{"id":41464,"date":"2020-02-11T12:07:54","date_gmt":"2020-02-11T09:07:54","guid":{"rendered":"https:\/\/prohoster.info\/blog\/blog_prohoster\/immunnyj-imprinting-v-detstve-proishozhdenie-zashhity-ot-virusov"},"modified":"2020-02-11T12:07:54","modified_gmt":"2020-02-11T09:07:54","slug":"immunnyj-imprinting-v-detstve-proishozhdenie-zashhity-ot-virusov","status":"publish","type":"post","link":"https:\/\/prohoster.info\/cs\/blog\/immunnyj-imprinting-v-detstve-proishozhdenie-zashhity-ot-virusov","title":{"rendered":"Imunitn\u00ed imprinting v d\u011btstv\u00ed: p\u016fvod ochrany proti vir\u016fm","gt_translate_keys":[{"key":"rendered","format":"text"}]},"content":{"rendered":"

\"Imunitn\u00ed
\n
\nT\u00e9m\u011b\u0159 ka\u017ed\u00fd z n\u00e1s sly\u0161el nebo \u010detl zpr\u00e1vy o \u0161\u00ed\u0159\u00edc\u00edm se koronaviru. Stejn\u011b jako v p\u0159\u00edpad\u011b jak\u00e9koli jin\u00e9 nemoci je v boji proti nov\u00e9mu viru d\u016fle\u017eit\u00e1 v\u010dasn\u00e1 diagnostika. Nicm\u00e9n\u011b, ne ka\u017ed\u00fd naka\u017een\u00fd vykazuje stejnou sadu p\u0159\u00edznak\u016f a dokonce ani skenery na leti\u0161t\u00edch, ur\u010den\u00e9 k odhalen\u00ed zn\u00e1mek infekce, ne v\u017edy \u00fasp\u011b\u0161n\u011b identifikuj\u00ed nemocn\u00e9ho mezi davem cestuj\u00edc\u00edch. Vznik\u00e1 ot\u00e1zka \u2014 pro\u010d se ten sam\u00fd virus projevuje u r\u016fzn\u00fdch lid\u00ed r\u016fzn\u011b? Samoz\u0159ejm\u011b, prvn\u00ed odpov\u011b\u010f \u2014 imunitn\u00ed syst\u00e9m. To v\u0161ak nen\u00ed jedin\u00fd d\u016fle\u017eit\u00fd parametr, kter\u00fd ovliv\u0148uje variabilitu symptom\u016f a z\u00e1va\u017enost prob\u00edhaj\u00edc\u00ed nemoci. V\u011bdci z Kalifornsk\u00e9 a Arizonsk\u00e9 univerzity (USA) zjistili, \u017ee s\u00edla odolnosti v\u016f\u010di vir\u016fm z\u00e1vis\u00ed nejen na tom, jak\u00fdmi podtypy ch\u0159ipky \u010dlov\u011bk onemocn\u011bl b\u011bhem \u017eivota, ale tak\u00e9 na jejich sekvenci. Co p\u0159esn\u011b v\u011bdci zjistili, jak\u00e9 metody byly pou\u017eity v t\u00e9to studii a jak m\u016f\u017ee tato pr\u00e1ce pomoci v boji proti epidemi\u00edm? Odpov\u011bdi na tyto ot\u00e1zky nalezneme ve zpr\u00e1v\u011b v\u00fdzkumn\u00e9 skupiny. Jdeme na to.<\/a><\/noindex><\/p>\n

