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Shelter from the cytokine storm: pitfalls and prospects in the development of SARS-CoV-2 vaccines for an elderly population
Seminars in Immunopathology ( IF 7.9 ) Pub Date : 2020-11-06 , DOI: 10.1007/s00281-020-00821-0
Annalisa Ciabattini 1 , Paolo Garagnani 2, 3, 4 , Francesco Santoro 1 , Rino Rappuoli 5, 6, 7 , Claudio Franceschi 8 , Donata Medaglini 1
Affiliation  

The SARS-CoV-2 pandemic urgently calls for the development of effective preventive tools. COVID-19 hits greatly the elder and more fragile fraction of the population boosting the evergreen issue of the vaccination of older people. The development of a vaccine against SARS-CoV-2 tailored for the elderly population faces the challenge of the poor immune responsiveness of the older population due to immunosenescence, comorbidities, and pharmacological treatments. Moreover, it is likely that the inflammaging phenotype associated with age could both influence vaccination efficacy and exacerbate the risk of COVID-19-related “cytokine storm syndrome” with an overlap between the factors which impact vaccination effectiveness and those that boost virulence and worsen the prognosis of SARS-CoV-2 infection. The complex and still unclear immunopathological mechanisms of SARS-CoV-2 infection, together with the progressive age-related decline of immune responses, and the lack of clear correlates of protection, make the design of vaccination strategies for older people extremely challenging. In the ongoing effort in vaccine development, different SARS-CoV-2 vaccine candidates have been developed, tested in pre-clinical and clinical studies and are undergoing clinical testing, but only a small fraction of these are currently being tested in the older fraction of the population. Recent advances in systems biology integrating clinical, immunologic, and omics data can help to identify stable and robust markers of vaccine response and move towards a better understanding of SARS-CoV-2 vaccine responses in the elderly.



中文翻译:

抵御细胞因子风暴:针对老年人群开发 SARS-CoV-2 疫苗的陷阱和前景

SARS-CoV-2 大流行迫切需要开发有效的预防工具。COVID-19 极大地打击了老年人口和弱势群体,加剧了老年人疫苗接种这一长期存在的问题。开发针对老年人群的 SARS-CoV-2 疫苗面临着老年人群由于免疫衰老、合并症和药物治疗而导致的免疫反应较差的挑战。此外,与年龄相关的炎症表型可能会影响疫苗接种效果,并加剧与 COVID-19 相关的“细胞因子风暴综合征”的风险,影响疫苗接种效果的因素与提高毒力和恶化疫苗接种效果的因素之间存在重叠。 SARS-CoV-2 感染的预后。SARS-CoV-2 感染的免疫病理学机制复杂且仍不清楚,加上与年龄相关的免疫反应逐渐下降,以及缺乏明确的保护相关性,使得针对老年人的疫苗接种策略设计极具挑战性。在疫苗开发的持续努力中,不同的 SARS-CoV-2 候选疫苗已经被开发出来,在临床前和临床研究中进行测试,并且正在进行临床测试,但目前只有一小部分正在较老的部分中进行测试。人口。系统生物学的最新进展整合了临床、免疫学和组学数据,有助于识别稳定而稳健的疫苗反应标记物,并有助于更好地了解老年人的 SARS-CoV-2 疫苗反应。

更新日期:2020-11-09
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