Zoster Vaccine Response in the Frail Elderly
25 de octubre de 2018 actualizado por: McMaster University
Immune and Genetic Correlates of Response to Zoster Vaccine in the Frail Elderly: a Pilot Study
This study is being done to evaluate the zoster vaccine response in the nursing home elderly (80 years or older).
As the immune system ages, the response to vaccines is not always as strong as in younger people.
Previous zoster vaccine studies have excluded nursing home residents so the vaccine effect in this population is not known.
Furthermore, the immune and genetic reasons as to why the vaccine works well in some people but not in others are also unknown.
The goal of this study is to evaluate why some immune systems respond well to the vaccine and why others do not.
Descripción general del estudio
Estado
Terminado
Condiciones
Intervención / Tratamiento
Descripción detallada
Deleterious changes in immunity that occur with aging are known as immunosenescence. Such changes, particularly in adaptive immunity, may lead to an impaired vaccine response in the elderly. Characterizing the immune determinants and the genetic basis for vaccine response in the frail elderly is a practical approach to better our understanding of immunosenescence. Data on genetic determinants to immunization are sparse, furthermore, to the best of our knowledge, none exist in the elderly. In this pilot study, we propose studying the immune response to the herpes zoster vaccine and the underlying genetic determinants of the immune response in elderly residents of nursing homes.
The three specific aims of this study are to generate data in order to 1) assess the T-cell response to the varicella-zoster virus (VZV) vaccine in the frail elderly; 2) assess whether immune (T-cell) phenotypes are associated with a response; 3) test the association between immune response genotype sets and T-cell response. We hypothesize that response to the VZV vaccine in elderly nonambulatory nursing home residents is a function of characteristic T-cell immune phenotypes prior to vaccination and that there are immune genetic polymorphisms associated with the response. This study will allow us to generate preliminary data and establish feasibility in order to address these questions fully in a larger population in a subsequent grant application.
Tipo de estudio
De observación
Inscripción (Actual)
241
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
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Ontario
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Hamilton, Ontario, Canadá
- Macassa Lodge
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Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
80 años y mayores (Adulto Mayor)
Acepta Voluntarios Saludables
Sí
Géneros elegibles para el estudio
Todos
Método de muestreo
Muestra no probabilística
Población de estudio
Elderly, non-ambulatory residents of nursing homes.
Descripción
Inclusion Criteria:
- nursing home resident
- greater than or equal to 80 years old
- non-ambulatory
Exclusion Criteria:
- less than 80 years old
- ambulatory
- taking immunosuppressive medication
- history of primary or acquired immuno-deficiency states including leukemia, other malignant neoplasms affecting the bone marrow or lymphatic system, and AIDS
- active untreated tuberculosis
- previous receipt of varicella vaccine
- residents expected to expire within 30 days, in the opinion of the most responsible physician
- residents planning to move nursing homes within the year
- temporary residents
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
Cohortes e Intervenciones
Grupo / Cohorte |
Intervención / Tratamiento |
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Nursing Home Elderly Cases
Non-ambulatory nursing home residents >= 80 years old will be vaccinated with the zoster vaccine and provide baseline and post-vaccination blood samples.
We will assess differences in genotype frequencies between participants with high and low RCF and ELISPOT responses using a candidate gene approach with SNPs (single nucleotide polymorphisms).
A case will be considered failure to mount a high response.
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Otros nombres:
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Nursing Home Elderly Controls
Non-ambulatory nursing home residents >= 80 years old will be vaccinated with the zoster vaccine and provide baseline and post-vaccination blood samples.
We will assess differences in genotype frequencies between participants with high and low RCF and ELISPOT responses using a candidate gene approach with SNPs.
A control will be a participant who mounted an adequate response as defined in primary outcomes.
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Otros nombres:
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Community dwelling seniors
Community dwelling seniors ages 60-75 will be enrolled as a control group for the laboratory testing.
