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The American Journal of Tropical... Sep 2013Abstract. Current regulations stipulate a yellow fever (YF) booster every 10 years. We conducted a systematic review of the protective efficacy and duration of immunity... (Review)
Review
Abstract. Current regulations stipulate a yellow fever (YF) booster every 10 years. We conducted a systematic review of the protective efficacy and duration of immunity of YF vaccine in residents of disease-endemic areas and in travelers to assess the need for a booster in these two settings and in selected populations (human immunodeficiency virus-infected persons, infants, children, pregnant women, and severely malnourished persons). Thirty-six studies and 22 reports were included. We identified 12 studies of immunogenicity, 8 of duration of immunity, 8 of vaccine response in infants and children, 7 of human-immunodeficiency virus-infected persons, 2 of pregnant women, and 1 of severely malnourished children. Based on currently available data, a single dose of YF vaccine is highly immunogenic and confers sustained life-long protective immunity against YF. Therefore, a booster dose of YF vaccine is not needed. Special considerations for selected populations are detailed.
Topics: Antibody Formation; Humans; Immunity; Immunization, Secondary; Randomized Controlled Trials as Topic; Risk Factors; Vaccination; Yellow Fever; Yellow Fever Vaccine; Yellow fever virus
PubMed: 24006295
DOI: 10.4269/ajtmh.13-0264 -
Vaccine Sep 2013Evidence is accumulating that several markers in the human leukocyte antigen (HLA) region have been associated with decreased or increased antibody response to hepatitis... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND AIM
Evidence is accumulating that several markers in the human leukocyte antigen (HLA) region have been associated with decreased or increased antibody response to hepatitis B vaccine in different individuals. This meta-analysis is to assess the associations of HLA class II DRB1 and DQB1 alleles with immunologic response to hepatitis B vaccine in healthy people.
METHODS
A systematic review of cohort studies in healthy people was performed. We searched databases for relevant studies that were published in English or Chinese up to February 17, 2012. Odds ratios (ORs) with corresponding 95% confidence intervals (CIs) of HLA alleles response to hepatitis B vaccine were pooled by using of a fixed-effects or random-effects model depending on absence or presence of significant heterogeneity. All statistical tests were two-sided.
RESULTS
Fifteen studies were included in this meta-analysis after scanning 774 potentially relevant articles. A total of 2308 subjects (including 1215 responders, 873 nonresponders and 220 control populations) were included. For DRB1 alleles, pooled ORs showed that three HLA variants, DRB1*01, DRB1*1301 and DRB1*15 were associated with a significant increase antibody response to hepatitis B vaccine, their pooled ORs were 2.73, 5.94 and 2.29 respectively. While DRB1 *03 (DRB1*0301), DRB1*04, DRB1*07 and DRB1*1302 were opposite, their pooled ORs were 0.55(0.42), 0.57, 0.24 and 0.25 respectively. And for DQB1 alleles, pooled ORs showed that DQB1*05 (DQB1*0501), DQB1*06, DQB1*0602 were associated with a significant increase antibody response to hepatitis B vaccine. Their merger ORs were 1.85, 2.35, 2.34 and 3.32 respectively. While DQB1*02 (pooled OR=0.27) was adverse. Sensitivity and specificity analysis of HLA alleles showed that DRB1*1301and DQB1*0602 had high specificity (94.2% and 90.1%) but low sensitivity (25.1% and 26.3%), respectively.
CONCLUSION
It was suggested that specific HLA class II alleles (DRB1 and DQB1) were associated with antibody response to HepB.
Topics: Antibody Formation; Cohort Studies; Female; Genetic Variation; HLA-DQ beta-Chains; HLA-DRB1 Chains; Hepatitis B Antibodies; Hepatitis B Vaccines; Hepatitis B virus; Humans; Male
PubMed: 23887040
DOI: 10.1016/j.vaccine.2013.06.108 -
PloS One 2013Infectious diseases after solid organ transplantation (SOT) are one of the major complications in transplantation medicine. Vaccination-based prevention is desirable,... (Review)
Review
BACKGROUND
Infectious diseases after solid organ transplantation (SOT) are one of the major complications in transplantation medicine. Vaccination-based prevention is desirable, but data on the response to active vaccination after SOT are conflicting.
