İmmunosenescence and The İmportance of İnfluenza and Pneumococcal Vaccine in Elderly?

Öz

The vaccination of the elderly is generally ignored and their vaccination is insufficient. However, infectious diseases such as influenza and pneumococcus can be prevented or alleviated by vaccination. The "immune aging" ("immunosenescence") results in a decrease in the functions of the humoral and cellular immune systems in the elderly. Therefore, susceptibility to infections is increasing such as influenza and pneumococcus. Vaccination is effective and protective in these infections as it is important for many infections. If there is no contraindication or immunodeficiency, influenza and pneumococcal vaccinations are recommended for those aged 65 years and over by CDC (Center for Disease Control and Prevention). In this review, the importance of vactination against influenza and pneumococcal infections was discussed in the light of current studies. Yaşlıların aşılanması genel olarak göz ardı edilmekte olup aşılanmaları yetersizdir oysa influenza ve pnömokok gibi enfeksiyöz hastalıklar ve komplikasyonları, aşı ile önlenebilir ya da hafifletilebilirler. Yaşlılarda immün yaşlanma (immunosenescence) sonucu humoral ve hücresel immün sistem fonksiyonlarında azalma olmaktadır dolayısıyla/Bu nedenle influenza ve pnömokok gibi enfeksiyonlara karşı hassasiyet artmaktadır. Birçok enfeksiyon etkenine karşı aşılanmanın önemi olduğu gibi bu enfeksiyonlarda da aşılanma etkili ve koruyucudur. Eğer bir kontrendikasyon ya da immün yetmezliği yoksa CDC (Center for Disease Control and Prevention) tarafından 65 yaş ve üzeri olanlara, influenza ve pnömokok aşısı önerilmektedir. Bu derlemede, güncel çalışmalar ışığında immün yaşlanma ve bununla ilişkili olarak inflüenza ve pnömokok enfeksiyonlarına karşı aşılanmanın önemi tartışıldı.

Anahtar Kelimeler

• Aged,İmmunosenescence,Influenza vaccines,Pneumococcal vaccines

Kaynakça

1. 1- World Health Organization. Ageing and health: Fact sheet, http://www.who.int/news-room/fact-sheets/detail/ageing-and-health [Accessed 23 Apr 2019]
2. 2- Turkish Statistical Institute. Main statistics results of 2017, http://www.tuik.gov.tr. [Accessed 24 Apr 2019]
3. 3- Montecino-Rodriguez E, Berent-Maoz B, Dorshkind K. Causes, consequences, and reversal of immune system aging. J Clin Invest 2013; 123(3): 958-65.
4. 4-Weinberger B, Herndler-Brandstetter D, Schwanninger A, Weiskopf D, Grubeck-Loebenstein B. Biology of immune responses to vaccines in elderly persons. Clin Infect Dis 2008; 46(7): 1078-84.
5. 5- Weinberger B, Grubeck-Loebenstein B. Vaccines for the elderly. Clin Microbiol Infect 2012; 18(5): 100-8.
6. 6- Tasselli L, Wei Z, Katrin FC. "SIRT6: novel mechanisms and links to aging and disease." Trends in Endocrinology & Metabolism 2017; 28(3): 168-85
7. 7- Sharma A, Diecke S, Zhang WY, Lan F, He C, Mordwinkin NM et al. The role of SIRT6 protein in aging and reprogramming of human induced pluripotent stem cells. The Journal of biological chemistry. 2013; 288(25): 18439-47.
8. 8- Dominy JE Jr, Lee Y, Jedrychowski MP, Chim H, Jurczak MJ, Camporez JP et al. The deacetylase Sirt6 activates the acetyltransferase GCN5 and suppresses hepatic gluconeogenesis. Molecular cell. 2012; 48(6): 900–13

