Immune-mediated attenuation of influenza illness after infection: opportunities and challenges

Summary: Sterilising immunity that blocks infection for life, and thus prevents illness after infection, is the ultimate goal for vaccines. Neither influenza infection nor vaccination provide sterilising immunity. Mutations during influenza viral genome replication result in the emergence of viruses...

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Autores principales:	Manish M Patel, MD, Ian A York, PhD, Arnold S Monto, MD, Mark G Thompson, PhD, Alicia M Fry, MD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Medicine (General) R5-920 Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/8d08d1ff5baf4a2d85511066506a7b28
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spelling	oai:doaj.org-article:8d08d1ff5baf4a2d85511066506a7b282021-12-02T05:03:51ZImmune-mediated attenuation of influenza illness after infection: opportunities and challenges2666-524710.1016/S2666-5247(21)00180-4https://doaj.org/article/8d08d1ff5baf4a2d85511066506a7b282021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2666524721001804https://doaj.org/toc/2666-5247Summary: Sterilising immunity that blocks infection for life, and thus prevents illness after infection, is the ultimate goal for vaccines. Neither influenza infection nor vaccination provide sterilising immunity. Mutations during influenza viral genome replication result in the emergence of viruses that evade immunity and cause reinfections. Waning of immunity also results in reinfections to homologous influenza viruses. However, immunity might limit the severity of disease after infection or vaccination (ie, immunoattenuation). We provide a comprehensive examination of experimental and observational peer reviewed evidence since 1933, when the first influenza virus was isolated, on whether immunity blocks subsequent infection or attenuates illness. Although an abundance of experimental evidence supports immunoattenuation, clinical evidence is rudimentary and conflicting. To the extent that immunoattenuation occurs, understanding the varied pathways to illness, pathogenesis, clinical manifestations, and correlates of attenuation can improve the design and evaluation of influenza vaccines. By elucidating the mechanisms of immunoattenuation and phenotypes of illness, we clarify ambiguities and identify unmet needs that, if addressed with priority, could strategically improve the design of vaccines for the prevention of influenza.Manish M Patel, MDIan A York, PhDArnold S Monto, MDMark G Thompson, PhDAlicia M Fry, MDElsevierarticleMedicine (General)R5-920MicrobiologyQR1-502ENThe Lancet Microbe, Vol 2, Iss 12, Pp e715-e725 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920 Microbiology QR1-502
spellingShingle	Medicine (General) R5-920 Microbiology QR1-502 Manish M Patel, MD Ian A York, PhD Arnold S Monto, MD Mark G Thompson, PhD Alicia M Fry, MD Immune-mediated attenuation of influenza illness after infection: opportunities and challenges
description	Summary: Sterilising immunity that blocks infection for life, and thus prevents illness after infection, is the ultimate goal for vaccines. Neither influenza infection nor vaccination provide sterilising immunity. Mutations during influenza viral genome replication result in the emergence of viruses that evade immunity and cause reinfections. Waning of immunity also results in reinfections to homologous influenza viruses. However, immunity might limit the severity of disease after infection or vaccination (ie, immunoattenuation). We provide a comprehensive examination of experimental and observational peer reviewed evidence since 1933, when the first influenza virus was isolated, on whether immunity blocks subsequent infection or attenuates illness. Although an abundance of experimental evidence supports immunoattenuation, clinical evidence is rudimentary and conflicting. To the extent that immunoattenuation occurs, understanding the varied pathways to illness, pathogenesis, clinical manifestations, and correlates of attenuation can improve the design and evaluation of influenza vaccines. By elucidating the mechanisms of immunoattenuation and phenotypes of illness, we clarify ambiguities and identify unmet needs that, if addressed with priority, could strategically improve the design of vaccines for the prevention of influenza.
format	article
author	Manish M Patel, MD Ian A York, PhD Arnold S Monto, MD Mark G Thompson, PhD Alicia M Fry, MD
author_facet	Manish M Patel, MD Ian A York, PhD Arnold S Monto, MD Mark G Thompson, PhD Alicia M Fry, MD
author_sort	Manish M Patel, MD
title	Immune-mediated attenuation of influenza illness after infection: opportunities and challenges
title_short	Immune-mediated attenuation of influenza illness after infection: opportunities and challenges
title_full	Immune-mediated attenuation of influenza illness after infection: opportunities and challenges
title_fullStr	Immune-mediated attenuation of influenza illness after infection: opportunities and challenges
title_full_unstemmed	Immune-mediated attenuation of influenza illness after infection: opportunities and challenges
title_sort	immune-mediated attenuation of influenza illness after infection: opportunities and challenges
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/8d08d1ff5baf4a2d85511066506a7b28
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Immune-mediated attenuation of influenza illness after infection: opportunities and challenges

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