medical School and University Hospitals of Geneva, Nutrition Unit, Geneva, Switzerland
| | - Nikolaos Samaras
- Medical School and University Hospitals of Geneva, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva, Switzerland
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Lang PO, Mendes A, Socquet J, Assir N, Govind S, Aspinall R. Effectiveness of influenza vaccine in aging and older adults: comprehensive analysis of the evidence. Clin Interv Aging 2012; 7:55-64. [PMID: 22393283 PMCID: PMC3292388 DOI: 10.2147/cia.s25215] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Foremost amongst the diseases preventable by vaccination is influenza. Worldwide, influenza virus infection is associated with serious adverse events leading to hospitalization, debilitating complications, and death in elderly individuals. Immunization is considered to be the cornerstone for preventing these adverse health outcomes, and vaccination programs are timed to optimize protection during the annual influenza season. Trivalent inactivated influenza virus vaccines are believed to be both effective and cost-saving; however, in spite of widespread influenza vaccination programs, rates of hospitalization for acute respiratory illness and cardiovascular diseases have been increasing in this population during recent annual influenza seasons. From meta-analyses summarizing estimates of influenza vaccine effectiveness from available observational clinical studies, this review aims to examine how effective current influenza vaccine strategies are in the aging and older adult population and to analyze which are the most important biases that interfere with measurements of influenza vaccine effectiveness. Furthermore, consideration is given to strategies that should be adopted in order to optimize influenza vaccine effectiveness in the face of immune exhaustion.
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Affiliation(s)
- Pierre-Olivier Lang
- Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals and Medical School of Geneva, Geneva, Switzerland.
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Lang PO, Samaras D, Samaras N, Govind S, Aspinall R. Influenza vaccination in the face of immune exhaustion: is herd immunity effective for protecting the elderly? INFLUENZA RESEARCH AND TREATMENT 2012; 2011:419216. [PMID: 23074656 PMCID: PMC3447292 DOI: 10.1155/2011/419216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2011] [Accepted: 12/22/2011] [Indexed: 12/22/2022]
Abstract
At the start of the 21st century, seasonal influenza virus infection is still a major public health concern across the world. The recent body of evidence confirms that trivalent inactivated influenza vaccines (TIVs) are not optimal within the population who account for approximately 90% of all influenza-related death: elderly and chronically ill individuals regardless of age. With the ever increasing aging of the world population and the recent fears of any pandemic influenza rife, great efforts and resources have been dedicated to developing more immunogenic vaccines and strategies for enhancing protection in these higher-risk groups. This paper describes the mechanisms that shape immune response at the extreme ages of life and how they have been taken into account to design more effective immunization strategies for these vulnerable populations. Furthermore, consideration will be given to how herd immunity may provide an effective strategy in preventing the burden of seasonal influenza infection within the aged population.
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Affiliation(s)
- Pierre Olivier Lang
- Department of Internal Medicine, Rehabilitation and Geriatrics, Medical school and University Hospitals of Geneva, CH-1226 Thônex-Geneva, Switzerland
- Translational Medicine Research Group, Cranfield Health, Cranfield University, Cranfield MK43 0AL, UK
| | - Dimitrios Samaras
- Nutrition Unit, Medical school and University Hospitals of Geneva, CH-1205 Geneva, Switzerland
| | - Nikolaos Samaras
- Department of Internal Medicine, Rehabilitation and Geriatrics, Medical school and University Hospitals of Geneva, CH-1226 Thônex-Geneva, Switzerland
| | - Sheila Govind
- Translational Medicine Research Group, Cranfield Health, Cranfield University, Cranfield MK43 0AL, UK
| | - Richard Aspinall
- Translational Medicine Research Group, Cranfield Health, Cranfield University, Cranfield MK43 0AL, UK
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Lang PO, Samaras D. Aging adults and seasonal influenza: does the vitamin d status (h)arm the body? J Aging Res 2011; 2012:806198. [PMID: 22162810 PMCID: PMC3228300 DOI: 10.1155/2012/806198] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Accepted: 08/23/2011] [Indexed: 02/06/2023] Open
Abstract
Vitamin D (VitD), although originally described as an essential hormone for bone and mineral homeostasis, appears to have an active role in regulating specific facets of human immunity. Indeed, VitD has been shown to have significant effects on cytokine production and lymphocyte proliferation. Evidence that VitD affects clearance of selected pathogens is supported by epidemiological and clinical data, while its coadministration with influenza vaccine in mice enhanced both mucosal and systemic antibody responses. This paper aims to examine how VitD may contribute to limiting the burden of influenza infection in the aging and aged adults, a population in which this burden remains considerable. Furthermore, we discuss how VitD status may play a role in host resistance to influenza virus and influence the immunogenicity of the influenza vaccines currently licensed for adults aged 65 years or over by its effects on innate and adaptive immunities.
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Affiliation(s)
- Pierre Olivier Lang
- Department of Internal Medicine, Rehabilitation and Geriatrics, Medical School and University Hospitals of Geneva, Hospital of Trois-Chêne, Chemin du Pont-Bochet 3, CH-1226 Thônex-Geneva, Switzerland
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