METHODS
In this systematic review, we identify the serologic response rate of SOT recipients to post-transplantation vaccination against tetanus, diphtheria, polio, hepatitis A and B, influenza, Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitides, tick-borne encephalitis, rabies, varicella, mumps, measles, and rubella.
RESULTS
Of the 2478 papers initially identified, 72 were included in the final review. The most important findings are that (1) most clinical trials conducted and published over more than 30 years have all been small and highly heterogeneous regarding trial design, patient cohorts selected, patient inclusion criteria, dosing and vaccination schemes, follow up periods and outcomes assessed, (2) the individual vaccines investigated have been studied predominately only in one group of SOT recipients, i.e. tetanus, diphtheria and polio in RTX recipients, hepatitis A exclusively in adult LTX recipients and mumps, measles and rubella in paediatric LTX recipients, (3) SOT recipients mount an immune response which is for most vaccines lower than in healthy controls. The degree to which this response is impaired varies with the type of vaccine, age and organ transplanted and (4) for some vaccines antibodies decline rapidly.
CONCLUSION
Vaccine-based prevention of infectious diseases is far from satisfactory in SOT recipients. Despite the large number of vaccination studies preformed over the past decades, knowledge on vaccination response is still limited. Even though the protection, which can be achieved in SOT recipients through vaccination, appears encouraging on the basis of available data, current vaccination guidelines and recommendations for post-SOT recipients remain poorly supported by evidence. There is an urgent need to conduct appropriately powered vaccination trials in well-defined SOT recipient cohorts.
Topics: Antibodies; Antibody Formation; Cohort Studies; Humans; Organ Transplantation; Vaccines
PubMed: 23451126
DOI: 10.1371/journal.pone.0056974 -
Journal of Alternative and... May 2013The aim of this review is to summarize and assess critically clinical trial evidence of the effect of t'ai chi (TC) exercise on immunity and TC efficacy for treating... (Review)
Review
PURPOSE
The aim of this review is to summarize and assess critically clinical trial evidence of the effect of t'ai chi (TC) exercise on immunity and TC efficacy for treating infectious diseases.
METHODS
Fourteen databases were searched from their respective inceptions through January 2011. No language restrictions were imposed. Quality and validity of the included clinical trials were evaluated using standard scales.
RESULTS
Sixteen (16) studies, including 7 randomized controlled trials, 4 controlled clinical trials, and 5 retrospective case-control studies, met the inclusion criteria for this review. One (1) study examined clinical symptoms, 3 studies tested functional measures of immunity (antigen-induced immunity), and the other studies tested enumerative parameters of immunity. such as lymphocytes, immunoglobulins, complements, natural-killer cells, and myeloid dendritic cells. Overall, these studies suggested favorable effects of TC exercise.
CONCLUSIONS
TC exercise appears to improve both cell-mediated immunity and antibody response in immune system, but it remains debatable whether or not the changes in immune parameters are sufficient to provide protection from infections.
