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Infections caused by SARS-CoV-2 induce a severe acute respiratory syndrome called COVID-19 and have led to more than six million deaths worldwide. Vaccination is the most effective preventative measure, and cellular and humoral immunity is crucial to developing individual protection. Here, we aim to investigate hybrid immunity against SARS-CoV-2 triggered by the ChAadOx1 nCoV-19 vaccine in a Brazilian cohort. We investigated the immune response from ChAadOx1 nCoV-19 vaccination in naïve (noCOVID-19) and previously infected individuals (COVID-19) by analyzing levels of D-dimers, total IgG, neutralizing antibodies (Nabs), IFN-γ (interferon-γ) secretion, and immunophenotyping of memory lymphocytes. No significant differences in D-dimer levels were observed 7 or 15 days after vaccination (DAV). All vaccinated individuals presented higher levels of total IgG or Nabs with a positive correlation (R = 0.88). Individuals in the COVID-19 group showed higher levels of antibody and memory B cells, with a faster antibody response starting at 7 DAV compared to noCOVID-19 at 15 DAV. Further, ChAadOx1 nCoV-19 vaccination led to enhanced IFN-γ production (15 DAV) and an increase in activated T CD4+ naïve cells in noCOVID-19 individuals in contrast with COVID-19 individuals. Hence, our data support that hybrid immunity triggered by ChAadOx1 nCoV-19 vaccination is associated with enhanced humoral response, together with a balanced cellular response.

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INTRODUCTION AND OBJECTIVES: Primary immunodeficiency diseases (PIDs) are disorders associated mainly with recurrent and severe infection and an increase in susceptibility to autoimmune conditions and cancer. In Venezuela, PIDs are underdiagnosed and there is usually a delay in their diagnosis. Hence there are no data concerning the frequency and type of PIDs that occur. The aim of this study was to identify and quantify the types of PIDs that occur in Merida, a population within Venezuela. PATIENTS OR MATERIALS AND METHODS: Following an informative program designed to alert local health professionals to the warning signs for PIDs, patients with a history of recurrent infections were referred to the Instituto de Inmunologia Clinica, Universidad de Los Andes. RESULTS AND CONCLUSIONS: During the three-year period January 2014 to January 2017, thirty-two cases of PIDs were identified in pediatric patients, and 17 different types of PIDs, were identified. Predominantly antibody deficiencies were most frequent (40.6%), followed by immunodeficiencies affecting cellular and humoral immunity (21.8%), congenital defects of phagocyte (18.7%), CID with associated or syndromic features (9.3%), defects in intrinsic and innate immunity (6.4%) and diseases of immune dysregulation (3.2%). These results have important implications not only to the future approach for management of patients in our regions, but add important knowledge concerning PIDs in Latin America and worldwide.

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Measles virus (MeV) represents one of the main causes of death among young children, particularly in developing countries. Upon infection, MeV controls both interferon induction (IFN) and the interferon signaling pathway which results in a severe host immunosuppression that can persists for up to 6 mo after infection. Despite the global biology of MeV infection is well studied, the role of the plasmacytoid dendritic cells (pDCs) during the host innate immune response after measles vaccination remains largely uncharacterized. Here we investigated the role of pDCs, the major producers of interferon in response to viral infections, in the development of adaptive immune response against MeV vaccine. We report that there is a strong correlation between pDCs population and the humoral immune response to Edmonston Zagreb (EZ) measles vaccination in 9-month-old mexican infants. Five infants were further evaluated after vaccination, showing a clear increase in pDCs at baseline, one week and 3 months after immunization. Three months postvaccination they showed increase in memory T-cells and pDCs populations, high induction of adaptive immunity and also observed a correlation between pDCs number and the humoral immune response. These findings suggest that the development and magnitude of the adaptive immune response following measles immunization is directly dependent on the number of pDCs of the innate immune response.