Z\u00e1klad v\u00fdzkumu<\/h3>\n

\nJak v\u00edme, ch\u0159ipka se u r\u016fzn\u00fdch lid\u00ed projevuje r\u016fzn\u011b. Krom\u011b lidsk\u00e9ho faktoru (imunitn\u00ed syst\u00e9m, u\u017e\u00edv\u00e1n\u00ed antivirotik, preventivn\u00ed opat\u0159en\u00ed atd.) je d\u016fle\u017eit\u00fdm aspektem samotn\u00fd virus, konkr\u00e9tn\u011b jeho podtyp, kter\u00fdm je infikov\u00e1n dan\u00fd pacient. Ka\u017ed\u00fd podtyp m\u00e1 sv\u00e9 vlastn\u00ed zvl\u00e1\u0161tnosti, v\u010detn\u011b stupn\u011b posti\u017een\u00ed r\u016fzn\u00fdch demografick\u00fdch skupin. V\u011bdci uv\u00e1d\u011bj\u00ed, \u017ee viry H1N1 (\"prase\u010d\u00ed ch\u0159ipka\") a H3N2 (hongkongsk\u00e1 ch\u0159ipka), kter\u00e9 se v sou\u010dasnosti staly nejroz\u0161\u00ed\u0159en\u011bj\u0161\u00edmi, r\u016fzn\u00fdm zp\u016fsobem postihuj\u00ed lidi r\u016fzn\u00e9ho v\u011bku: H3N2 je p\u0159\u00ed\u010dinou v\u011bt\u0161iny t\u011b\u017ek\u00fdch p\u0159\u00edpad\u016f nemoci u star\u0161\u00edch osob, p\u0159i\u010d\u00edt\u00e1 se mu tak\u00e9 v\u011bt\u0161ina smrteln\u00fdch p\u0159\u00edpad\u016f; H1N1 je m\u00e9n\u011b smrteln\u00fd, ale nej\u010dast\u011bji postihuje lidi st\u0159edn\u00edho v\u011bku a ml\u00e1de\u017e. <\/p>\n

Takov\u00e9 rozd\u00edly mohou b\u00fdt zp\u016fsobeny jak rozd\u00edlem v rychlosti evoluce samotn\u00fdch vir\u016f, tak i rozd\u00edlem v imunitn\u00edm imprintingu*<\/i> u d\u011bt\u00ed.<\/p>\n

Imunitn\u00ed imprinting*<\/b> je jak\u00e1si dlouhodob\u00e1 pam\u011b\u0165 imunitn\u00edho syst\u00e9mu, formovan\u00e1 na z\u00e1klad\u011b pro\u017eit\u00fdch virov\u00fdch \u00fatok\u016f na organismus a jeho reakc\u00ed na n\u011b.<\/p><\/blockquote>\n

V t\u00e9to studii v\u011bdci provedli anal\u00fdzu epidemiologick\u00fdch dat, aby zjistili, zda imprinting v d\u011btstv\u00ed ovliv\u0148uje epidemiologii sez\u00f3nn\u00ed ch\u0159ipky a pokud ano, zda p\u016fsob\u00ed p\u0159edev\u0161\u00edm prost\u0159ednictv\u00edm homosubtypick\u00e9*<\/i> imunitn\u00ed pam\u011bti nebo prost\u0159ednictv\u00edm \u0161ir\u0161\u00ed heterosubtypick\u00e9*<\/i> pam\u011bti.<\/p>\n

Homosubtypick\u00e1 imunita*<\/b> \u2014 infekce sez\u00f3nn\u00edmi viry ch\u0159ipky A p\u0159isp\u00edv\u00e1 k rozvoji imunologick\u00e9 ochrany proti konkr\u00e9tn\u00edmu podtypu viru.<\/p><\/blockquote>\n

Heterosubtypick\u00e1 imunita* <\/b> \u2014 infekce sez\u00f3nn\u00edmi viry ch\u0159ipky A p\u0159isp\u00edv\u00e1 k rozvoji imunologick\u00e9 ochrany proti nesouvisej\u00edc\u00edm sub-\u0161tam\u016fm.<\/p><\/blockquote>\n

Jin\u00fdmi slovy, d\u011btsk\u00e1 imunita a v\u0161e, co si pro\u0161la, zanech\u00e1v\u00e1 sv\u016fj otisk v imunit\u011b po cel\u00fd \u017eivot. D\u0159\u00edve proveden\u00e9 studie uk\u00e1zaly, \u017ee dosp\u011bl\u00ed lid\u00e9 maj\u00ed siln\u011bj\u0161\u00ed imunitu v\u016f\u010di t\u011bm typ\u016fm vir\u016f, kter\u00fdmi byli infikov\u00e1ni v d\u011btstv\u00ed. Tak\u00e9 bylo ned\u00e1vno zji\u0161t\u011bno, \u017ee imprinting chr\u00e1n\u00ed p\u0159ed nov\u00fdmi podtypy viru pta\u010d\u00ed ch\u0159ipky t\u00e9\u017ee fylogenetick\u00e9 skupiny hemaglutinin (hemaglutinin<\/i>, HA), tak jak p\u0159i prvn\u00edm naka\u017een\u00ed v d\u011btstv\u00ed. <\/p>\n

