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Impact of Cytomegalovirus (CMV) seropositivity and microbiota profile on the immune/inflammatory response both systemic and in the upper airways of elderly vaccinated for respiratory diseases


Currently, the world is facing a pandemic caused by the new coronavirus SARS-CoV-2, which is associated with the disease called "coronavirus disease-2019" or COVID-19. More recently, in our country, an outbreak of influenza, caused by the H1N1 and H3N2 viruses, has increased the number of hospitalizations or even the demand for medical assistance. Among several aspects, both for COVID-19 and for influenza, it is known that the older adult population is not only the most affected population but also that it accounts for the highest number of deaths from these diseases. Studies suggest that the increase in the rate of infection, severity, and lethality by the SARS-CoV-2 and Influenza viruses in the older adult is associated with both the occurrence of immunosenescence and the "inflammaging" phenomenon. In this sense, it has been proposed that a microbiota with predominant pathogenic agents as well as the reactivation of infection by Cytomegalovirus (CMV), a herpes virus, may favor the development of immunosenescence, as this may be an important triggering factor of "inflammaging". It is worth noting that the literature points out that immunosenescence and "inflammaging" have a negative impact on the vaccine responses of older adults. Objective: Based on this data, we aim to investigate the impact of CMV seropositivity and of the microbiota profile on systemic and upper airway immune/inflammatory responses in older adults individuals vaccinated for COVID-19 and influenza.Methods: Two hundred (n=200) older adults seropositive (n=100) or not (n=100) for CMV, of both sexes, aged between 60 and 85 years, vaccinated against COVID-19 and influenza, will be invited to participate in this study. Blood, saliva, and feces samples will be obtained in two time-points: before and 30 days after vaccination for each type of virus. The samples will be used to confirm seropositivity and activation status of CMV infection, in addition to evaluating the concentrations of IgA, IgM, and IgG specific to SARS-CoV-2 and Influenza antigens, the cytokines associated with the profiles Th1, Th2, Th17, and T regulatory, as well as for immunophenotyping of TCD4+ and TCD8+ lymphocytes and monocyte subtypes (classical, intermediate and non-classical) and also the microbiome. (AU)

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