The SENIEUR protocol and the efficacy of hepatitis B vaccination in healthy elderly persons by age, gender, and vaccine route.
Aging
Antibody
Cellular immunity
Hepatitis B
Immunesenescence
Vaccine
Journal
Immunity & ageing : I & A
ISSN: 1742-4933
Titre abrégé: Immun Ageing
Pays: England
ID NLM: 101235427
Informations de publication
Date de publication:
2020
2020
Historique:
received:
14
11
2019
accepted:
31
03
2020
entrez:
2
5
2020
pubmed:
2
5
2020
medline:
2
5
2020
Statut:
epublish
Résumé
Reduced response to hepatitis B vaccines is associated with aging, confounding and comorbid conditions, as well as inadvertent subcutaneous (SC) inoculation. We hypothesized that the antibody and T cell-mediated immune responses (T-CMI) of elderly adults to a vaccine intended for intramuscular (IM) administration would be attenuated when deposited into SC fat, independent of confounding conditions. Fifty-two healthy, community dwelling elderly adults (65-82 years), seronegative for HBV, were enrolled in the SENIEUR protocol as a strictly healthy population. These seniors were randomized to receive a licensed alum-adjuvanted recombinant HBV vaccine either SC or IM, with the inoculum site verified by imaging. The response rates, defined as hepatitis B surface antibodies (HBsAb) ≥10 IU/L, were significantly lower in the elderly than in young adults, a group of 12, healthy, 21-34-year-old volunteers. Moreover, elderly participants who received the vaccine IM were significantly more likely to be responders than those immunized SC (54% versus 16%, Our data demonstrate the blunted immunogenicity of SC inoculation as measured by peak titers and response rates. Further, the qualitative and quantitative deficits in B- and T-CMI responses to primary alum adjuvanted protein antigens persisted even in strictly healthy elderly populations with verified IM placement compared to younger populations. ClinicalTrials.gov, NCT04162223. Registered 14 November 2019. Retrospectively registered.
Sections du résumé
BACKGROUND
BACKGROUND
Reduced response to hepatitis B vaccines is associated with aging, confounding and comorbid conditions, as well as inadvertent subcutaneous (SC) inoculation. We hypothesized that the antibody and T cell-mediated immune responses (T-CMI) of elderly adults to a vaccine intended for intramuscular (IM) administration would be attenuated when deposited into SC fat, independent of confounding conditions.
RESULTS
RESULTS
Fifty-two healthy, community dwelling elderly adults (65-82 years), seronegative for HBV, were enrolled in the SENIEUR protocol as a strictly healthy population. These seniors were randomized to receive a licensed alum-adjuvanted recombinant HBV vaccine either SC or IM, with the inoculum site verified by imaging. The response rates, defined as hepatitis B surface antibodies (HBsAb) ≥10 IU/L, were significantly lower in the elderly than in young adults, a group of 12, healthy, 21-34-year-old volunteers. Moreover, elderly participants who received the vaccine IM were significantly more likely to be responders than those immunized SC (54% versus 16%,
CONCLUSIONS
CONCLUSIONS
Our data demonstrate the blunted immunogenicity of SC inoculation as measured by peak titers and response rates. Further, the qualitative and quantitative deficits in B- and T-CMI responses to primary alum adjuvanted protein antigens persisted even in strictly healthy elderly populations with verified IM placement compared to younger populations.
CLINICAL TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov, NCT04162223. Registered 14 November 2019. Retrospectively registered.
Identifiants
pubmed: 32355503
doi: 10.1186/s12979-020-00179-9
pii: 179
pmc: PMC7187507
doi:
Banques de données
ClinicalTrials.gov
['NCT04162223']
Types de publication
Journal Article
Langues
eng
Pagination
9Subventions
Organisme : NIA NIH HHS
ID : P30 AG028747
Pays : United States
Organisme : NIAID NIH HHS
ID : T32 AI007524
Pays : United States
Informations de copyright
© The Author(s) 2020.
Déclaration de conflit d'intérêts
Competing interestsThe authors declare that they have no competing interests.
