A community-based survey of varicella-zoster virus-specific immune responses in the elderly
Section snippets
Background
Varicella-zoster virus (VZV) causes varicella in children, and establishes lifelong latency in the sensory ganglia. Reactivation of the latent VZV causes herpes zoster (zoster).1 Many risk factors for the occurrence of zoster have been reported,2, 3, 4, 5 and increasing age is considered a key risk factor.2, 6, 7, 8 Antibody levels are reported to be relatively constant with increasing age,6, 7, 9 while a decline in VZV-specific cell-mediated immunity (CMI) with advancing age, and in
Objectives
The objective of this study was to conduct a detailed survey at large scale about VZV-immunity profile of older people in Japan. Therefore, here, we carried out a large-scale VZV-immune profile investigation in a population living in an island cluster in Japan where elder people have stayed for a long period without moving.
Volunteers
Epidemiological description of the Shozu Herpes Zoster (SHEZ) Study, a large cohort study, was recently reported,13 and this study has been done as a part of SHEZ Study. We enrolled 365 healthy volunteers from Shozu County, which consists of small islands in the middle of Japan, from December 2008 to October 2009. Shozu County, Kagawa Prefecture is an administrative division. All of the volunteers were continuous residents of the island and were age 60 or older: 121 volunteers were in their
Correlation among the immunologic tests results
The coefficient range from the Pearson correlation analysis was from 0.549 to 0.666 between all combinations of the humoral immunity tests, indicating strong correlations (Fig. 1A). A strong correlation was found between the edema and erythema in the skin test (Fig. 1B). Weak correlation (Pearson r from 0.231 to 0.251) was found between the ELISPOT and erythema, and between the ELISPOT and edema (Fig. 1B). No correlation was found between the cellular and humoral immunity results (Fig. 1C).
Decreased CMI to VZV with increasing age
We
Discussion
To investigate the immunity to VZV, a plethora of tests have been developed over the years. Advantage and disadvantage of each test have also been reported.17, 18 Since it is likely that more convincing data are obtained when combined tests are performed for an immunologic survey, here we used a panel of immunologic tests to investigate the detailed immunity profile of each subject. We enrolled healthy volunteers, 60 or older, from an island cluster and demonstrated that the CMI to VZV
Funding
This study is funded as “Epidemiological Research for the Development of Herpes Zoster Vaccine” (KHC1102) by a research grant from the Labour Sciences Research Grants at Research on Publicly Essential Drugs and Medical Devices of Health.
Competing interest
Authors (H.T., E.M., S.O., H.I., H.A., K.Y. and Y.M.) report no potential conflicts of interest. Y.O. belongs to Biken which produces skin test reaction and Oka vaccine.
Ethical approval
This study was approved by ethical committees of all the involved institutions. Written informed consent was obtained from each volunteer.
Acknowledgments
We thank the cooperating medical organizations belonging to the Shozu County Medical Society: 11 of the 13 medical organizations in Shozu County consisting of 6 private clinics, 2 municipal clinics, 1 private hospital and 2 municipal hospitals. Dermatology department exists only at the 2 municipal hospitals, where dermatological services are provided by part-time dermatologists on 3 days a week, Shodoshima Federation of Self-Government Bodies, Tonosho Town Autonomous Liaison Council, Shodoshima
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