Influenza is a respiratory disease caused by the influenza virus, which is highly transmissible in humans. This paper presents a systematic review and meta-analysis of randomized controlled trials (RCTs) and test-negative designs (TNDs) to assess the vaccine effectiveness (VE) of seasonal influenza vaccines (SIVs) in humans aged 15 to 64 years. An electronic search to identify all relevant studies was performed. The outcome measure of interest was VE on laboratory-confirmed influenza (any strain). Quality assessment was performed using the Cochrane risk-of-bias tool for RCTs and the ROBINS-I tool for TNDs. The search identified a total of 2993 records, but only 123 studies from 73 papers were included in the meta-analysis. Of these studies, 9 were RCTs and 116 were TNDs. The pooled VE was 48% (95% CI: 42–54) for RCTs, 55.4% (95% CI: 43.2–64.9) when there was a match between the vaccine and most prevalent circulating strains and 39.3% (95% CI: 23.5–51.9) otherwise. The TNDs’ adjusted VE was equal to 39.9% (95% CI: 31–48), 45.1 (95% CI: 38.7–50.8) when there was a match and 35.1 (95% CI: 29.0–40.7) otherwise. The match between strains included in the vaccine and strains in circulation is the most important factor in the VE. It increases by more than 25% when there is a match with the most prevalent circulating strains. The laboratorial method for confirmation of influenza is a possible source of bias when estimating VE.
BackgroundJuvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children. Our group has recently demonstrated that extended oligoarticular and polyarticular JIA mostly evolve to a rheumatoid arthritis (RA)-like phenotype in adulthood. Disturbances in B cells, T follicular helper (Tfh) and T follicular regulatory (Tfr) cell immune responses are associated with RA pathogenesis, but their exact role in JIA development is poorly understood.ObjectivesThe main goal of this study was to characterize the frequency and phenotype of B, Tfh and Tfr cells in peripheral blood and the cytokine environment present in circulation in children with with extended oligoarticular JIA (eoJIA) and polyarticular JIA (pJIA) when compared to healthy controls, children with persistent oligoarticular JIA (poJIA) and adult JIA patients.MethodsBlood samples were collected from 105 JIA patients (children and adults) and 50 age- and gender-matched healthy individuals. Peripheral blood mononuclear cells were isolated and the frequency and phenotype of B, Tfh and Tfr cells were evaluated by flow cytometry. Serum levels of APRIL, BAFF, IL-1β, IL-2, IL-4, IL-6, IL-10, IL-17A, IL-21, IL-22, IFN-γ, PD-1, PD-L1, sCD40L, CXCL13 and TNF were measured by multiplex bead-based immunoassay and/ or ELISA in all groups included.ResultsThe frequency of B, Tfh and Tfr cells was similar between JIA patients and controls. Children with eoJIA and pJIA, but not poJIA, had significantly lower frequencies of plasmablasts, regulatory T cells and higher levels of Th17-like Tfh cells in circulation when compared to controls. Furthermore, APRIL, BAFF, IL-6 and IL-17A serum levels were significantly higher in pediatric eoJIA and pJIA patients when compared to controls. These immunological alterations were not found in adult JIA patients in comparison to controls.ConclusionChanges in B and Tfh cell subpopulations, but not in Tfr cells, were found in peripheral blood of children with eoJIA and pJIA when compared to controls. Our results suggest a potential role and/ or activation profile of B and Th17-like Tfh cells in the pathogenesis of eoJIA and pJIA, but not poJIA.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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