A\u017e do ned\u00e1vn\u00e9 doby byl \u00fazk\u00fd k\u0159\u00ed\u017eov\u00fd ochrann\u00fd imunitn\u00ed syst\u00e9m, specifick\u00fd pro varianty jednoho podtypu HA, pova\u017eov\u00e1n za hlavn\u00ed zp\u016fsob ochrany proti sez\u00f3nn\u00ed ch\u0159ipce. Existuj\u00ed v\u0161ak nov\u00e9 \u00fadaje, kter\u00e9 tvrd\u00ed, \u017ee na formov\u00e1n\u00ed imunity m\u016f\u017ee m\u00edt vliv i pam\u011b\u0165 dal\u0161\u00edch antigen\u016f ch\u0159ipky (nap\u0159\u00edklad neuraminid\u00e1zy, NA). Od roku 1918 byly u lid\u00ed zaznamen\u00e1ny t\u0159i podtypy HA: H1, H2 a H3. P\u0159i\u010dem\u017e H1 a H2 pat\u0159\u00ed do fylogenetick\u00e9 skupiny 1, zat\u00edmco H3 je skupina 2.<\/p>\n

Pokud vezmeme v \u00favahu, \u017ee imprinting pravd\u011bpodobn\u011b vyvol\u00e1v\u00e1 \u010detn\u00e9 zm\u011bny v imunitn\u00ed pam\u011bti, lze p\u0159edpokl\u00e1dat, \u017ee tyto zm\u011bny maj\u00ed ur\u010ditou hierarchii. <\/p>\n

V\u011bdci zaznamenali, \u017ee od roku 1977 se mezi populac\u00ed sezon\u00e1ln\u011b cirkulovaly dva podtypy ch\u0159ipky A \u2014 H1N1 a H3N2. Rozd\u00edly v demografii n\u00e1kazy a v symptomech byly dost z\u0159ejm\u00e9, ale \u0161patn\u011b prozkouman\u00e9. Tyto rozd\u00edly mohou b\u00fdt spojeny pr\u00e1v\u011b s imprintingem v d\u011btstv\u00ed: star\u0161\u00ed lid\u00e9 byli t\u00e9m\u011b\u0159 jist\u011b vystaveni H1N1 v d\u011btstv\u00ed (mezi lety 1918 a 1975 to byl jedin\u00fd podtyp, kter\u00fd mezi lidmi cirkuloval). T\u00edm p\u00e1dem jsou tito lid\u00e9 v sou\u010dasnosti l\u00e9pe chr\u00e1n\u011bni p\u0159ed modern\u00edmi sez\u00f3nn\u00edmi variantami viru tohoto podtypu. Podobn\u011b u mlad\u00fdch lid\u00ed je nejvy\u0161\u0161\u00ed pravd\u011bpodobnost imprintingu v d\u011btstv\u00ed spojena s modern\u011bj\u0161\u00edm H3N2 (Obr\u00e1zek \u010d. 1), co\u017e souhlas\u00ed s relativn\u011b n\u00edzk\u00fdm po\u010dtem klinicky zaznamenan\u00fdch p\u0159\u00edpad\u016f H3N2 v t\u00e9to demografick\u00e9 skupin\u011b.<\/p>\n

\"Imunitn\u00ed
\nObr\u00e1zek \u010d. 1: varianty model\u016f z\u00e1vislosti imunity na imprintingu v d\u011btstv\u00ed a faktoru virov\u00e9 evoluce.<\/i><\/p>\n

Na druh\u00e9 stran\u011b mohou b\u00fdt tyto rozd\u00edly spojeny s evoluc\u00ed samotn\u00fdch podtyp\u016f vir\u016f. Nap\u0159\u00edklad H3N2 vykazuje rychlej\u0161\u00ed drift*<\/i> sv\u00e9ho antigenov\u00e9ho fenotypu ne\u017e H1N1.<\/p>\n

Drift antigen\u016f*<\/b> \u2014 zm\u011bny imunotvorn\u00fdch povrchov\u00fdch faktor\u016f vir\u016f.<\/p><\/blockquote>\n

Z tohoto d\u016fvodu m\u016f\u017ee H3N2 l\u00e9pe unikat d\u0159\u00edve vytvo\u0159en\u00e9 imunit\u011b u imunologicky zku\u0161en\u00fdch (d\u0159\u00edve nemocn\u00fdch) dosp\u011bl\u00fdch, zat\u00edmco H1N1 m\u016f\u017ee b\u00fdt relativn\u011b omezen v s\u00edle sv\u00e9ho \u00fa\u010dinku v\u00fdhradn\u011b na imunologicky nezku\u0161en\u00e9 (d\u0159\u00edve ne nemocn\u00e9) d\u011bti.<\/p>\n