They will be vaccinated and will provide pre- and post-vaccination blood.
If nursing home residents do not show a response it is important to know that it is not a failure of the laboratory's measurement of immunogenicity.
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Otros nombres:
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Change From Baseline in T-cell Response to the VZV Vaccine in the Frail Elderly
Periodo de tiempo: 6 weeks
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As the primary phenotype, we will compare change in Enzyme-linked immunosorbent spot (ELISPOT) from baseline (i.e., pre and post vaccination).
A high baseline T cell response will be defined as ELISPOT = >50 spots and a low baseline response will be ELISPOT = <10 spots.
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6 weeks
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Assessment of Immune Parameters Compatible With Inflammaging: CD4+/CD8+ Ratio
Periodo de tiempo: Baseline
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Characterization of T-cell populations will be conducted on whole blood using multi-parametric flow cytometry prior to immunization to characterize the immunological function of circulating T-cells in the nursing home vaccine group.
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Baseline
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Assessment of Immune Parameters Compatible With Inflammaging: High T Regulatory Cells
Periodo de tiempo: Baseline
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Characterization of T-cell populations will be conducted on whole blood using multi-parametric flow cytometry prior to immunization to characterize the immunological function of circulating T-cells in the nursing home vaccine group.
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Baseline
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Otras medidas de resultado
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Assessment of Immune Parameters Compatible With Inflammaging: TEMRA Cells
Periodo de tiempo: Baseline
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Characterization of Tcell populations will be conducted on whole blood using multiparametric flow cytometry prior to immunization to characterize the immunological function of circulating Tcells in each participant.
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Baseline
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Assessment of Immune Parameters Compatible With Inflammaging: High CD8+CD28CD45RA+T Cells
Periodo de tiempo: Baseline
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Characterization of Tcell populations will be conducted on whole blood using multiparametric flow cytometry prior to immunization to characterize the immunological function of circulating Tcells in each participant.
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Baseline
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Testing 150 Candidate Immune Response Genes for SNP Analysis
Periodo de tiempo: Baseline
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These will include Tolllike receptors, cytokines, chemokines, chemokine receptors, interferons and interferon receptors.
Tolllike receptors: TLR1TLR9 Cytokines: ILI1A, ILI1B, IL1RN, IL4, IL5, IL12B, IL13, CSF2 Chemokines: CCL1CCL3, CCL3L1, CCL4CCL8, CCL11, CCL13, CCL15CCL28, CXCL1CXCL14, CXCL16, CX3CL1 Chemokine receptors: CCR1CCR10, CXCR1CXCR6, CX3CR1, XCR1XCR2 Interferons: IFNA1IFNA2, IFNA4IFNA8, IFNA10, IFNA13, IFNA14, IFNA16IFNA17, IFNA21, IFNB1, IFNB3, IFNG, IFNK, IFNW1 Interferon receptors: IFNAR1, IFNAR2, IFNGR1, IFNGR2
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Baseline
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Assessment of Immune Parameters Compatible With Inflammaging: CD4 Cell Frequency
Periodo de tiempo: Baseline
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Characterization of T-cell populations will be conducted on whole blood using multi-parametric flow cytometry prior to immunization to characterize the immunological function of circulating T-cells in the nursing home vaccine group.
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Baseline
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Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Mark B. Loeb, FRCPC,MD,MSc, McMaster University
Publicaciones y enlaces útiles
La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio
1 de mayo de 2011
Finalización primaria (Actual)
1 de marzo de 2015
Finalización del estudio (Actual)
1 de marzo de 2015
Fechas de registro del estudio
Enviado por primera vez
15 de marzo de 2011
Primero enviado que cumplió con los criterios de control de calidad
1 de abril de 2011
Publicado por primera vez (Estimar)
4 de abril de 2011
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
29 de octubre de 2018
Última actualización enviada que cumplió con los criterios de control de calidad
25 de octubre de 2018
Última verificación
1 de octubre de 2018
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- 09-450
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