Читать книгу Vaccines for Older Adults: Current Practices and Future Opportunities - Группа авторов - Страница 37

In the elderly, infections such as influenza, pneumonia, or shingles are preventable by the use of adequate vaccines [1, 2]. The widely accepted paradigm is that vaccine efficacy is decreased with aging due to what is called immunosenescence and its corollary – inflammaging [3–5]. However, recent studies did not confirm this paradigm [6–9] as the recently introduced vaccine for herpes zoster had an efficacy of >80% even in older subjects aged over 80 years, and the same is true for some recently introduced new influenza vaccines. Vaccine efficacy depends on an efficient and coordinated function of the immune system [10, 11]. The immune system and its response to pathogens are divided into two parts, the innate and the adaptive, each with its own components of distinct immune cells and soluble mediators. They have separate functions but necessarily and closely collaborate with each other. Natural killer (NK) cells are included in the innate, less specific part of the system, along with neutrophils, monocytes/macrophages, and dendritic cells (DCs) [12, 13]. So far, most vaccination studies have been devoted to the investigation of the adaptive part of the immune response which was found to be changed with aging [1]. In this chapter, we will discuss NK cell subsets and functions, their changes with aging, and whether and how they could participate in the vaccine response [14–16], be it directly or through the modulation of other immune cell functions.