Pro ov\u011b\u0159en\u00ed v\u0161ech pravd\u011bpodobn\u00fdch hypot\u00e9z v\u011bdci provedli anal\u00fdzu epidemiologick\u00fdch dat, vytvo\u0159ili funkce pravd\u011bpodobnosti pro ka\u017edou variantu statistick\u00fdch model\u016f, jejich\u017e porovn\u00e1n\u00ed bylo provedeno prost\u0159ednictv\u00edm informa\u010dn\u00edho krit\u00e9ria Akaike (AIC). <\/p>\n

Byla tak\u00e9 provedena dodate\u010dn\u00e1 anal\u00fdza hypot\u00e9zy, ve kter\u00e9 jsou rozd\u00edly zp\u016fsobeny nikoli imprintingem, ale evoluc\u00ed vir\u016f.<\/p>\n

P\u0159\u00edprava na v\u00fdzkum<\/h3>\n

\nV modelov\u00e1n\u00ed hypot\u00e9z byla vyu\u017eita data ze zdravotn\u00edho odd\u011blen\u00ed st\u00e1tu Arizona (ADHS), konkr\u00e9tn\u011b 9510 p\u0159\u00edpad\u016f sez\u00f3nn\u00edch H1N1 a H3N2 po cel\u00e9m st\u00e1t\u011b. P\u0159ibli\u017en\u011b 76 % ze registrovan\u00fdch p\u0159\u00edpad\u016f bylo zaznamen\u00e1no v nemocnic\u00edch a laborato\u0159\u00edch, zb\u00fdvaj\u00edc\u00ed p\u0159\u00edpady nebyly up\u0159esn\u011bny v laborato\u0159\u00edch. Tak\u00e9 je zn\u00e1mo, \u017ee p\u0159ibli\u017en\u011b polovina z laboratorn\u011b potvrzen\u00fdch p\u0159\u00edpad\u016f byla dost v\u00e1\u017en\u00e1, co\u017e vedlo k hospitalizaci. <\/p>\n

Data pou\u017eit\u00e9 ve studii se vztahuj\u00ed k obdob\u00ed 22 let: od sez\u00f3ny ch\u0159ipky 1993\u20131994 po sezonu 2014\u20132015. Je t\u0159eba poznamenat, \u017ee velikosti vzorku se v\u00fdrazn\u011b zv\u00fd\u0161ily po pandemii v roce 2009, tak\u017ee toto obdob\u00ed bylo ze vzorku vylou\u010deno (tabulka \u010d. 1).<\/p>\n

\"Imunitn\u00ed
\nTabulka \u010d. 1: epidemiologick\u00e1 data od roku 1993 do 2015 t\u00fdkaj\u00edc\u00ed se zaznamenan\u00fdch p\u0159\u00edpad\u016f vir\u016f H1N1 a H3N2.<\/i><\/p>\n

Je tak\u00e9 d\u016fle\u017eit\u00e9 vz\u00edt v \u00favahu, \u017ee od roku 2004 byly komer\u010dn\u00ed laborato\u0159e v USA povinny p\u0159ed\u00e1vat st\u00e1tn\u00edm zdravotn\u00edm org\u00e1n\u016fm v\u0161echna data o virov\u00e9m naka\u017een\u00ed pacient\u016f. Nicm\u00e9n\u011b v\u011bt\u0161ina analyzovan\u00fdch p\u0159\u00edpad\u016f (9150\/9451) byla sledov\u00e1na od sez\u00f3ny 2004\u20132005, ji\u017e po p\u0159ijet\u00ed tohoto pravidla.<\/p>\n

Ze v\u0161ech 9510 p\u0159\u00edpad\u016f bylo vylou\u010deno 58, proto\u017ee se jednalo o osoby narozen\u00e9 p\u0159ed rokem 1918 (jejich imPrinting status nelze jednozna\u010dn\u011b ur\u010dit), a jeden p\u0159\u00edpad kv\u016fli chybn\u011b uveden\u00e9mu roku narozen\u00ed. Tak bylo do modelu anal\u00fdzy zahrnuto 9541 p\u0159\u00edpad\u016f.<\/p>\n

V prvn\u00edm kroku modelov\u00e1n\u00ed byly ur\u010deny pravd\u011bpodobnosti imPrinting viry H1N1, H2N2 nebo H3N2, specifick\u00e9ho pro rok narozen\u00ed. Tato pravd\u011bpodobnost odr\u00e1\u017e\u00ed charakter vlivu viru A na d\u011bti a jeho roz\u0161\u00ed\u0159en\u00ed v pr\u016fb\u011bhu let. <\/p>\n

