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dc.contributor.authorMohn, Kristin Greve-Isdahl
dc.description.abstractInfluenza causes great human morbidity and mortality from annual epidemics and pandemics occurring at irregular intervals. The socioeconomic impact of influenza is significant with 5% of adults and 20% of children infected, and 500 000 fatal cases globally each year. Elderly have the highest risk of fatal disease, while children are main transmitters of the virus and the youngest are most often hospitalized. Influenza is a vaccine preventable disease, but the vaccines require annual updating due to constant viral mutations, and they are only moderately effective. The immune system is vital in clearing influenza illness, and the mechanisms behind the complex immune response to the virus are not clear. Increased knowledge of these responses is required for the development of the much needed, improved future influenza vaccines. In this doctoral work we investigated the immunological mechanisms elicited in both vaccinated children and influenza infected adults. Two clinical studies were conducted and immune responses analysed. Firstly, we investigated the immunogenicity after vaccination with a live attenuated influenza vaccine (LAIV) in 55 children and controls. Evidence of early and durable LAIV induced responses was found in saliva, blood and tonsils, with responses both in the cellular and humoral immune compartments. This indicates a broad, protective response, where especially cellular responses are interesting. To our knowledge we are the first to show tonsillar responses after LAIV, and lasting cellular responses, up to one year. Saliva IgA is suggested as a possible, non-invasive correlate of immunogenicity after LAIV. Secondly, we dissected the immunological responses in adults infected during the 2009 influenza pandemic. Patients in the acute phase showed low levels of CD8+ T-cells compared to convalescent patients, and those with severe disease showed the highest levels of antibodies. CD8+ T-cells are vital for viral clearance, however there are few reports on responses from naturally infected patients. Differences in T-cell subsets may define disease severity. The multifaceted immune response induced by vaccination or infection indicates that T-cells are important in the immune defence against influenza and are therefore ideal targets for future influenza vaccines.en_US
dc.publisherThe University of Bergenen_US
dc.relation.haspartPaper I: Mohn K, Bredholt G, Brokstad K, Pathirana R, Tøndel C, Aarstad HJ, Cox RJ. Longevity of B & T cell responses after live attenuated influenza vaccination in children. The Journal of Infectious Diseases 2014, 15; 211(10):1541-9. The article is available at: <a href="" target="blank"></a>en_US
dc.relation.haspartPaper II: Mohn K, Brokstad K, Pathirana R, Bredholt G, Jul-Larsen Å, Trieu MC, Lartey SL, Montomoli, C. Tøndel, H.J. Aarstad and R.J. Cox. Live attenuated influenza vaccination in children induces B-cell responses in tonsils. The Journal of Infectious Diseases 2016, 214 (5): 722-731. The article is available at: <a href="" target="blank"></a>en_US
dc.relation.haspartPaper III: Mohn K, Cox RJ, Tunheim G, Berdal JE, Hauge AG, Jul-Larsen, Å, Norwegian Pandemic Group, Peters B, Oftung F, Jonassen CM, Mjaaland S. Immune responses in acute and convalescent patients with mild, moderate and severe disease during the 2009 influenza pandemic in Norway, PlosOne 2015, 10(11): e0143281. The article is available at: <a href="" target="blank"></a>en_US
dc.rightsNavngivelse-Ikkekommersiell 4.0 Internasjonal*
dc.titleImmune response to influenza after vaccination and infectionen_US
dc.typeDoctoral thesisen_US
dc.rights.holderCopyright the authoren_US

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Navngivelse-Ikkekommersiell 4.0 Internasjonal
Except where otherwise noted, this item's license is described as Navngivelse-Ikkekommersiell 4.0 Internasjonal