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Immunization of preterm infants: current evidence and future strategies to individualized approaches

Preterm infants are at particularly high risk for infectious diseases. As this vulnerability extends beyond the neonatal period into childhood and adolescence, preterm infants benefit greatly from infection-preventive measures such as immunizations. However, there is an ongoing discussion about vacc...

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Autores principales: Fortmann, Mats Ingmar, Dirks, Johannes, Goedicke-Fritz, Sybelle, Liese, Johannes, Zemlin, Michael, Morbach, Henner, Härtel, Christoph
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9362650/
https://www.ncbi.nlm.nih.gov/pubmed/35922638
http://dx.doi.org/10.1007/s00281-022-00957-1
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author Fortmann, Mats Ingmar
Dirks, Johannes
Goedicke-Fritz, Sybelle
Liese, Johannes
Zemlin, Michael
Morbach, Henner
Härtel, Christoph
author_facet Fortmann, Mats Ingmar
Dirks, Johannes
Goedicke-Fritz, Sybelle
Liese, Johannes
Zemlin, Michael
Morbach, Henner
Härtel, Christoph
author_sort Fortmann, Mats Ingmar
collection PubMed
description Preterm infants are at particularly high risk for infectious diseases. As this vulnerability extends beyond the neonatal period into childhood and adolescence, preterm infants benefit greatly from infection-preventive measures such as immunizations. However, there is an ongoing discussion about vaccine safety and efficacy due to preterm infants’ distinct immunological features. A significant proportion of infants remains un- or under-immunized when discharged from primary hospital stay. Educating health care professionals and parents, promoting maternal immunization and evaluating the potential of new vaccination tools are important means to reduce the overall burden from infectious diseases in preterm infants. In this narrative review, we summarize the current knowledge about vaccinations in premature infants. We discuss the specificities of early life immunity and memory function, including the role of polyreactive B cells, restricted B cell receptor diversity and heterologous immunity mediated by a cross-reactive T cell repertoire. Recently, mechanistic studies indicated that tissue-resident memory (Trm) cell populations including T cells, B cells and macrophages are already established in the fetus. Their role in human early life immunity, however, is not yet understood. Tissue-resident memory T cells, for example, are diminished in airway tissues in neonates as compared to older children or adults. Hence, the ability to make specific recall responses after secondary infectious stimulus is hampered, a phenomenon that is transcriptionally regulated by enhanced expression of T-bet. Furthermore, the microbiome establishment is a dominant factor to shape resident immunity at mucosal surfaces, but it is often disturbed in the context of preterm birth. The proposed function of Trm T cells to remember benign interactions with the microbiome might therefore be reduced which would contribute to an increased risk for sustained inflammation. An improved understanding of Trm interactions may determine novel targets of vaccination, e.g., modulation of T-bet responses and facilitate more individualized approaches to protect preterm babies in the future. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00281-022-00957-1.
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spelling pubmed-93626502022-08-10 Immunization of preterm infants: current evidence and future strategies to individualized approaches Fortmann, Mats Ingmar Dirks, Johannes Goedicke-Fritz, Sybelle Liese, Johannes Zemlin, Michael Morbach, Henner Härtel, Christoph Semin Immunopathol Review Preterm infants are at particularly high risk for infectious diseases. As this vulnerability extends beyond the neonatal period into childhood and adolescence, preterm infants benefit greatly from infection-preventive measures such as immunizations. However, there is an ongoing discussion about vaccine safety and efficacy due to preterm infants’ distinct immunological features. A significant proportion of infants remains un- or under-immunized when discharged from primary hospital stay. Educating health care professionals and parents, promoting maternal immunization and evaluating the potential of new vaccination tools are important means to reduce the overall burden from infectious diseases in preterm infants. In this narrative review, we summarize the current knowledge about vaccinations in premature infants. We discuss the specificities of early life immunity and memory function, including the role of polyreactive B cells, restricted B cell receptor diversity and heterologous immunity mediated by a cross-reactive T cell repertoire. Recently, mechanistic studies indicated that tissue-resident memory (Trm) cell populations including T cells, B cells and macrophages are already established in the fetus. Their role in human early life immunity, however, is not yet understood. Tissue-resident memory T cells, for example, are diminished in airway tissues in neonates as compared to older children or adults. Hence, the ability to make specific recall responses after secondary infectious stimulus is hampered, a phenomenon that is transcriptionally regulated by enhanced expression of T-bet. Furthermore, the microbiome establishment is a dominant factor to shape resident immunity at mucosal surfaces, but it is often disturbed in the context of preterm birth. The proposed function of Trm T cells to remember benign interactions with the microbiome might therefore be reduced which would contribute to an increased risk for sustained inflammation. An improved understanding of Trm interactions may determine novel targets of vaccination, e.g., modulation of T-bet responses and facilitate more individualized approaches to protect preterm babies in the future. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00281-022-00957-1. Springer Berlin Heidelberg 2022-08-03 2022 /pmc/articles/PMC9362650/ /pubmed/35922638 http://dx.doi.org/10.1007/s00281-022-00957-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Review
Fortmann, Mats Ingmar
Dirks, Johannes
Goedicke-Fritz, Sybelle
Liese, Johannes
Zemlin, Michael
Morbach, Henner
Härtel, Christoph
Immunization of preterm infants: current evidence and future strategies to individualized approaches
title Immunization of preterm infants: current evidence and future strategies to individualized approaches
title_full Immunization of preterm infants: current evidence and future strategies to individualized approaches
title_fullStr Immunization of preterm infants: current evidence and future strategies to individualized approaches
title_full_unstemmed Immunization of preterm infants: current evidence and future strategies to individualized approaches
title_short Immunization of preterm infants: current evidence and future strategies to individualized approaches
title_sort immunization of preterm infants: current evidence and future strategies to individualized approaches
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9362650/
https://www.ncbi.nlm.nih.gov/pubmed/35922638
http://dx.doi.org/10.1007/s00281-022-00957-1
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