V\u011bt\u0161ina lid\u00ed narozen\u00fdch v obdob\u00ed mezi pandemiemi v letech 1918 a 1957 se poprv\u00e9 nakazila pr\u00e1v\u011b podtypem H1N1. Lid\u00e9 narozen\u00ed v obdob\u00ed mezi pandemiemi let 1957 a 1968 byli prakticky v\u0161ichni naka\u017eeni podtypem H2N2 (1A<\/b>). A od roku 1968 byl dominantn\u00edm podtypem viru H3N2, kter\u00fd zp\u016fsobil naka\u017een\u00ed v\u011bt\u0161iny lid\u00ed z mlad\u0161\u00ed demografick\u00e9 skupiny.<\/p>\n

Navzdory roz\u0161\u00ed\u0159enosti H3N2, H1N1 p\u0159esto sez\u00f3nn\u011b cirkuloval mezi obyvatelstvem od roku 1977, co\u017e vedlo k imPrinting u \u010d\u00e1sti lid\u00ed narozen\u00fdch od poloviny 70. let (1A<\/b>).<\/p>\n

Pokud imprinting na \u00farovni podtypu HA zvy\u0161uje pravd\u011bpodobnost n\u00e1kazy b\u011bhem sez\u00f3nn\u00ed ch\u0159ipky, pak by expozice podtyp\u016fm H1 nebo H3 v ran\u00e9m d\u011btstv\u00ed m\u011bla zajistit do\u017eivotn\u00ed imunitu v\u016f\u010di nov\u011bj\u0161\u00edm variant\u00e1m t\u00e9ho\u017e podtypu HA. Pokud v\u0161ak imunitn\u00ed imprinting funguje p\u0159ev\u00e1\u017en\u011b proti specifick\u00fdm typ\u016fm NA (neuraminid\u00e1za), pak bude celo\u017eivotn\u00ed ochrana charakteristick\u00e1 pro N1 nebo N2 (1A<\/b>).<\/p>\n

Pokud je imprinting zalo\u017een na \u0161ir\u0161\u00edm NA, tj. chr\u00e1n\u00ed p\u0159ed \u0161ir\u0161\u00edm spektrem podtyp\u016f, pak by lid\u00e9 s imprintingem od H1 a H2 m\u011bli b\u00fdt chr\u00e1n\u011bni p\u0159ed modern\u00ed sez\u00f3nn\u00ed H1N1. Z\u00e1rove\u0148 lid\u00e9 s imprintingem k H3 budou chr\u00e1n\u011bni pouze p\u0159ed modern\u00ed sez\u00f3nn\u00ed H3N2 (1A<\/b>).<\/p>\n

V\u011bdci zd\u016fraz\u0148uj\u00ed, \u017ee kolinearita (zjednodu\u0161en\u011b \u0159e\u010deno, paralelnost) predikc\u00ed r\u016fzn\u00fdch model\u016f imprintingu (1C<\/b>—1I<\/b>) byla nevyhnuteln\u00e1, vzhledem k omezen\u00e9 rozmanitosti antigenn\u00edch podtyp\u016f ch\u0159ipky, kter\u00e9 kolovaly mezi populac\u00ed v pr\u016fb\u011bhu minul\u00e9ho stolet\u00ed.<\/p>\n

Kl\u00ed\u010dovou roli v diferenciaci mezi imprintingem na \u00farovni podtypu HA, podtypu NA nebo na \u00farovni skupiny HA hraj\u00ed lid\u00e9 st\u0159edn\u00edho v\u011bku, kte\u0159\u00ed se poprv\u00e9 nakazili pr\u00e1v\u011b H2N2 (1A<\/b>). <\/p>\n

Ka\u017ed\u00fd z prov\u011b\u0159en\u00fdch model\u016f pou\u017eil line\u00e1rn\u00ed kombinaci infekce souvisej\u00edc\u00ed s v\u011bkem (1B<\/b>), a infekce souvisej\u00edc\u00ed s rokem narozen\u00ed (1C<\/b>—1F<\/b>), k z\u00edsk\u00e1n\u00ed rozlo\u017een\u00ed p\u0159\u00edpad\u016f H1N1 nebo H3N2 (1G<\/b> \u2013 1I<\/b>).<\/p>\n

Celkem byly vytvo\u0159eny 4 modely: ten nejjednodu\u0161\u0161\u00ed obsahoval pouze v\u011bkov\u00fd faktor, zat\u00edmco do slo\u017eit\u011bj\u0161\u00edch model\u016f byly p\u0159id\u00e1ny faktory imprintingu na \u00farovni podtypu HA, na \u00farovni podtypu NA nebo na \u00farovni skupiny HA.<\/p>\n