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Introducción: el trauma provoca importantes alteraciones inmunitarias que, de no ser corregidas, conllevan a complicaciones y muerte. Objetivo: evaluar el índice predictivo Trauma Injury Severity Score (TRISS) como predictor del estado de la proteína C reactiva y como parte de la respuesta inmune al trauma. Métodos: se realizó un estudio prospectivo y analítico en 55 lesionados, ingresados en el Hospital Militar Central "Dr. Luis Díaz Soto" entre los años 2005 y 2008. Se efectuaron pruebas inmunológicas. Las variables inmunológicas, la probabilidad de sobrevida-TRISS, las complicaciones y el estado al egreso fueron las más importantes. Se emplearon diferentes métodos estadísticos. Resultados: En la medida en que disminuyó la probabilidad de sobrevida, según el TRISS, se incrementaron los valores séricos de la proteína C reactiva. Las alteraciones inmunológicas fueron más intensas en los fallecidos y los de peor pronóstico. Las mayores afectaciones inmunitarias se produjeron durante la primera semana. Conclusiones: Las alteraciones inmunitarias, y dentro de ellas las relacionadas con la proteína de fase aguda, proteína C reactiva, aumentan en la medida en que disminuye la probabilidad de sobrevida; esto reafirma el valor predictor del TRISS en la valoración integral de los lesionados.

Introduction: the trauma provokes immunity which if are not corrected, leads to complications and death. Objective: to assess the "trauma injury severity score" predictive index (TRISS) as a predictor of status of the reactive C protein and as part of the immune response to trauma. Methods: an analytical and prospective study was conducted in 55 injured, admitted in the "Dr. Luis Díaz Soto" Central Military Hospital between 2005 and 2008. Immunologic tests were made. Immunological variables, the survival-TRISS probability, complications and the status at discharge were the more important. Results: insofar as the survival probability decreases according TRISS, the serum values of the reactive C protein increased. Immunological alterations were more intensive in the deceased ones and in those with a poor prognosis. The great immunity alterations occurred over the first week. Conclusions: the immunity alterations and within them, those related to acute phase protein, the reactive C protein increase insofar as the survival probability decrease confirming the predictor value of TRISS in the integral assessment of injured patients.

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Introducción: las tendencias y proyecciones actuales con respecto a los traumatismos indican que estos se convertirán en una crisis mundial de salud pública. Objetivo: evaluar la utilidad del índice predictivo Trauma Injury Severity Score (TRISS), como predictor de las alteraciones en las subpoblaciones linfocitarias CD3+ en los lesionados. Métodos: se realizó un estudio prospectivo y analítico en 55 pacientes traumatizados, ingresados en el Hospital Militar Central Dr. Luis Díaz Soto entre los años 2005 y 2008. Se efectuaron pruebas inmunológicas. Las variables inmunológicas, la probabilidad de sobrevida-TRISS, las complicaciones y el estado al egreso fueron las más importantes. Se emplearon diferentes métodos estadísticos. Resultados: Predominaron las complicaciones infecciosas. En los fallecidos, la depleción inmunitaria fue la más significativa. En la medida en que disminuyó la probabilidad de sobrevida, según el índice predictivo TRISS, se afectaron las poblaciones de linfocitos CD3+. Las alteraciones inmunológicas fueron más intensas en los fallecidos y los de peor pronóstico. Las mayores afectaciones inmunitarias se produjeron durante la primera semana. Conclusiones: las alteraciones en la inmunidad celular de los traumatizados tienen relación directa con la gravedad de las lesiones y afectan la probabilidad de sobrevida de los pacientes, según el índice predictivo TRISS; esto confirma su valor predictor en la valoración integral de este tipo de lesionado

Introduction: the current trends and projections regarding traumata demonstrate that they become a public health world crisis. Objective: to assess the usefulness of the trauma injury severity score (TRISS) predictive index as predictor index of alterations in the subpopulations of CD3+ lymphocytes in injured patients. Methods: an analytic and prospective study was conducted in 55 patients with trauma admitted in the Luís Díaz Soto Central Military Hospital between 2005 and 2008. Immunologic tests were carried out. The immunologic variables, TRISS-survival probability, complications and the status at discharge were the more important ones. Different statistic methods were used. Results: there was predominance of infectious complications. In the deceased ones, the immunity depletion was the more significant. Insofar as the survival probability decreased, according to the TRISS-predictive index, the CD3+ lymphocyte populations were affected. The immunological alterations were more intensive in the deceased patients and in those with a poor prognosis. The major immune affections appeared during the first week. Conclusions: the cellular immunity alterations of the traumatized patients have a direct relation to the severity of injuries affecting the survival probability of patients, according to the TRISS predictive index, confirming its predictor value in the integral assessment of this type of injured patient

