Clinical and immunologic predictors of influenza illness among vaccinated older adults

详细信息    查看全文

• 作者：Zainab Shahid ; Alison Kleppinger ; Beth Gentleman ; Ann R. Falsey ; Janet E. McElhaney
• 关键词：Influenza ; Granzyme B ; Interferon-γ ; Interleukin-10 ; Elderly
• 刊名：Vaccine
• 出版年：2010
• 出版时间：31 August 2010
• 年：2010
• 卷：28
• 期：38
• 页码：6145-6151
• 全文大小：265 K

文摘

The diagnosis of influenza is often missed in older adults and illness presentation may be modified by prior vaccination. We evaluated the symptoms and immunologic markers predicting laboratory-confirmed influenza (LCI) among vaccinated older adults. In subjects with influenza-like illness (ILI), fever distinguished subjects with laboratory-confirmed influenza (LCI) from those with other ILI (39 % vs. 12.5 % , p = 0.009). In LCI subjects who did not seroconvert to influenza infection, pre-infection levels of the cytolytic mediator, granzyme B, correlated with fever (r = 1.000; p = 0.01) and the IFN-γ:IL-10 ratio (r = 0.999; p = 0.03), and increased following influenza infection in LCI vs. ILI subjects (p = 0.03). The cell-mediated immune response to influenza distinguishes A/H3N2 LCI from other ILI in older adults, and suggests a link between cell-mediated immunity and influenza illness severity in vaccinated older adults.