K\u0159ivka v\u011bkov\u00e9ho faktoru m\u00e1 tvar schodovit\u00e9 funkce, v n\u00ed\u017e byl relativn\u00ed riziko n\u00e1kazy stanoven jako 1 ve v\u011bkov\u00e9 skupin\u011b 0\u20134. Krom\u011b prim\u00e1rn\u00ed v\u011bkov\u00e9 skupiny byly dal\u0161\u00ed: 5\u201310, 11\u201317, 18\u201324, 25\u201331, 32\u201338, 39\u201345, 46\u201352, 53\u201359, 60\u201366, 67\u201373, 74\u201380, 81+.<\/p>\n

V modelech, kter\u00e9 obsahovaly efekty imprintingu, se p\u0159edpokl\u00e1dalo, \u017ee pod\u00edl lid\u00ed v ka\u017ed\u00e9m roce narozen\u00ed s ochrann\u00fdm imprintingem v d\u011btstv\u00ed je \u00fam\u011brn\u00fd sn\u00ed\u017een\u00ed rizika n\u00e1kazy.<\/p>\n

Do modelov\u00e1n\u00ed byl zohledn\u011bn tak\u00e9 faktor virov\u00e9 evoluce. K tomu byla pou\u017eita data, kter\u00e1 popsala ro\u010dn\u00ed antigenov\u00fd pokrok, definovan\u00fd jako pr\u016fm\u011brn\u00e1 antigenov\u00e1 vzd\u00e1lenost mezi kmeny ur\u010dit\u00e9 virov\u00e9 linie (H1N1 p\u0159ed rokem 2009, H1N1 po roce 2009 a H3N2). \"Antigenov\u00e1 vzd\u00e1lenost\" mezi dv\u011bma kmeny ch\u0159ipky se pou\u017e\u00edv\u00e1 jako ukazatel podobnosti antigenov\u00e9ho fenotypu a potenci\u00e1ln\u00ed imunologick\u00e9 k\u0159\u00ed\u017eov\u00e9 ochrany.<\/p>\n

Abychom vyhodnotili vliv antigenov\u00e9 evoluce na epidemiologick\u00e9 v\u011bkov\u00e9 rozlo\u017een\u00ed, byla provedena anal\u00fdza zm\u011bn pod\u00edlu p\u0159\u00edpad\u016f u d\u011bt\u00ed v sez\u00f3n\u00e1ch, kdy do\u0161lo k v\u00fdznamn\u00fdm antigenov\u00fdm zm\u011bn\u00e1m.<\/p>\n

Pokud je \u00farove\u0148 antigenov\u00e9ho driftu rozhoduj\u00edc\u00edm faktorem v\u011bkov\u00e9ho rizika n\u00e1kazy, pak by pod\u00edl p\u0159\u00edpad\u016f pozorovan\u00fdch u d\u011bt\u00ed m\u011bl b\u00fdt negativn\u011b spojen s ka\u017edoro\u010dn\u00edm antigenov\u00fdm pokrokem. Jin\u00fdmi slovy, kmeny, kter\u00e9 neutrp\u011bly v\u00fdznamn\u00e9 antigenov\u00e9 zm\u011bny v porovn\u00e1n\u00ed s p\u0159edchoz\u00ed sez\u00f3nou, by m\u011bly b\u00fdt neschopny uniknout d\u0159\u00edve existuj\u00edc\u00ed imunit\u011b u dosp\u011bl\u00fdch s imunologick\u00fdm zku\u0161enostmi. Takov\u00e9 kmeny budou v\u00edce aktivn\u00ed mezi populac\u00ed, kter\u00e1 nem\u00e1 imunologick\u00e9 zku\u0161enosti, tedy mezi d\u011btmi.<\/p>\n

V\u00fdsledky v\u00fdzkumu<\/h3>\n

\nAnal\u00fdza dat podle let uk\u00e1zala, \u017ee sez\u00f3nn\u00ed H3N2 byla hlavn\u00ed p\u0159\u00ed\u010dinou infekc\u00ed mezi star\u0161\u00ed populac\u00ed, zat\u00edmco H1N1 zasahoval lidi st\u0159edn\u00edho v\u011bku a ml\u00e1de\u017e (obr\u00e1zek \u010d. 2).<\/p>\n