Références
J Psychiatr Res. 1975 Nov;12(3):189-98
pubmed: 1202204
Respir Res. 2009 Nov 18;10:112
pubmed: 19922665
Am J Physiol Endocrinol Metab. 2013 Mar 1;304(5):E453-65
pubmed: 23277185
Hum Vaccin. 2008 Jan-Feb;4(1):67-73
pubmed: 17881890
J Gen Intern Med. 1986 May-Jun;1(3):199-201
pubmed: 2945916
Scand J Immunol. 2012 Jun;75(6):641-6
pubmed: 22443369
Vaccine. 2012 May 2;30(21):3147-50
pubmed: 22421557
Biogerontology. 2009 Feb;10(1):83-94
pubmed: 18563620
J Immunol. 2016 Oct 1;197(7):2704-14
pubmed: 27549170
Ann Intern Med. 1996 Feb 1;124(3):299-304
pubmed: 8554224
Nat Med. 2012 Oct;18(10):1518-24
pubmed: 23023500
Dig Dis Sci. 2012 May;57(5):1366-72
pubmed: 22143368
JAMA. 1997 Jun 4;277(21):1709-11
pubmed: 9169899
JAMA. 1993 Dec 22-29;270(24):2935-9
pubmed: 8254853
Trends Immunol. 2009 Jul;30(7):351-9
pubmed: 19540808
Vaccine. 2003 Sep 8;21(25-26):3623-8
pubmed: 12922091
Lancet. 1972 Jun 3;1(7762):1208-12
pubmed: 4113191
MMWR Recomm Rep. 2018 Jan 12;67(1):1-31
pubmed: 29939980
Mech Ageing Dev. 1984 Nov;28(1):47-55
pubmed: 6513613
Immun Ageing. 2019 Sep 13;16:25
pubmed: 31528180
N Engl J Med. 1982 Aug 5;307(6):356-8
pubmed: 7088101
Nat Rev Immunol. 2016 Jun;16(6):367-77
pubmed: 27108521
Ann Intern Med. 2018 Feb 6;168(3):210-220
pubmed: 29404596
Vaccine. 2015 Aug 26;33(36):4422-9
pubmed: 26163925
Nat Immunol. 2013 May;14(5):428-36
pubmed: 23598398
Arch Fam Med. 1994 Feb;3(2):146-8
pubmed: 7994436
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
Front Immunol. 2018 May 15;9:1035
pubmed: 29868000
Geriatr Gerontol Int. 2012 Apr;12(2):223-9
pubmed: 21951819
Vaccine. 2012 May 2;30(21):3155-8
pubmed: 22446632
Expert Rev Vaccines. 2015;14(11):1509-23
pubmed: 26313239
J Clin Immunol. 2011 Apr;31(2):137-46
pubmed: 21243520
Hum Vaccin Immunother. 2020 Apr 2;16(4):858-866
pubmed: 31634025
Vaccine. 1989 Oct;7(5):425-30
pubmed: 2530717
J Am Geriatr Soc. 2005 Sep;53(9):1570-6
pubmed: 16137289
J Gerontol. 1981 Jul;36(4):428-34
pubmed: 7252074
JAMA. 1997 May 7;277(17):1380-6
pubmed: 9134944
Nat Rev Immunol. 2014 Jun;14(6):417-28
pubmed: 24854591
Immun Ageing. 2009 Jun 12;6:9
pubmed: 19523191
J Immunol Methods. 2015 Oct;425:69-78
pubmed: 26099800
Clin Infect Dis. 2008 Apr 1;46(7):1078-84
pubmed: 18444828
Clin Infect Dis. 2002 Dec 1;35(11):1368-75
pubmed: 12439800
Vaccine. 2018 Jan 29;36(5):668-674
pubmed: 29289383
Pediatrics. 2010 Mar;125(3):e508-12
pubmed: 20142295
Haemophilia. 2015 Jan;21(1):e39-43
pubmed: 25381731
J Leukoc Biol. 2007 Mar;81(3):584-92
pubmed: 17135573
Med Microbiol Immunol. 2019 Aug;208(3-4):305-321
pubmed: 30949763
Eur J Epidemiol. 1988 Jun;4(2):256-8
pubmed: 2969825
N Engl J Med. 1976 Sep 2;295(10):542-6
pubmed: 950960
Vaccine. 2013 Aug 20;31(37):3979-86
pubmed: 23770306
Curr Opin Immunol. 2013 Aug;25(4):504-10
pubmed: 23932400
Nat Commun. 2018 Aug 3;9(1):3060
pubmed: 30076309