tetano
Editor, Senior Moderator
Clin Infect Dis. 2014 Jul 21. pii: ciu582. [Epub ahead of print]
Immunogenicity of Intradermal Trivalent Influenza Vaccine with Topical Imiquimod, a Double Blind Randomized Controlled Trial.
**** IF1, Zhang AJ2, To KK2, Chan JF2, Li C2, Zhu HS3, Li P2, Li C2, Chan TC3, Cheng VC2, Chan KH2, Yuen KY2.
Author information
Abstract
BACKGROUND:
Imiquimod, a synthetic Toll-like receptor 7-agonist enhanced immunogenicity of influenza vaccine in mouse model. We hypothesized that topical imiquimod before intradermal influenza vaccination (TIV) will produce similar effect in human.
METHODS:
We performed a prospective one-year follow-up double-blind randomized controlled trial on adults with co-morbidities. Subjects were randomized to one of the three vaccinations: topical 5% 250 mg imiquimod ointment followed by intradermal TIV (Intanza?15, Sanofi-Pasteur, France), or topical aqueous-cream followed by intradermal TIV, or topical aqueous-cream followed by intramuscular TIV (Vaxigrip?, Sanofi-Pasteur, France). Patients and investigators were blinded to the type of topical treatment applied. Hemagglutination inhibition (HI) and microneutralization antibody titers were measured. Primary outcome was day 7 seroconversion rate.
RESULTS:
Ninety-one recruited subjects completed the study. The median age was 73 years. On day 7, 27/30 (90%) patients who received imiquimod and intradermal TIV achieved seroconversion against the H1N1 strain by HI, compared to 4/30 (13.3%) who received aqueous-cream and intramuscular TIV (p<0.001) and 12/31 (38.7%) who received aqueous-cream and intradermal TIV (p<0.001). The seroconversion, seroprotection and geometric mean titre fold increase were met in all 3 strains in the imiquimod and intradermal TIV group two weeks earlier, and the better seroconversion rate was sustained from day 7 to year 1 (p≤0.001). The better immunogenicity was associated with less hospitalization for influenza or pneumonia (P<0.05). All adverse reactions were self-limited.
CONCLUSIONS:
Pretreatment with topical imiquimod significantly expedited, augmented and prolonged the immunogenicity of influenza vaccination. This strategy for influenza immunization should be considered in the elderly population.
? The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
PMID:
25048848
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/25048848
Immunogenicity of Intradermal Trivalent Influenza Vaccine with Topical Imiquimod, a Double Blind Randomized Controlled Trial.
**** IF1, Zhang AJ2, To KK2, Chan JF2, Li C2, Zhu HS3, Li P2, Li C2, Chan TC3, Cheng VC2, Chan KH2, Yuen KY2.
Author information
Abstract
BACKGROUND:
Imiquimod, a synthetic Toll-like receptor 7-agonist enhanced immunogenicity of influenza vaccine in mouse model. We hypothesized that topical imiquimod before intradermal influenza vaccination (TIV) will produce similar effect in human.
METHODS:
We performed a prospective one-year follow-up double-blind randomized controlled trial on adults with co-morbidities. Subjects were randomized to one of the three vaccinations: topical 5% 250 mg imiquimod ointment followed by intradermal TIV (Intanza?15, Sanofi-Pasteur, France), or topical aqueous-cream followed by intradermal TIV, or topical aqueous-cream followed by intramuscular TIV (Vaxigrip?, Sanofi-Pasteur, France). Patients and investigators were blinded to the type of topical treatment applied. Hemagglutination inhibition (HI) and microneutralization antibody titers were measured. Primary outcome was day 7 seroconversion rate.
RESULTS:
Ninety-one recruited subjects completed the study. The median age was 73 years. On day 7, 27/30 (90%) patients who received imiquimod and intradermal TIV achieved seroconversion against the H1N1 strain by HI, compared to 4/30 (13.3%) who received aqueous-cream and intramuscular TIV (p<0.001) and 12/31 (38.7%) who received aqueous-cream and intradermal TIV (p<0.001). The seroconversion, seroprotection and geometric mean titre fold increase were met in all 3 strains in the imiquimod and intradermal TIV group two weeks earlier, and the better seroconversion rate was sustained from day 7 to year 1 (p≤0.001). The better immunogenicity was associated with less hospitalization for influenza or pneumonia (P<0.05). All adverse reactions were self-limited.
CONCLUSIONS:
Pretreatment with topical imiquimod significantly expedited, augmented and prolonged the immunogenicity of influenza vaccination. This strategy for influenza immunization should be considered in the elderly population.
? The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
PMID:
25048848
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/25048848