\"Imunitn\u00ed
\nObr\u00e1zek \u010d. 2: rozlo\u017een\u00ed ch\u0159ipky H1N1 a H3N2 podle v\u011bku v r\u016fzn\u00fdch \u010dasov\u00fdch obdob\u00edch.<\/i><\/p>\n

Tato tendence byla p\u0159\u00edtomna jak v datech p\u0159ed pandemiemi z roku 2009, tak po n\u00ed. <\/p>\n

Data uk\u00e1zala, \u017ee imprinting na \u00farovni podtypu NA p\u0159eva\u017euje nad imprintingem na \u00farovni podtypu HA (\u0394AIC = 34.54). P\u0159itom prakticky zcela chyb\u011bl imprinting na \u00farovni skupiny HA (\u0394AIC = 249.06), jako\u017e i \u00fapln\u00e1 absence imprintingu (\u0394AIC = 385.42).<\/p>\n

\"Imunitn\u00ed
\nObr\u00e1zek \u010d. 3: hodnocen\u00ed shody model\u016f s daty v\u00fdzkumu.<\/i><\/p>\n

Vizu\u00e1ln\u00ed hodnocen\u00ed shody model\u016f (3C<\/b> a 3D<\/b>) potvrdila, \u017ee modely obsahuj\u00edc\u00ed imprintingov\u00e9 efekty na \u00fazk\u00fdch \u00farovn\u00edch subt\u00edpy NA nebo HA, zaji\u0161\u0165uj\u00ed nejlep\u0161\u00ed shodu s daty pou\u017eit\u00fdmi ve studii. Skute\u010dnost, \u017ee model, ve kter\u00e9m chyb\u00ed imprinting, nem\u016f\u017ee b\u00fdt potvrzen daty, nazna\u010duje, \u017ee imprinting je velmi d\u016fle\u017eit\u00fdm aspektem utv\u00e1\u0159en\u00ed imunity dosp\u011bl\u00e9 populace v\u016f\u010di sezonn\u00edm subtyp\u016fm ch\u0159ipky. Nicm\u00e9n\u011b, imprinting funguje na velmi \u00fazk\u00e9 specializaci, tedy p\u016fsob\u00ed v\u00fdhradn\u011b na ur\u010dit\u00fd subtyp, a ne na cel\u00fd spektrum subtyp\u016f ch\u0159ipky.<\/p>\n

\"Imunitn\u00ed
\nTabulka \u010d. 2: hodnocen\u00ed shody model\u016f s daty studie.<\/i><\/p>\n

Po zohledn\u011bn\u00ed demografick\u00e9ho rozlo\u017een\u00ed podle v\u011bku byl p\u0159edpokl\u00e1dan\u00fd v\u011bkov\u00fd rizikov\u00fd faktor nejvy\u0161\u0161\u00ed u d\u011bt\u00ed a star\u0161\u00edch osob, co\u017e odpov\u00eddalo akumulaci imunitn\u00ed pam\u011bti v d\u011btstv\u00ed a oslaben\u00ed imunitn\u00ed funkce u star\u0161\u00edch osob (na 3A<\/b> zobrazena p\u0159ibli\u017en\u00e1 k\u0159ivka z nejlep\u0161\u00edho modelu). Odhady parametr\u016f imprintingu byly men\u0161\u00ed ne\u017e jedna, co\u017e nazna\u010duje ur\u010dit\u00e9 sn\u00ed\u017een\u00ed relativn\u00edho rizika (tabulka \u010d. 2). V r\u00e1mci nejlep\u0161\u00edho modelu bylo p\u0159edpokl\u00e1dan\u00e9 sn\u00ed\u017een\u00ed relativn\u00edho rizika z imprintingu v d\u011btstv\u00ed siln\u011bj\u0161\u00ed pro H1N1 (0.34, 95% CI 0.29\u20130.42) ne\u017e pro H3N2 (0.71, 95% CI 0.62\u20130.82).<\/p>\n

Pro ov\u011b\u0159en\u00ed vlivu virov\u00e9 evoluce na v\u011bkov\u00e9 rozlo\u017een\u00ed rizika n\u00e1kazy v\u011bdci hledali sn\u00ed\u017een\u00ed pod\u00edlu p\u0159\u00edpad\u016f n\u00e1kazy mezi d\u011btmi v obdob\u00edch spojen\u00fdch s antigenn\u00edmi zm\u011bnami, kdy kmeny s vysok\u00fdm antigenn\u00edm driftem efektivn\u011bji infikovaly dosp\u011bl\u00e9 imunologicky zku\u0161en\u00e9 jedince.<\/p>\n

