Herpes Zoster Vaccine for the Elderly: Boosting Immunity

Chua, Joel V; Chen, Wilbur H.

doi:10.2217/ahe.10.5

Cited by 8 publications

(7 citation statements)

References 53 publications

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“…Reactivation of latent VZV is largely kept in check through cell-mediated immunity [ 9 ], with antibodies playing very little role in VZV control. Individuals with severe clinical VZV reactivation including those who develop post-herpetic neuralgia often have high antibody titres, which are believed to correlate with more widespread VZV replication [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Viral load and antibody boosting following herpes zoster diagnosis

Warren‐Gash

Forbes

Maple

et al. 2018

Journal of Clinical Virology

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HighlightsVaricella zoster virus reactivation causes serum antibody boosting.Antibody titres at 1, 3 and 6 months following zoster diagnosis reflect baseline varicella zoster virus load.Antibody titres could discriminate patients post shingles from healthy blood donors, 1–6 months after shingles. However, to achieve a sensitivity of 80%, the specificity is between 55 and 70%, whilst to achieve 80% specificity, the sensitivity is between 35 and 70%.

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Section: Discussionmentioning

confidence: 99%

Viral load and antibody boosting following herpes zoster diagnosis

Warren‐Gash

Forbes

Maple

et al. 2018

Journal of Clinical Virology

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“…Unfortunately, immunity acquired naturally against this pathogen breaks down with age. 60 Zostavax (Merck & Co, Whitehouse Station, NJ), a live attenuated variant of VZV, was developed to mimic infection and bolster the waning immune memory in older adults. Although it reduces the incidence of herpes zoster by approximately 50% in adults older than 60 years, its efficacy dramatically declines with age, where adults older than 80 years show only 18% vaccine efficacy.…”

Section: Differential Recall Responses In Older Individualsmentioning

confidence: 99%

Influence of immune aging on vaccine responses

Gustafson

Kim

Weyand

et al. 2020

Journal of Allergy and Clinical Immunology

199

177

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Impaired vaccine responses in older individuals are associated with alterations in both the quantity and quality of the T-cell compartment with age. As reviewed herein, the T-cell response to vaccination requires a fine balance between the generation of inflammatory effector T cells versus follicular helper T (T FH) cells that mediate high-affinity antibody production in tandem with the induction of longlived memory cells for effective recall immunity. During aging, we find that this balance is tipped where T cells favor short-lived effector but not memory or T FH responses. Consistently, vaccine-induced antibodies commonly display a lower protective capacity. Mechanistically, multiple, potentially targetable, changes in T cells have been identified that contribute to these age-related defects, including posttranscription regulation, T-cell receptor signaling, and metabolic function. Although research into the induction of tissue-specific immunity by vaccines and with age is still limited, current mechanistic insights provide a framework for improved design of age-specific vaccination strategies that require further evaluation in a clinical setting. (

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“…Notably, antibody responses to influenza and tick-borne encephalitis vaccines were impaired in the elderly [1], [2], [3]. With regard to T cell immunity, recent reports from a large-scale immunization study with a live vaccine against varicella zoster demonstrated that while it is possible to boost zoster-specific CD4+ T cells to a protective level in individuals >60 years of age, vaccine responsiveness did appear to wane in individuals >75 years of age [4], [5]. These data support the concept that immunosenescence may be an issue to overcome in the development of effective vaccines for elderly individuals; however, further research is required to truly understand the extent of immune dysfunction in older humans.…”

Section: Introductionmentioning

confidence: 99%

The Polyfunctionality of Human Memory CD8+ T Cells Elicited by Acute and Chronic Virus Infections Is Not Influenced by Age

et al. 2012

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As humans age, they experience a progressive loss of thymic function and a corresponding shift in the makeup of the circulating CD8+ T cell population from naïve to memory phenotype. These alterations are believed to result in impaired CD8+ T cell responses in older individuals; however, evidence that these global changes impact virus-specific CD8+ T cell immunity in the elderly is lacking. To gain further insight into the functionality of virus-specific CD8+ T cells in older individuals, we interrogated a cohort of individuals who were acutely infected with West Nile virus (WNV) and chronically infected with Epstein Barr virus (EBV) and Cytomegalovirus (CMV). The cohort was stratified into young (<40 yrs), middle-aged (41–59 yrs) and aged (>60 yrs) groups. In the aged cohort, the CD8+ T cell compartment displayed a marked reduction in the frequency of naïve CD8+ T cells and increased frequencies of CD8+ T cells that expressed CD57 and lacked CD28, as previously described. However, we did not observe an influence of age on either the frequency of virus-specific CD8+ T cells within the circulating pool nor their functionality (based on the production of IFNγ, TNFα, IL2, Granzyme B, Perforin and mobilization of CD107a). We did note that CD8+ T cells specific for WNV, CMV or EBV displayed distinct functional profiles, but these differences were unrelated to age. Collectively, these data fail to support the hypothesis that immunosenescence leads to defective CD8+ T cell immunity and suggest that it should be possible to develop CD8+ T cell vaccines to protect aged individuals from infections with novel emerging viruses.

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Herpes Zoster Vaccine for the Elderly: Boosting Immunity

Cited by 8 publications

References 53 publications

Viral load and antibody boosting following herpes zoster diagnosis

Viral load and antibody boosting following herpes zoster diagnosis

Influence of immune aging on vaccine responses

The Polyfunctionality of Human Memory CD8+ T Cells Elicited by Acute and Chronic Virus Infections Is Not Influenced by Age

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