近日，Clinical Infectious Diseases刊登最新研究文章，研究發(fā)現(xiàn)，患有抑郁癥的老年人，其接種的帶狀皰疹疫苗效力會有所下降。帶狀皰疹是由水痘-帶狀皰疹病毒復(fù)發(fā)引起的神經(jīng)系統(tǒng)疾病，老年人是帶狀皰疹的高發(fā)人群，美國每年有超過一百萬新發(fā)病例。帶狀皰疹疫苗可增強(qiáng)細(xì)胞免疫力，降低發(fā)病可能，緩解發(fā)病癥狀。
    原文：Varicella Zoster Virus–Specific Immune Responses to a Herpes Zoster Vaccine in Elderly Recipients With Major Depression and the Impact of Antidepressant Medications
    Author: Michael R. Irwin, Myron J. Levin, Mark L. Laudenslager, Richard Olmstead, Anne Lucko, Nancy Lang, Carmen Carrillo, Harold A. Stanley, Michael J. Caulfield, Adriana Weinberg, Ivan S. F. Chan, Jim Clair, Jeff G. Smith, R. D. Marchese, Heather M. Williams, Danielle J. Beck, Patricia T. McCook, Jane H. Zhang, Gary Johnson, Michael N. Oxman
    Background: The Depression Substudy of the Shingles Prevention Study (SPS) was designed to evaluate the association between major depression and immune responses to a high-titer live attenuated varicella zoster virus (VZV) vaccine (zoster vaccine), which boosts cell-mediated immunity (CMI) to VZV and decreases the incidence and severity of herpes zoster (HZ). The Depression Substudy was a 2-year longitudinal cohort study in 92 community-dwelling adults ≥60 years of age who were enrolled in the SPS, a large, double-blind, placebo-controlled Veterans Affairs Cooperative zoster vaccine efficacy study.
    Methods: Forty subjects with major depressive disorder, stratified by use of antidepressant medications, and 52 age- and sex-matched controls with no history of depression or other mental illness had their VZV-CMI measured prior to vaccination with zoster vaccine or placebo and at 6 weeks, 1 year, and 2 years postvaccination.
    Results: Depressed subjects who were not treated with antidepressant medications had lower levels of VZV-CMI following administration of zoster vaccine than nondepressed controls or depressed subjects receiving antidepressants even when antidepressant medications failed to alter depressive symptom severity (P < .005).Similar results were obtained taking into account the time-varying status of depression and use of antidepressant medications, as well as changes in depressive symptoms, during the postvaccination period.
    Conclusions: Depressed patients have diminished VZV-CMI responses to zoster vaccine, and treatment with antidepressant medication is associated with normalization of these responses. Because higher levels of VZV-CMI correlate with lower risk and severity of HZ, untreated depression may increase the risk and severity of HZ and reduce the efficacy of zoster vaccine.
    (原文：http://cid.oxfordjournals.org/content/early/2013/02/12/cid.cis1208.full)