9. 9- Xu Z, Zhang L, Zhang W, Meng D, Zhang H, Jiang Y et al. SIRT6 rescues the age related decline in base excision repair in a PARP1-dependent manner. Cell cycle. 2015; 14(2): 269–76.
10. 10- Ozkan O, Tural K. Changes in the Expression and the Role of Sirtuin 3 in Cancer Cells and in Cardiovascular Health and Disease. In: Uchiumi, F ed. Gene Expression and Regulation in Mammalian Cells-Transcription Toward the Establishment of Novel Therapeutics. London: IntechOpen, 2018:249-326.
11. 11- Haq K, McElhaney JE. Immunosenescence: Influenza vaccination and the elderly. Curr Opin Immunol. 2014; 29: 38-42. doi: 10.1016/j.coi.2014.03.008. 12-Lang PO, Aspinall R. Vaccination in the elderly: what can be recommended? Drug Aging 2014; 31(8): 581-99.
12. 13-Ludwig E, Bonanni P, Rohde G, Sayiner A,Torres A. The remaining challenges of pneumococcal disease in adults. Eur Respir Rev 2012; 21(123): 57-65.
13. 14-Mooney JD, Weir A, McMenamin J, Ritchie LD, Macfarlane TV, Simpson CR et al. The impact and effectiveness of pneumococcal vaccination in Scotland for those aged 65 and over during winter 2003/2004. BMC Infect Dis 2008; 8(1):53.
14. 15-CDC. Recommended Immunizations for Adults: By Age, https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-schedule-easy-read.pdf. [Accessed 23 Apr 2019]
15. 16.Koldaş Z. Yaşlı popülasyonda bağışıklama(aşılama). Turk Kardiyol Dern Ars 2017;45 (S5):124-127.
16. 17- McElhaney E, Gavazzi G, Flamaing J, Petermans J. The role of vaccination in successful independent ageing. European Geriatric Medicine 2016; 7(2); 171-5.
17. 18- Bacchetta R, Gregori S, Roncarolo MG. CD4+ regulatory T cells: mechanisms of induction and effector function. Autoimmun Rev 2005; 4(8): 491-6
18. 19- Weintraub A. Immunology of bacterial polysaccharide antigens. Carbohydr Res 2003; 338(23): 2539-47.
19. 20- Lee CJ, Lee LH, Lu CS, Wu A. Bacterial polysaccharides as vaccines–immunity and chemical characterization. Adv Exp Med Biol 2001; 491: 453-71.
20. 21-Trıglav TK, Poljak M. Vaccination indications and limits in the elderly. Acta Derm-Venereol 2013; 22(3): 65-70.
21. 22- Polat HH, Öncel S, Turhan Ö, Akcan A, Eravşar K, Yalcin AN. İnfluenza vaccınatıon in 65 and over age adults in Antalya/Turkey. Turk Geriatri Derg 2012; 15(4): 371-7.
22. 23- Erdoğdu Hİ, Çatak B. Influenza, Pneumococcal and Herpes Zoster vaccınatıon rates amongst people aged 65 years and older and related factors. Turkish Journal of Geriatrics 2018; 21(4): 498-06
23. 24- Lang PO. Why influenza viruses continue to pose a significant threat to aging and aged populations worldwide. Curr Geriatr Rep 2014; 3(1): 56-65.
24. 25- Huang CH, Chao DY, Wu CC, Hsu SY, Soon MS, Chang CC et al. Influenza vaccination and the endurance against air pollution among elderly with acute coronary syndrome. Vaccine 2016; 34(50): 6316-22.
25. 26- Karabağ Y, Çağdaş M, Rencuzogullari I, Karakoyun S, Artaç İ, İliş D, Yesin M, Çiftçi H, Erdoğdu HI, Tanboğa IH. The C-Reactive Protein to Albumin Ratio Predicts Acute Kidney Injury in Patients With ST-segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Heart Lung Circ. 2018. doi: 10.1016/j.hlc.2018.08.009. [Epub ahead of print].
26. 27- Wong K, Campitelli MA, Stukel TA, Kwong JC. Estimating influenza vaccine effectiveness in community-dwelling elderly patients using the instrumental variable analysis method. Arch Intern Med 2012; 172(6): 484-91.
27. 28-Büke AÇ. Yaşlılarda bağışıklama. Ege Journal of Medicine 2015; 54: 35-40
28. 29-Tomczyk S, Bennett NM, Stoecker C, et al. Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged≥65 years: Recommendations of the Advisory Committee on Immunization Practices (ACIP). Centers for Disease Control and Prevention (CDC). MMWR Morb Mortal Wkly Rep 2014; 63(37): 822-5.
29. 30-Webber C, Patton M, Patterson S, Schmoele-Thoma B, Huijts SM, Bonten MJ. Exploratory efficacy endpoints in the community-acquired pneumonia immunization trial in adults (CAPiTA). Vaccine 2017; 35(9): 1266-72.
30. 31- Chiou WY, Lee MS, Hung SK, Lin HY, Lo YC, Hsu FC et al. Effectiveness of 23-valent pneumococcal polysaccharide vaccine on elderly long-term cancer survivors: a population-based propensity score matched cohort study. BMJ open 2018; 8(5): e019364.
31. 32-Hedlund J, Christenson B, Lundbergh P, Örtqvist A. Effects of a large-scale intervention with influenza and 23-valent pneumococcal vaccines in elderly people: a 1-year follow-up. Vaccine 2003; 21(25-26): 3906-11.
32. 33-Avcı S, Erdoğdu Hİ. Acil Servise Başvuran Geriatrik Hastaların Cinsiyete Göre Değerlendirilmesi. Kafkas J Med Sci 2017; 7(3): 209-13
33. 34-Stoecker C. Incremental cost-effectiveness of modifying PPSV and PCV recommendations for adults age 50 and over. Presented at the Advisory Committee on Immunization Practices June 25, 2014 meeting, Atlanta, GA; 2014, http://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2014-06/pcv13-02-stoecker.pdf [Accessed 23 Apr 2019]