Abstract
Chronic immune activation has been considered as the driving force for CD4+ T cell depletion in people infected with HIV-1. Interestingly, the normal immune profile of adult HIV-negative individuals living in Africa also exhibit chronic immune activation, reminiscent of that observed in HIV-1 infected individuals. It is characterized by increased levels of soluble immune activation markers, such as the cytokines interleukin (IL)-4, IL-10, TNF-α, and cellular activation markers including HLA-DR, CD-38, CCR5, coupled with reduced naïve and increased memory cells in CD4+ and CD8+ subsets. In addition, it is accompanied by low CD4+ T cell counts when compared to Europeans. There is also evidence that mononuclear cells from African infants secrete less innate cytokines than South and North Americans and Europeans in vitro. Chronic immune activation in Africans is linked to environmental factors such as parasitic infections and could be responsible for previously observed immune hypo-responsiveness to infections and vaccines. It is unclear whether the immunogenicity and effectiveness of anti-SARS-CoV-2 vaccines will also be reduced by similar mechanisms. A review of studies investigating this phenomenon is urgently required as they should inform the design and delivery for vaccines to be used in African populations.
Highlights
CD4+ T cells play a pivotal role in the regulation of the immune system, protecting the host against various pathogens and autoimmunity [1]
We reviewed the potential influence of chronic immune activation or immune dysregulation and low CD4+ T cell count background against pathogens and vaccines on individuals residing in Africa
Systemic persistent immune activation has been considered as the driving force of CD4+ T cell depletion in people infected with HIV-1 [3]
Summary
CD4+ T cells play a pivotal role in the regulation of the immune system, protecting the host against various pathogens and autoimmunity [1]. CD4+ T cells, designated as T-helper (TH) cells, branch into five major subsets: TH1, TH2, TH17, follicular T helper (TFH) and regulatory T cells (Treg) CD4+ T cells [1]. These different subsets of TH cells are differentiated by the expression of different lineage markers and transcription factors as well as the production of different cytokines. We reviewed the potential influence of chronic immune activation or immune dysregulation and low CD4+ T cell count background against pathogens and vaccines on individuals residing in Africa. We discuss the potential role of altered immune responses that may impact on SARS-CoV-2 vaccine efficacy
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