Enhancement of immunity against VZV by giving live varicella vaccine to the elderly assessed by VZV skin test and IAHA, gpELISA antibody assay

Takahashi, Michiaki; Okada, Shintaro; Miyagawa, Hiromi; Amo, Kiyoko; Yoshikawa, Kunihiko; Asada, Hideo; Kamiya, Hitoshi; Torigoe, Sadayoshi; Asano, Yoshizo; Ozaki, Takao; Terada, K.; Muraki, Ryouichi; Higa, Keila T.; Iwasaki, Hiroshi; Akiyama, Masataka; Takamizawa, Akihisa; Shiraki, K.; Yanagi, Kazuhiro; Yamanishi, Koichi

doi:10.1016/s0264-410x(03)00303-7

Cited by 54 publications

(37 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Also in Japan, immunisation with live varicella vaccine (Oka/BIKEN) enhanced CMI to VZV in adults age ≥50 years [783, 784], and in subjects aged 60–70 with or without diabetes [785]. A case of recurrent HZO cured by varicella vaccination was also reported [786].…”

Section: Management and Preventionmentioning

confidence: 99%

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

et al. 2017

View full text Add to dashboard Cite

BackgroundHerpes zoster (HZ) is a prevalent viral disease that inflicts substantial morbidity and associated healthcare and socioeconomic burdens. Current treatments are not fully effective, especially among the most vulnerable patients. Although widely recommended, vaccination against HZ is not routine; barriers in Asia-Pacific include long-standing neglect of adult immunisation and sparse local data. To address knowledge gaps, raise awareness, and disseminate best practice, we reviewed recent data and guidelines on HZ from the Asia-Pacific region.MethodsWe searched PubMed, Scopus, and World Health Organization databases for articles about HZ published from 1994 to 2014 by authors from Australia, China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, New Zealand, the Philippines, Singapore, Taiwan, Thailand, and Vietnam. We selected articles about epidemiology, burden, complications, comorbidities, management, prevention, and recommendations/guidelines. Internet searches retrieved additional HZ immunisation guidelines.ResultsFrom 4007 retrieved articles, we screened-out 1501 duplicates and excluded 1264 extraneous articles, leaving 1242 unique articles. We found guidelines on adult immunisation from Australia, India, Indonesia, Malaysia, New Zealand, the Philippines, South Korea, and Thailand.HZ epidemiology in Asia-Pacific is similar to elsewhere; incidence rises with age and peaks at around 70 years – lifetime risk is approximately one-third. Average incidence of 3–10/1000 person-years is rising at around 5% per year. The principal risk factors are immunosenescence and immunosuppression. HZ almost always causes pain, and post-herpetic neuralgia is its most common complication. Half or more of hospitalised HZ patients have post-herpetic neuralgia, secondary infections, or inflammatory sequelae that are occasionally fatal. These disease burdens severely diminish patients’ quality of life and incur heavy healthcare utilisation.ConclusionsSeveral countries have abundant data on HZ, but others, especially in South-East Asia, very few. However, Asia-Pacific countries generally lack data on HZ vaccine safety, efficacy and cost-effectiveness. Physicians treating HZ and its complications in Asia-Pacific face familiar challenges but, with a vast aged population, Asia bears a unique and growing burden of disease. Given the strong rationale for prevention, most adult immunisation guidelines include HZ vaccine, yet it remains underused. We urge all stakeholders to give higher priority to adult immunisation in general and HZ in particular.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2198-y) contains supplementary material, which is available to authorized users.

show abstract

Section: Management and Preventionmentioning

confidence: 99%

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Herpes zoster (HZ; shingles), which is the result of reactivation of this latent VZV infection, is characterized by a painful, unilateral, dermatomal, vesicular rash (5, 7, 14). There is a close correlation between the age-related incidence of HZ and the age-related decline in VZV-specific cell-mediated immunity (VZV-CMI) measured by T lymphocyte proliferation assays (using responder cell frequency [RCF] or gamma interferon [IFN-␥] enzyme-linked immunospot [ELISPOT] assays) (10, 21), whereas the level of serum immunoglobulin antibody to VZV remains relatively constant with age (10,15,19).These observations suggest that HZ develops in older individuals because their VZV-CMI falls below some critical threshold that is permissive for clinically apparent VZV reactivation. The pivotal trial with the licensed zoster vaccine was based on this assumed relationship (14).…”

mentioning

confidence: 99%

Varicella-Zoster Virus-Specific Enzyme-Linked Immunospot Assay Responses and Zoster-Associated Pain in Herpes Zoster Subjects