Topics: Adult; Aged; Aged, 80 and over; Antibody Formation; Complement System Proteins; Controlled Clinical Trials as Topic; Female; Humans; Immunity, Cellular; Immunocompetence; Immunoglobulins; Infections; Lymphocyte Count; Male; Middle Aged; Randomized Controlled Trials as Topic; Tai Ji
PubMed: 23317394
DOI: 10.1089/acm.2011.0593 -
Journal of Thrombosis and Haemostasis :... Sep 2011This review of published studies was conducted to derive data on patients with congenital fibrinogen deficiency (CFD), including dosing of fibrinogen replacement... (Review)
Review
This review of published studies was conducted to derive data on patients with congenital fibrinogen deficiency (CFD), including dosing of fibrinogen replacement therapy, outcome, and adverse events, either temporally related or distant to fibrinogen replacement, in order to assist clinicians in developing treatment plans for patients with CFD. A systematic review was performed of case reports identified by a MEDLINE search between 1961 and 2010. Eligible studies included subjects with a diagnosis of CFD who received fibrinogen replacement. An attempt was made to extract dose, frequency, duration, hemostatic efficacy and adverse events such as thrombosis or allergic reactions. Reported thrombotic events distant from fibrinogen replacement were also recorded. From 104 papers reviewed, a total of 50 cases were identified: afibrinogenemia (35), hypofibrinogenemia (6), and dysfibrinogenemia (9). Fibrinogen replacement therapy was generally effective in preventing or treating bleeding in doses adequate to achieve and maintain fibrinogen activity above 50-100 mg dL(-1) (non-surgical and obstetric use) or 100-200 mg dL(-1) (surgical prophylaxis). Increased fibrinogen clearance was observed with massive hemorrhage, major surgery, and advanced pregnancy. Obstetric outcomes were optimized when fibrinogen replacement was initiated prior to conception. Uncontrolled hemorrhage, allergic reactions and antibody formation were rare events. However, thromboses, both related and unrelated to fibrinogen replacement, occurred in 15 of 50 (30%) patients overall, and in eight of 12 (67%) adult non-obstetric patients with afibrinogenemia. Published fibrinogen replacement regimens are presented for 50 CFD patients. Fibrinogen replacement therapy requires careful monitoring of fibrinogen levels. Afibrinogenemia is associated with thromboembolic complications with or without treatment.
Topics: Adolescent; Adult; Afibrinogenemia; Child; Child, Preschool; Female; Fibrinogen; Hemorrhage; Hemostasis, Surgical; Humans; Infant; Infant, Newborn; Male; Pregnancy; Pregnancy Complications, Hematologic; Thrombosis; Young Adult
PubMed: 21711446
DOI: 10.1111/j.1538-7836.2011.04424.x -
Cancer Immunology, Immunotherapy : CII Oct 2009This review summarizes studies on humoral immune responses against tumor-associated antigens (TAAs) with a focus on antibody frequencies and the potential diagnostic,... (Review)
Review
This review summarizes studies on humoral immune responses against tumor-associated antigens (TAAs) with a focus on antibody frequencies and the potential diagnostic, prognostic, and etiologic relevance of antibodies against TAAs. We performed a systematic literature search in Medline and identified 3,619 articles on humoral immune responses and TAAs. In 145 studies, meeting the inclusion criteria, humoral immune responses in cancer patients have been analyzed against over 100 different TAAs. The most frequently analyzed antigens were p53, MUC1, NY-ESO-1, c-myc, survivin, p62, cyclin B1, and Her2/neu. Antibodies against these TAAs were detected in 0-69% (median 14%) of analyzed tumor patients. Antibody frequencies were generally very low in healthy individuals, with the exception of few TAAs, especially MUC1. For several TAAs, including p53, Her2/neu, and NY-ESO-1, higher antibody frequencies were reported when tumors expressed the respective TAA. Antibodies against MUC1 were associated with a favorable prognosis while antibodies against p53 were associated with poor disease outcome. These data suggest different functional roles of endogenous antibodies against TAAs. Although data on prediagnostic antibody levels are scarce and antibody frequencies for most TAAs are at levels precluding use in diagnostic assays for cancer early detection, there is some promising data on achieving higher sensitivity for cancer detection using panels of TAAs.
