基于流行病学调查的H1N1流感疫苗免疫应答评价研究  

An epidemiology-based evaluation of the immune response to a pandemic A/H1N1 influenza vaccine

作　　者：李申生[1] 华来庆[1,2] 季萍[2] 刘景壹[1] 张俊婕[1] 刘春敏 周颖[4] 沈浩[2] 汪轶颖[1] 王颖[2] 

机构地区：[1]上海市徐汇区疾病预防控制中心,上海200237 [2]上海市免疫学研究所上海交通大学医学院,上海200025 [3]上海市徐汇区凌云街道社区卫生服务中心,上海200231 [4]上海市徐汇区中心医院,上海200031

出　　处：《现代免疫学》2014年第2期120-126,共7页Current Immunology

基　　金：上海市徐汇区医学科研课题计划(SHXH201018)

摘　　要：本文通过比较单价pH1N1疫苗接种者、pH1N1流感感染病例、流感患者密切接触者、健康对照人群的病毒特异性体液和细胞免疫水平,对pH1N1流感疫苗的免疫保护性效果进行了评价。采集4组人群外周血,检测血清中的pH1N1流感病毒特异性IgG抗体水平、抗体中和能力,以及PBMC经特异性病毒抗原刺激后分泌IFN-γ的能力。发现pH1N1流感病例组中抗血凝素特异性IgG抗体水平显著高于疫苗接种组、健康对照组和密切接触组,而疫苗接种组则高于密切接触组,但与健康对照组无统计学差异;病例组和密切接触组的血凝抑制水平和分泌IFN-γ的PBMC数量均高于疫苗接种组和健康对照组。同时,特异性IgG与血凝抑制水平呈正相关,分泌IFN-γ的PBMC数量也与血凝抑制水平呈正相关。本研究认为,pH1N1流感病毒感染诱发的特异性细胞免疫和体液免疫应答水平及抗体中和能力均高于疫苗接种者。相对于健康人群,疫苗接种组在诱导产生病毒特异性IgG方面虽然没有比健康人群表现出特别强的优势,但其较高的特异性IgG与血凝抑制水平,表明疫苗接种仍然不失为一种有效的产生保护性抗体的重要手段,但是和病毒感染后的免疫应答反应相比,其不能诱导产生有效的细胞免疫应答。通过新型疫苗佐剂的选择使用等措施促进疫苗接种后体液和细胞免疫共同保护作用的产生值得进一步深入研究。To evaluate the immune protection of pH1NI influenza vaccine from pH1N1 influenza, we compared the specific hu- moral and cellular immune responses levels among adults receiving monovalent pH1N1 flu vaccine to pH1N1 flu patients, close contacts of patients and healthy controls. Anti-HA IgG levels were detected by ELISA and hemagglutination inhibition （HI） assay was used to evaluate the neutralizing ability of serum antibody. Anti-virus specific cellular immune responses were deter- mined by IFN-y ELISPOT. Anti-HA IgG levels were the highest in pH1N1 flu patients of the four groups whereas adults re- cipients of the monovalent pHIN1 flu vaccine exhibited higher IgG levels than either the close contacts or the healthy controls without statistic significance. HI assay results indicated that the patient group and the close contacts displayed more efficient hemagglutination inhibition as well as higher frequency of IFN-~/secreting cells in PBMCs when compared to vaccination groups or the healthy controls. Both Anti-HA IgG levels and the number of IFN-y secreting cells in PBMCs were positively correlated with HI efficacy, pH1N1 virus infection induced stronger virus-specific cellular and humoral immune responses than conven- tional vaccination. However, specific anti-virus IgG antibody was elevated with the flu vaccination when compared to the non- immunized healthy controls, which indicated that vaccination was inclined to induce protective IgG for the prevention of influen- za virus infection, in the meanwhile it failed to induce specific T cell responses. Exploration of adjuvant application to arouse simultaneously humoral and cellular immune responses is worthy of further investigation.

关 键 词：pH1N1流感 单价pH1N1流感疫苗 体液免疫 细胞免疫 免疫保护 

分 类 号：R392[医药卫生—免疫学]