Tyring

Stek

Smith

et al. 2012

Clin Vaccine Immunol

View full text Add to dashboard Cite

ABSTRACTVaricella-zoster virus (VZV)-specific cell-mediated immunity (CMI) responses were compared over time following an episode of herpes zoster (HZ) with those of age-, race-, and gender-matched healthy controls (HC) without HZ, using a validated gamma interferon (IFN-γ) enzyme-linked immunospot (ELISPOT) assay. The zoster brief-pain inventory (ZBPI) was used to assess zoster-associated pain. HZ patients (n= 140) had significantly higher IFN-γ ELISPOT responses to VZV antigen than did HC (n= 140). ELISPOT geometric mean count (GMC) responses (with 95% confidence intervals [CI]) for subjects who presented within 72 h were as follows: for HZ patients ≥ 60 years of age, at day 0 the GMC was 110 and at week 2 the GMC was 235; for HZ patients 21 to 59 years of age, at day 0 the GMC was 111 and at week 2 the GMC was 198; for HC ≥ 60 years of age, at day 0 the GMC was 19 and at week 2 the GMC was 18; and for HC 21 to 59 years of age, at day 0 the GMC was 59 and at week 2 the GMC was 56. The mean pain score (95% CI) across age groups at 1 week postrash (n= 106) was 6.0 (5.5, 6.5) and at 2 weeks postrash (n= 119) was 3.5 (2.9, 4.0). The percentage of HZ patients with substantial pain (score ≥ 3) at 6 weeks postrash increased with age from 8% for patients 21 to 49 years of age to 16% for patients 50 to 59 years of age to 22% for patients ≥ 60 years of age. The VZV-specific CMI response was substantially boosted by an episode of HZ, as measured by ELISPOT results. Older adults had lower VZV-specific cellular immunity than younger subjects at baseline, but the boosting effect of HZ was substantial for all age groups. HZ patients experienced considerable zoster-associated acute (1 to 2 weeks after rash) pain across age groups, while chronic pain increased with age.

show abstract

“…A VZV-specific skin test representing delayed-type hypersensitivity was introduced earlier for testing of CMI in humans with past VZV infection or in humans and guinea pigs after VZV immunization, and the results were compared with those of other assays of immune responses (23)(24)(25). The accumulation of CD4 ϩ T cells and CD4 ϩ regulatory T cells at the site of VZV antigen challenge in the skin has recently been described (26).…”

Section: Discussionmentioning

confidence: 99%

High-Level Cellular and Humoral Immune Responses in Guinea Pigs Immunized Intradermally with a Heat-Inactivated Varicella-Zoster Virus Vaccine

Sarkadi

Jankovics

Fodor

et al. 2015

Clin. Vaccine Immunol.

View full text Add to dashboard Cite

V aricella-zoster virus (VZV) causes varicella by primary infection and herpes zoster by reactivation of the latent virus in the sensory ganglia of infected individuals. After primary infection, the immune response comprises VZV-specific antibody and T cell-mediated immunity (CMI), which are important for recovery from varicella. T cell responses are necessary to control latent VZV in the sensory ganglia. A lack or a declining level of CMI to VZV has been associated with a higher risk of development of herpes zoster (1).A varicella vaccine consisting of live, attenuated strain OKA (vOKA) has been developed in Japan and licensed for mass vaccination in Japan, South Korea, the United States, and several European countries or recommended for only selected groups of the population in other countries (2, 3). To prevent herpes zoster, a zoster vaccine containing 14 times as many PFU of vOKA than the varicella vaccine was developed and licensed for the vaccination of immunocompetent subjects older than 60 years in the United States in 2006 (4). Varicella and zoster vaccines are administered by the subcutaneous (s.c.) route. However, vaccination of immunocompromised individuals with live VZV vaccines can be problematic and different strategies for safe immunization need to be explored (5).Several clinical studies have indicated that the use of a heatinactivated VZV vaccine is an alternative mode of immunization of immunocompromised individuals. Triple vaccination of bone marrow transplant patients with a heat-inactivated varicella vaccine administered s.c. decreased the severity of herpes zoster (6) and four s.c. doses of a heat-inactivated zoster vaccine proved safe and immunogenic in patients with tumor malignancy, HIV-infected individuals, or hematopoietic stem cell transplant recipients (7). When healthy elderly subjects were immunized s.c. with a single dose of either live or heat-inactivated varicella vaccine, there were no differences in antibody responses or IFN-␥ production by peripheral blood mononuclear cells (8). These data indicated that a heat-inactivated VZV vaccine might be useful in preventing herpes zoster. However, protection against herpes zoster following immunization with either a live or heat-inactivated vaccine is not optimal and a more potent antigenic stimulus is needed to improve the efficacy of the vaccine in high-risk patients (9).The skin is a highly immunogenic organ (10). Noninvasive, needle-free liquid jet injection of liquid or powder into the skin has been used in clinical trials for immunization against viral infections (11-13). The barrier structure and thickness of the stratum corneum, the outermost layer of the skin, are similar in guinea pigs and humans (18.6 and 18.2 m, respectively) (14), and thus, the i.d. route of immunization and the effectiveness of a potential i.d. delivery device for humans can be tested in guinea pigs. Moreover, the parental OKA strain is attenuated in human

show abstract

Enhancement of immunity against VZV by giving live varicella vaccine to the elderly assessed by VZV skin test and IAHA, gpELISA antibody assay

Cited by 54 publications

References 25 publications

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

Varicella-Zoster Virus-Specific Enzyme-Linked Immunospot Assay Responses and Zoster-Associated Pain in Herpes Zoster Subjects

High-Level Cellular and Humoral Immune Responses in Guinea Pigs Immunized Intradermally with a Heat-Inactivated Varicella-Zoster Virus Vaccine

Contact Info

Product

Resources

About