Greater activation of peripheral T follicular helper cells following high dose influenza vaccine in older adults forecasts seroconversion

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• 作者：Mark A. Pilkinton^a ; Katherine J. Nicholas^b ; Christian M. Warren^c ; Rita M. Smith^a ; Sandra M. Yoder^d ; H. Keipp Talbot^a ; Spyros A. Kalams^a ; ^b ; ^{s.kalams@vanderbilt.edu}
• 关键词：SD IIV ; standard dose inactivated influenza vaccine ; HD IIV ; high dose inactivated influenza vaccine ; pTfh ; peripheral T follicular helper cell
• 刊名：Vaccine
• 出版年：2017
• 出版时间：5 January 2017
• 年：2017
• 卷：35
• 期：2
• 页码：329-336
• 全文大小：1521 K
• 卷排序：35

文摘

Influenza related morbidity and mortality disproportionately impacts older adults. The serologic response to vaccine is diminished in older adults; however, high dose inactivated influenza vaccine (HD IIV) has shown improved rates of seroconversion compared to standard dose (SD IIV). We hypothesize this may be due to the superior ability of high dose vaccine to activate T follicular helper (Tfh) cells and provide B cell dependent T cell help.MethodsWe measured peripheral Tfh (pTfh) activation in 50 community dwelling adults 65 years or older who were randomly assigned to receive either the HD IIV or SD IIV.ResultsThe HD vaccination elicited significantly higher levels of ICOS expression on pTfh cells, at day 7 compared to SD vaccination (p = 0.02). The magnitude of the increase in ICOS+ pTfh cells from baseline to day 7 was predictive of seroconversion for both influenza A and B vaccination.ConclusionStrong Tfh activation in response to influenza vaccination forecasts successful seroconversion in older adults, and HD IIV elicits greater Tfh activation than SD IIV. Future vaccine studies should focus on ways to further optimize the Tfh response.