Journal
VACCINE
Volume 28, Issue 38, Pages 6145-6151Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.vaccine.2010.07.036
Keywords
Influenza; Granzyme B; Interferon-gamma; Interleukin-10; Elderly
Categories
Funding
- National Institutes of Health
- National Institute of Allergy and Infectious Diseases [R01 AI68265]
- Canadian Institutes of Health Research
- NIL-I
- National Center for Research Resources [MO1 RR06192]
- NIH, (University of Connecticut Health Center, J.E. McElhaney, PI) [RO1 AI68265]
- GSK Canada
- Sanofi pasteru
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The diagnosis of influenza is often missed in older adults and illness presentation may be modified by prior vaccination. We evaluated the symptoms and immunologic markers predicting laboratory-confirmed influenza (LCI) among vaccinated older adults. In subjects with influenza-like illness (ILI), fever distinguished subjects with laboratory-confirmed influenza (LCI) from those with other ILI (39% vs. 12.5%, p = 0.009). In LCI subjects who did not seroconvert to influenza infection, pre-infection levels of the cytolytic mediator, granzyme B, correlated with fever (r = 1.000; p = 0.01) and the IFN-gamma:IL-10 ratio (r = 0.999; p = 0.03), and increased following influenza infection in LCI vs. ILI subjects (p = 0.03). The cell-mediated immune response to influenza distinguishes A/H3N2 LCI from other ILI in older adults, and suggests a link between cell-mediated immunity and influenza illness severity in vaccinated older adults. (C) 2010 Elsevier Ltd. All rights reserved.
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