The elderly patient population is the most susceptible to influenza virus infection and its associated complications. Polypharmacy is common in the aged, who often have multiple co-morbidities. Previous studies have demonstrated that commonly used prescription drugs can have extensive impact on immune defenses and responses to vaccination. In this study, we examined how the dynamics of immune responses to the two influenza A virus strains of the trivalent inactivated influenza vaccine (TIV) can be affected by patient’s history of using the prescription drugs Metformin, NSAIDs or Statins. We provide evidence for differential antibody (Ab) production, B-cell phenotypic changes, alteration in immune cell proportions and transcriptome-wide perturbation in individuals with a history of long-term medication use, compared with non-users. We noted a diminished response to TIV in the elderly on Metformin, whereas those on NSAIDs or Statins had higher baseline responses but reduced relative increases in virus-neutralizing Abs (VNAs) or Abs detected by an enzyme-linked immunosorbent assay (ELISA) following vaccination. Collectively, our findings suggest novel pathways that might underlie how long-term medication use impacts immune response to influenza vaccination in the elderly. They provide a strong rationale for targeting the medication-immunity interaction in the aged population to improve vaccination responses.

中文翻译：

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老年人对流感疫苗接种的免疫反应因长期用药而改变


老年患者群体最容易受到流感病毒感染及其相关并发症的影响。多重用药在老年人中很常见，他们经常有多种合并症。先前的研究表明，常用的处方药可以对免疫防御和疫苗接种反应产生广泛的影响。在这项研究中，我们研究了患者使用处方药二甲双胍、非甾体抗炎药或他汀类药物的历史如何影响对三价灭活流感疫苗 (TIV) 的两种甲型流感病毒株的免疫反应动态。我们提供了证据，证明有长期用药史的个体与非用药者相比，抗体 (Ab) 的产生差异、B 细胞表型变化、免疫细胞比例的改变和转录组范围内的扰动。我们注意到，服用二甲双胍的老年人对 TIV 的反应减弱，而服用 NSAID 或他汀类药物的老年人的基线反应较高，但疫苗接种后病毒中和抗体 (VNA) 或通过酶联免疫吸附测定 (ELISA) 检测到的抗体的相对增加减少。总的来说，我们的研究结果表明，新的途径可能是长期用药如何影响老年人对流感疫苗免疫反应的基础。它们为针对老年人群中的药物-免疫相互作用以改善疫苗接种反应提供了强有力的理由。