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Durante los últimos decenios, el trauma ha sido la principal causa de muerte en personas menores de 45 años de edad. Como expresión del avance de las investigaciones en el campo de la traumatología, hoy día se le presta cada vez mayor interés al análisis y comprensión de los procesos inmunológicos que repercuten en la evolución y enfrentamiento del organismo a las lesiones, que determinan el pronóstico final de estos pacientes al influir, inexorablemente, en la aparición de complicaciones, sobre todo de tipo infecciosas, como causas fundamentales de las llamadas muertes tardías como consecuencia del trauma. Las características y los elementos fundamentales que conforman el sistema inmune, la estrecha relación que existe entre los diferentes componentes del llamado sistema integrador psico-neuro-inmuno-endocrino y su función frente al estrés, así como el estado de disfunción inmunitaria luego de un daño severo, se evidencian con el objetivo de profundizar en el estudio de los fenómenos que caracterizan las alteraciones inmunitarias luego del trauma. Para ello se realizó una revisión, a partir de índices referativos impresos, revistas y textos nacionales e internacionales de actualidad, que tratan el tema. Se concluye, que los traumatismos inducen inmunosupresión e hiperactivación, por lo que la inmunomodulación debería incluir no solo la restauración de respuestas inmunitarias deprimidas, sino también la regulación de respuestas inmunitarias exageradas cuando sea necesario

During past decades, trauma has been the major cause of death in persons aged under 45. As an expression of advance of researches in the field of traumatology, nowadays there is more interest in the analysis and comprehension of immunologic processes with repercussion in course and confrontation of organism to injuries, determining the final prognosis of these patients influencing inexorably in the appearance of complications, mainly of infectious type, as major causes of the so called late deaths due to trauma. The characteristic and the main elements conforming the immune system, the close relation among the different components of the called psycho-neuro-immune-endocrine integration system and its function in face of stress, as well as the immune dysfunction after a severe damage are evidenced to deepen in the study of phenomena characterizing the immune alterations after a trauma. Thus, authors carried out a revision from the printed reference indexes, journals and national and international updated texts on this subject. We conclude that traumata lead to immunosuppression and hyperactivation, thus the immunomodulation must to includes not only the restoration of depressed immune responses, but also the regulation of exaggerated immune responses when it is necessary

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La agresión traumática da lugar a importantes procesos metabólicos, proporcionales con la intensidad de la agresión sufrida, y aunque estos son más evidentes en las dos primeras semanas tras el trauma, suelen persistir y exigen un adecuado soporte nutricional. Se describen las características y las diferentes fases de la respuesta sistémica al trauma. También se hace referencia a la interacción neuro-endocrino-inmunitaria en la respuesta y a las consecuencias metabólicas posteriores a la lesión, que fueron determinadas mediante la revisión actualizada de documentos y revistas nacionales e internacionales, con el objetivo de profundizar en el estudio de las principales alteraciones metabólicas que desencadena el trauma. Las capacidades del organismo para poder sobrevivir, cuando ocurre un trauma importante, pueden ser insuficientes, de ahí la necesidad de apoyo, que resulta decisiva. Comprender los elementos descritos en la respuesta inmunometabólica y la complicación séptica, se consideran vitales, así como el control de las alteraciones posteriores a la injuria

Traumatic aggression leads to significant metabolic processes, in proportion to the intensity of the aggression suffered, and although these are more obvious in the first weeks after trauma, they remain and demand an appropriate nutritional support. The characteristics and the different phases of systemic response to trauma are described. Also, authors make reference to the interaction neuro-endocrine-immune in the response and to the metabolic consequences after injury, determined by means of the updated revision of documents and of national and international journals to deepen in the study of the major metabolic alterations triggering the trauma. The abilities of the organism to survive, when occur a significant trauma, may be enough, hence the need of support which is decisive. To understand the elements described in the immuno-metabolic response and the septic complication, are vital, as well as the control of alterations after injury

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