水痘ワクチンによる帯状庖疹発症予防の可能性  [in Japanese] Possibility of Prevention of Herpes Zoster by Use of Varicella Vaccine  [in Japanese]

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Abstract

帯状疱疹は高齢者に多く発症するが, その理由は加齢により, varicella-zoster virus (VZV) に対する特異細胞性免疫が低下するためと考えられている. 高齢者に水痘ワクチンを接種することで特異細胞性免疫を高めることができれば, 帯状疸疹の発症が予防できるかもしれない. そこで今回, 私どもは, 40歳以上の中高年者15名を対象に, 水痘ワクチン接種前と接種2-3カ月後に, VZV特異細胞性免疫 (リンパ球増殖反応, 水痘皮内反応) と血清VZV-lgG抗体を測定し, 比較検討した. そ結果, リンパ球増殖反応でみた場合 (stimulation Index: S. I. で評価, 2.0以上が陽性), S. 1. (平均±標準偏差) は接種前が2.7±1.8, 接種後が2.7±1.9で有意な増強はみられなかった. 一方, 水痘皮内反応では, 接種前後で判定できた13名中10名で発赤長径が大きくなっており, ブースター効果が観察された. また, 血清VZVIgG抗体でも有意な上昇は得られなかった.<BR>リンパ球増殖反応と水痘皮内反応の結果が一致しなかった理由は明らかでなく, 水痘ワクチン接種前後での特異細胞性免疫の測定方法については, 今後さらに検討が必要である. また, 接種回数が1回では特異細胞性免疫の増強には不十分であった可能性もあり, 接種回数についても考慮すべきと考えられた.

It has been considered that a decline in specific cell-mediated immunity (CMI) for the varicella-zoster virus (VZV) could be responsible for a high incidence of herpes zoster in the elderly. If the strength of CMI for VZV could be increased by immunization of the elderly with a varicella vaccine, herpes zoster might be preventable. We compared the CMI for VZV (using a lymphoproliferative assay and a varicella skin test) and VZV-IgG antibodies in serum before and after 2-3 months of vaccination in 15 subjects more than 40 years old.<BR>When the CMI for VZV was measured by the lymphoproliferative assay, a stimulation index (SI) of more than 2.0 was estimated to be positive in this study. The SIs (mean±SD) before and after the vaccination were 2.7±1.8 and 2.7±1.9, respectively, and no significant difference was noted. On the other hand, the diameter of erythema in the varicella skin test after the vaccination became larger than that before the vaccination in the 10 of 13 subjects. In addition, serum VZV-IgG antibodies increased after vaccination in 6 of 14 subjects.<BR>There were no obvious reasons for the discrepancy in the results of the lymphoproliferative assay and the varicella skin test. However, because of the poor response indicated by the assay, only one vaccination for the elderly might not be enough to increase the CMI for VZV. The appropriate age for vaccination should also be considered. Lastly, further investigation of the CMI for VZV before and after vaccination on larger scale is required.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 72(7), 714-719, 1998-07-20

    The Japanese Association for Infectious Diseases

References:  10

Codes

  • NII Article ID (NAID)
    10008718437
  • NII NACSIS-CAT ID (NCID)
    AN00047715
  • Text Lang
    JPN
  • Article Type
    ART
  • ISSN
    03875911
  • NDL Article ID
    4536823
  • NDL Source Classification
    ZS9(科学技術--医学--病理学・微生物学・寄生虫学・感染・免疫学・血清学・アレルギー)
  • NDL Call No.
    Z19-193
  • Data Source
    CJP  NDL  J-STAGE 
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