title: Influenza infection in human host: challenges in making a better influenza vaccine.
abstract: Influenza is a ubiquitous infection with a spectrum ranging from mild to severe. The mystery regarding such variability in the clinical spectrum has not been fully unravelled, although a role for the complex interplay among virus characteristics, host immune response and environmental factors has been suggested. Antivirals and current vaccines have a limited role in prophylaxis and treatment because they primarily target surface glycoproteins which undergo antigenic/genetic changes under host immune pressure. Targeting conserved internal proteins could lead the way to a universal vaccine which can be used against various types/subtypes. However, this is on the distant horizon, so in the meantime, developing improved vaccines should be given high priority. In this review, we discuss where the current influenza research stands in terms of vaccines, adjuvants, and how we can better predict the vaccine strains for upcoming influenza seasons by understanding complex phenomena which drive the continuous antigenic evolution.
authors.affiliation: a Department of Medicine , National University of Singapore , Singapore.
authors.forename: Ramandeep Kaur
authors.initials: RK
authors.lastname: Virk
authors.affiliation: b Bioinformatics Institute (BII), Agency for Science Technology and Research (A*STAR) , Singapore.
authors.forename: Vithiagaran
authors.initials: V
authors.lastname: Gunalan
authors.affiliation: a Department of Medicine , National University of Singapore , Singapore.
authors.forename: Paul Anantharajah
authors.initials: PA
authors.lastname: Tambyah
mesh_terms: D000276:Adjuvants, Immunologic / Q000592:standards; D054884:Host-Pathogen Interactions; D006801:Humans; D007110:Immunity, Active; D007113:Immunity, Innate; D007252:Influenza Vaccines / Q000592:standards*; D007251:Influenza, Human / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control* / Q000821:virology*; D012621:Seasons
chemical_list: D000276:Adjuvants, Immunologic; D007252:Influenza Vaccines
keywords: Influenza; adaptive immune response; adjuvants; antigenic evolution; antigenic sites; heterosubtypic immunity; influenza proteins; innate immune response; universal vaccine; vaccine mismatch