近日,Clinical Infectious Diseases刊登最新研究文章,研究发现,患有抑郁症的老年人,其接种的带状疱疹疫苗效力会有所下降。带状疱疹是由水痘-带状疱疹病毒复发引起的神经系统疾病,老年人是带状疱疹的高发人群,美国每年有超过一百万新发病例。带状疱疹疫苗可增强细胞免疫力,降低发病可能,缓解发病症状。
原文:Varicella Zoster Virus–Specific Immune Responses to a Herpes Zoster Vaccine in Elderly Recipients With Major Depression and the Impact of Antidepressant Medications
Author: Michael R. Irwin, Myron J. Levin, Mark L. Laudenslager, Richard Olmstead, Anne Lucko, Nancy Lang, Carmen Carrillo, Harold A. Stanley, Michael J. Caulfield, Adriana Weinberg, Ivan S. F. Chan, Jim Clair, Jeff G. Smith, R. D. Marchese, Heather M. Williams, Danielle J. Beck, Patricia T. McCook, Jane H. Zhang, Gary Johnson, Michael N. Oxman
Background: The Depression Substudy of the Shingles Prevention Study (SPS) was designed to evaluate the association between major depression and immune responses to a high-titer live attenuated varicella zoster virus (VZV) vaccine (zoster vaccine), which boosts cell-mediated immunity (CMI) to VZV and decreases the incidence and severity of herpes zoster (HZ). The Depression Substudy was a 2-year longitudinal cohort study in 92 community-dwelling adults ≥60 years of age who were enrolled in the SPS, a large, double-blind, placebo-controlled Veterans Affairs Cooperative zoster vaccine efficacy study.
Methods: Forty subjects with major depressive disorder, stratified by use of antidepressant medications, and 52 age- and sex-matched controls with no history of depression or other mental illness had their VZV-CMI measured prior to vaccination with zoster vaccine or placebo and at 6 weeks, 1 year, and 2 years postvaccination.
Results: Depressed subjects who were not treated with antidepressant medications had lower levels of VZV-CMI following administration of zoster vaccine than nondepressed controls or depressed subjects receiving antidepressants even when antidepressant medications failed to alter depressive symptom severity (P < .005).Similar results were obtained taking into account the time-varying status of depression and use of antidepressant medications, as well as changes in depressive symptoms, during the postvaccination period.
Conclusions: Depressed patients have diminished VZV-CMI responses to zoster vaccine, and treatment with antidepressant medication is associated with normalization of these responses. Because higher levels of VZV-CMI correlate with lower risk and severity of HZ, untreated depression may increase the risk and severity of HZ and reduce the efficacy of zoster vaccine.
(原文:http://cid.oxfordjournals.org/content/early/2013/02/12/cid.cis1208.full)
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