The inactivated herpes zoster vaccine HZ/su induces a varicella zoster virus specific cellular and humoral immune response in patients on dialysis.

IF 9.7 1区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL EBioMedicine Pub Date : 2024-10-01 Epub Date: 2024-09-11 DOI:10.1016/j.ebiom.2024.105335
Franziska Hielscher, Tina Schmidt, Martin Enders, Sarah Leyking, Markus Gerhart, Kai van Bentum, Janine Mihm, David Schub, Urban Sester, Martina Sester
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Abstract

Background: To evaluate the immunogenicity of the inactivated herpes-zoster vaccine HZ/su in patients at increased risk for VZV-reactivation, we analysed the quantity and quality of the vaccine-induced cellular and humoral immunity in patients on dialysis with uremic immunodeficiency.

Methods: In this observational study, 29 patients and 39 immunocompetent controls underwent standard dual-dose vaccination. Blood samples were analysed before and two weeks after each vaccination, and after one year. Specific T-cells were characterized after stimulation with VZV-gE-peptides based on induction of cytokines and CTLA-4-expression using flow-cytometry. Antibodies were analysed using ELISA.

Findings: Both groups showed an increase in VZV-gE-specific CD4 T-cell levels over time (p < 0.0001), although median levels reached after second vaccination were lower in patients (0.17% (IQR 0.21%)) than in controls (0.24% (IQR 0.3%), p = 0.042). VZV-gE specific CD8 T-cells were only poorly induced. CTLA-4 expression on VZV-gE-specific CD4 T-cells was strongest after second dose with no differences between the groups (p = 0.45). Multifunctional cells co-expressing IFNγ, IL-2, and TNF were higher in patients after first vaccination (p = 0.028). Median VZV-specific IgG-levels reached a maximum after second vaccination with significantly lower levels in patients (10796 (IQR 12482) IU/l) than in controls (16899 (IQR 14019) IU/l, p = 0.009). Despite similar CD4 T-cell levels after one year (p = 0.415), antibody levels remained significantly lower in patients (p = 0.0008).

Interpretation: VZV-gE vaccination induced specific antibodies and CD4 T-cells in both patients and controls, whereas CD8 T-cell-induction was poor. Quantitative and qualitative differences in immunity may indicate reduced duration of protection which may necessitate booster vaccinations in patients on dialysis.

Funding: HOMFORexzellent (to D.S.).

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带状疱疹灭活疫苗 HZ/su 可诱导透析患者产生水痘带状疱疹病毒特异性细胞和体液免疫反应。
背景:为了评估疱疹-带状疱疹灭活疫苗 HZ/su 在 VZV 复活风险增加的患者中的免疫原性,我们分析了尿毒症免疫缺陷透析患者中疫苗诱导的细胞和体液免疫的数量和质量:在这项观察性研究中,29 名患者和 39 名免疫功能正常的对照组接受了标准的双剂量疫苗接种。每次接种前和接种后两周以及一年后对血液样本进行分析。使用流式细胞仪根据细胞因子的诱导和 CTLA-4 的表达对 VZV-gE 肽刺激后的特异性 T 细胞进行鉴定。使用 ELISA 分析抗体:结果:两组的 VZV-gE 特异性 CD4 T 细胞水平均随着时间的推移而增加(p):VZV-gE疫苗接种可诱导患者和对照组的特异性抗体和CD4 T细胞,而CD8 T细胞诱导效果较差。免疫力在数量和质量上的差异可能表明保护期缩短,因此有必要对透析患者进行加强接种:HOMFORexzellent (to D.S.).
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来源期刊
EBioMedicine
EBioMedicine Biochemistry, Genetics and Molecular Biology-General Biochemistry,Genetics and Molecular Biology
CiteScore
17.70
自引率
0.90%
发文量
579
审稿时长
5 weeks
期刊介绍: eBioMedicine is a comprehensive biomedical research journal that covers a wide range of studies that are relevant to human health. Our focus is on original research that explores the fundamental factors influencing human health and disease, including the discovery of new therapeutic targets and treatments, the identification of biomarkers and diagnostic tools, and the investigation and modification of disease pathways and mechanisms. We welcome studies from any biomedical discipline that contribute to our understanding of disease and aim to improve human health.
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