Topics: Animals; Antibodies, Neoplasm; Antibody Formation; Antigens, Neoplasm; Autoantibodies; Humans; Neoplasm Proteins; Neoplasms
PubMed: 19562338
DOI: 10.1007/s00262-009-0733-4 -
Respiratory Care Mar 2003Respiratory syncytial virus, the leading cause of serious upper and lower respiratory tract infection in infants and children, accounts for 125,000 hospitalizations and... (Review)
Review
Respiratory syncytial virus, the leading cause of serious upper and lower respiratory tract infection in infants and children, accounts for 125,000 hospitalizations and 450 deaths annually in the United States. It also may predispose to development of asthma later in life. Annual epidemics occur from November to April, and virtually all infants are infected by age 2. Immunity is not durable; hence, reinfection occurs throughout life, although subsequent infections are nearly always mild. Certain populations (eg, premature infants, infants with chronic lung disease, and immunocompromised individuals) are at risk for severe morbidity and have higher risk of mortality. Infection is spread to the nose and eyes by large droplets and direct contact with secretions, and fomites may remain infectious for up to 12 hours. Nosocomial infection is common. The virus infects airway ciliated epithelial cells, spreading by the formation of syncytia. Cellular debris and inflammation cause airway obstruction, hyperinflation, localized atelectasis, wheezing, and impaired gas exchange. Both humoral and cellular immune response are critical to ending the acute infection, but wheezing and reactive airways may persist for as long as 5-10 years after acute infection. No cure exists for respiratory syncytial virus infection, but commonly employed palliative treatments include oxygen, inhaled beta(2) agonists, racemic epinephrine, dornase alfa, systemic and inhaled corticosteroids, inhaled ribavirin, and nasopharyngeal suctioning. Infants suffering severe lower airways disease may require mechanical ventilation. Prophylactic measures include rigorous infection control and administration of polyclonal (RSV-IGIV [respiratory syncytial virus - immunoglobulin intravenous]) and monoclonal (palivizumab) antibodies. The cost of the prophylactic antibody treatment is high; it is cost-effective for only the highest risk patients. Development of a vaccine remains far in the future. Application of evidence-based clinical practice guidelines is making both out-patient and in-patient therapy as effective and economical as possible.
Topics: Disease Management; Humans; Infant; Infant, Newborn; Respiratory Syncytial Virus Infections; Respiratory Therapy; Risk Factors; United States
PubMed: 12667273
DOI: No ID Found -
Environmental Health Perspectives Dec 2002Animal studies indicate that the immune system is one of the most sensitive targets of the toxic effects of 2,3,7,8-tetrachloro-p-dibenzodioxin (TCDD). TCDD inhibits... (Comparative Study)
Comparative Study Review
Animal studies indicate that the immune system is one of the most sensitive targets of the toxic effects of 2,3,7,8-tetrachloro-p-dibenzodioxin (TCDD). TCDD inhibits immunoglobulin secretion and decreases resistance to bacterial, viral, and parasitic infections in exposed animals. Nearly 20 years after the Seveso, Italy, accident, we measured immunoglobulin and complement plasma levels in a random sample of the population in the most highly exposed zones (n = 62) and in the surrounding noncontaminated area (n = 58). Plasma IgG levels decreased with increasing TCDD plasma concentration (r = -0.35, p = 0.0002). Median IgG concentration decreased from 1,526 mg/dL in the group with the lowest (< 3.5 ppt) TCDD levels to 1,163 mg/dL in the group with the highest (20.1-89.9 ppt) TCDD levels (p = 0.002). The association was significant (p = 0.0004) after adjusting for age, sex, smoking, and consumption of domestic livestock and poultry in multiple regression analysis and persisted after exclusion of subjects with inflammatory diseases and those using antibiotics or nonsteroidal anti-inflammatory drugs. IgM, IgA, C3, and C4 plasma concentrations did not exhibit any consistent association with TCDD levels. We performed a systematic review of all the articles published between 1966 and 2001 on human subjects exposed to TCDD reporting information on circulating levels of immunoglobulins and/or complement components. The literature indicates that the evidence for effects of TCDD on humoral immunity is sparse. Methodologic issues, results, and possible sources of variation between studies are discussed. The possible long-term immunologic effects of TCDD exhibited by the participants of the present study, coupled with the increased incidence of lymphatic tumors in the area of the accident, warrant further investigation.
Topics: Accidents; Adult; Aged; Antibody Formation; Carcinogens; Child; Child, Preschool; Environmental Exposure; Female; Follow-Up Studies; Humans; Immunoglobulins; Italy; Lymphoma; Male; Middle Aged; Polychlorinated Dibenzodioxins; Public Health; Risk Assessment
PubMed: 12460794
DOI: 10.1289/ehp.021101169