title: Immune response of 23-valent pneumococcal polysaccharide vaccinated elderly and its relation to frailty indices, nutritional status, and serum zinc levels.
abstract: OBJECTIVE
  To detect the immunoglobulin M memory B cell population response following vaccination with the 23-valent pneumococcal polysaccharide vaccine and determine its relation to frailty indices, nutritional status, and serum zinc levels.
  
  
  METHODS
  A cross-sectional study was carried out in the outpatient geriatric clinic, Ain Shams University Hospital. It included 80 community-dwelling elderly, 32 male and 48 female. Each participant underwent vaccination with the 23-valent pneumococcal polysaccharide vaccine, comprehensive geriatric assessment, nutritional assessment with the DETERMINE check list, frailty indices assessment, and serum zinc level measurement. The percentage of immunoglobulin M memory B cells was evaluated before and 4 weeks after vaccination. Immune response was calculated as the difference between cell percentage before and after vaccination.
  
  
  RESULTS
  Before the vaccination, the immunoglobulin M memory B cell percentage was significantly lower among those eating fewer than two meals a day and taking three or more drugs a day; after vaccination significance was observed among those with tooth or mouth problems that make eating difficult. Immune response was significantly lower among those with tooth or mouth problems (P < 0.001), weight loss (P < 0.001), shrinking (P = 0.001), poor endurance (P = 0.04), multiple comorbidities (P = 0.013), and cognitive impairment (P = 0.001). Participants with immune response ≥10% showed significantly higher serum zinc levels compared to those with immune response <10% of increase in cell percentage.
  
  
  CONCLUSIONS
  Poor nutritional status, frailty and a lower zinc level impair the immunological response of elderly individuals.
authors.affiliation: Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Hamza
authors.forename: Shereen M
authors.initials: SM
authors.lastname: Mousa
authors.forename: Shereen E
authors.initials: SE
authors.lastname: Taha
authors.forename: Lamiaa A
authors.initials: LA
authors.lastname: Adel
authors.forename: Hanan E
authors.initials: HE
authors.lastname: Samaha
authors.forename: Dalia A
authors.initials: DA
authors.lastname: Hussein
mesh_terms: D000368:Aged; D001402:B-Lymphocytes / Q000276:immunology*; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology*; D007156:Immunologic Memory / Q000276:immunology*; D008297:Male; D009752:Nutritional Status / Q000276:immunology*; D022242:Pneumococcal Vaccines / Q000276:immunology*; D015032:Zinc / Q000097:blood*
chemical_list: C414006:23-valent pneumococcal capsular polysaccharide vaccine; D007075:Immunoglobulin M; D022242:Pneumococcal Vaccines; D015032:Zinc