title: Co-administration of l-cystine and l-theanine enhances efficacy of influenza vaccination in elderly persons: nutritional status-dependent immunogenicity.
abstract: OBJECTIVE
  The immune response to influenza vaccine is attenuated in elderly persons, though they are at greatest risk for morbidity and mortality by influenza virus infection. Experimental studies demonstrate that co-administration of l-cystine and l-theanine enhanced antigen-specific production of immunoglobulin in aged mice infected with influenza virus. We thus investigated the effect of l-cystine and l-theanine on antibody induction by influenza vaccines in elderly persons.
  
  
  METHODS
  Residents in a nursing home were randomly allocated to l-cystine and l-theanine (n = 32) or placebo (n = 33). The test substances were administered p.o. for 14 days before immunization. Serum influenza virus antibody titers were measured before and 4 weeks after vaccination.
  
  
  RESULTS
  Vaccination significantly elevated hemagglutination inhibition (HI) titers for all the three strains of influenza viruses (A/New Caledonia [H1N1], A/New York [H3N2] and B/Shanghai) in both groups. HI titers after vaccination were not significantly different between the two groups for either strain. Also, the seroconversion rate was not significantly different between the two groups in the aggregate. A stratified analysis showed that the rate of seroconversion was significantly greater in the l-cystine and l-theanine group compared with the placebo group for influenza virus A (H1N1) among subjects with low serum total protein (63% vs 10%, P < 0.05) or low hemoglobin (71% vs 9%, P < 0.05).
  
  
  CONCLUSIONS
  Co-administration of l-cystine and l-theanine before vaccination may enhance the immune response to influenza vaccine in elderly subjects with low serum total protein or hemoglobin.
authors.affiliation: Department of Internal Medicine, Nagoya Kosein Hospital, Nagoya, Japan. miyagawa@sc.starcat.ne.jp
authors.forename: Koichi
authors.initials: K
authors.lastname: Miyagawa
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Kurihara
authors.forename: Akiko
authors.initials: A
authors.lastname: Maeda
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000276:immunology; D003553:Cystine / Q000008:administration & dosage*; D019587:Dietary Supplements; D004359:Drug Therapy, Combination; D005260:Female; D016330:Frail Elderly; D005971:Glutamates / Q000008:administration & dosage*; D006707:Homes for the Aged; D006801:Humans; D007019:Hypoproteinemia / Q000276:immunology; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology; D053122:Influenza A Virus, H3N2 Subtype / Q000276:immunology; D009981:Influenza B virus / Q000276:immunology; D007252:Influenza Vaccines / Q000276:immunology*; D008297:Male; D009735:Nursing Homes
chemical_list: D005971:Glutamates; D007252:Influenza Vaccines; D003553:Cystine; C026166:theanine