THE USE OF ORAL DEHYDROEPIANDROSTERONE-SULFATE AS AN ADJUVANT IN TETANUS AND INFLUENZA VACCINATION OF THE ELDERLY

Elderly individuals often exhibit a poorer immune response and shorter duration of immunity to vaccines than younger persons. Improvement in vaccine response has been demonstrated when administering the hormone dehyroepiandrosterone sulfate (DHEAS) as an adjuvant in animal trials . Two separate, randomized double-blinded vaccine trials were therefor e conducted using DHEAS as an oral adjuvant in individuals age 65 or o lder. Sixty-six individuals were randomized to DHEAS 50 mg po bid for 4 days, or a placebo capsule. Tetanus vaccination was given immediatel y before the fifth dose. At entry the level of protective antibody was age-dependent (P = 0.009), and by 28 days postvaccination most indivi duals had protective levels of antibody, with no difference noted betw een treatment groups. In the second study, 67 individuals received pla cebo capsules or DHEAS immediately before and 24 h after influenza vac cination. The number of individuals who developed protective titers (g reater than or equal to 1.40) was not different in the two groups. The mean log increase in HAI response was greater in the DHEAS group to a ll three vaccine components, although this did not achieve significanc e. Minimal side-effects of DHEAS administration were noted. Given the trend toward improved response in the elderly to influenza, larger tri als using DHEA as an adjuvant in vaccines that are neoantigens may be indicated. Copyright (C) 1996 Elsevier Science Ltd.