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Review
. 2020 May 7:17:10.
doi: 10.1186/s12979-020-00181-1. eCollection 2020.

The immune response to influenza in older humans: beyond immune senescence

Janet E McElhaney  1 , Chris P Verschoor  1 , Melissa K Andrew  2 , Laura Haynes  3 , George A Kuchel  3 , Graham Pawelec  1   4
Affiliations
Review

The immune response to influenza in older humans: beyond immune senescence

Janet E McElhaney et al. Immun Ageing. .

Abstract

Despite widespread influenza vaccination programs, influenza remains a major cause of morbidity and mortality in older adults. Age-related changes in multiple aspects of the adaptive immune response to influenza have been well-documented including a decline in antibody responses to influenza vaccination and changes in the cell-mediated response associated with immune senescence. This review will focus on T cell responses to influenza and influenza vaccination in older adults, and how increasing frailty or coexistence of multiple (≥2) chronic conditions contributes to the loss of vaccine effectiveness for the prevention of hospitalization. Further, dysregulation of the production of pro- and anti-inflammatory mediators contributes to a decline in the generation of an effective CD8 T cell response needed to clear influenza virus from the lungs. Current influenza vaccines provide only a weak stimulus to this arm of the adaptive immune response and rely on re-stimulation of CD8 T cell memory related to prior exposure to influenza virus. Efforts to improve vaccine effectiveness in older adults will be fruitless until CD8 responses take center stage.

Keywords: Broadly neutralizing antibodies; CD4 and CD8 T cell response; Cytokines; Dendritic cells; Granzyme B; Hemagglutination inhibition antibody response; Influenza; Influenza vaccination; Vaccine adjuvants.

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Conflict of interest statement

Competing interestsJEM’s institution has received honoraria for presentations and participation in advisory boards and data safety and monitoring boards and related travel reimbursements from Sanofi, GSK, Pfizer and Merck outside of the submitted work. CPV has no competing interests. MKA has received grant funding from GSK, Sanofi and Pfizer and honoraria from Sanofi and the Canadian Frailty Network. LH and GAK declare no competing interest. GP has received honoraria and research support from Immatics Biotechnologies, Celgene, Pfizer, Sanofi, 4D-Pharma, Clasado and The Croeni Foundation, and consults for Repair Biotechnologies, Inc.

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