Anal\u00fdza dat uk\u00e1zala malou negativn\u00ed, ale nev\u00fdznamnou souvislost mezi ka\u017edoro\u010dn\u00edm zv\u00fd\u0161en\u00edm antigenicity a pod\u00edlem p\u0159\u00edpad\u016f H3N2 pozorovan\u00fdch u d\u011bt\u00ed (4A<\/b>).<\/p>\n

\"Imunitn\u00ed
\nObr\u00e1zek \u010d. 4: vliv virov\u00e9 evoluce na v\u011bkov\u00fd faktor rizika n\u00e1kazy.<\/p>\n

Nicm\u00e9n\u011b mezi antigenn\u00edmi zm\u011bnami a pod\u00edlem p\u0159\u00edpad\u016f pozorovan\u00fdch u d\u011bt\u00ed star\u0161\u00edch 10 let a dosp\u011bl\u00fdch nebyla zji\u0161t\u011bna jasn\u00e1 souvislost. Kdyby virov\u00e1 evoluce hr\u00e1la hlavn\u00ed roli v tomto rozlo\u017een\u00ed, byly by pozorov\u00e1ny jasn\u011bj\u0161\u00ed d\u016fkazy evolu\u010dn\u00edho vlivu mezi dosp\u011bl\u00fdmi, a ne pouze p\u0159i srovn\u00e1n\u00ed dosp\u011bl\u00fdch a d\u011bt\u00ed do 10 let.<\/p>\n

Krom\u011b toho, pokud je m\u00edra evolu\u010dn\u00edch zm\u011bn vir\u016f dominantn\u00ed pro podtypov\u011b specifick\u00e9 rozd\u00edly v distribuci epidemi\u00e1ln\u00edho v\u011bku, pak kdy\u017e podtypy H1N1 a H3N2 vykazuj\u00ed stejn\u00e9 m\u00edry ro\u010dn\u00edho \u0161\u00ed\u0159en\u00ed antigenu, m\u011blo by v\u011bkov\u00e9 rozd\u011blen\u00ed p\u0159\u00edpad\u016f infekce vypadat podobn\u011bji.<\/p>\n

Pro podrobn\u011bj\u0161\u00ed sezn\u00e1men\u00ed se s nuancemi v\u00fdzkumu doporu\u010duji nahl\u00e9dnout do zpr\u00e1vy v\u011bdc\u016f<\/a><\/noindex>.<\/p>\n

Epilog<\/h3>\n

\nV t\u00e9to pr\u00e1ci v\u011bdci analyzovali epidemiologick\u00e1 data p\u0159\u00edpad\u016f infekce H1N1, H3N2 a H2N2. Anal\u00fdza dat uk\u00e1zala jasnou z\u00e1vislost imprintingu v d\u011btstv\u00ed a m\u00edry rizika infekce v dosp\u011blosti. Jin\u00fdmi slovy, pokud byl d\u00edt\u011b v 50. letech infikov\u00e1no, kdy\u017e cirkuloval H1N1, zat\u00edmco H3N2 nebyl p\u0159\u00edtomen, bude v dosp\u011blosti pravd\u011bpodobnost infekce H3N2 mnohem vy\u0161\u0161\u00ed ne\u017e pravd\u011bpodobnost naka\u017een\u00ed H1N1.<\/p>\n

Hlavn\u00edm z\u00e1v\u011brem t\u00e9to studie je, \u017ee nen\u00ed d\u016fle\u017eit\u00e9 pouze to, \u010d\u00edm \u010dlov\u011bk onemocn\u011bl v d\u011btstv\u00ed, ale tak\u00e9 v jak\u00e9m po\u0159ad\u00ed. Imunitn\u00ed pam\u011b\u0165, kter\u00e1 se vytv\u00e1\u0159\u00ed b\u011bhem \u017eivota, aktivn\u011b \"zaznamen\u00e1v\u00e1\" \u00fadaje o prvn\u00edch virov\u00fdch infekc\u00edch, co\u017e p\u0159isp\u00edv\u00e1 k efektivn\u011bj\u0161\u00edmu boji proti nim v dosp\u011blosti. <\/p>\n

V\u011bdci doufaj\u00ed, \u017ee jejich pr\u00e1ce umo\u017en\u00ed l\u00e9pe p\u0159edpov\u011bd\u011bt, kter\u00e9 v\u011bkov\u00e9 skupiny jsou v\u00edce n\u00e1chyln\u00e9 k vlivu ur\u010dit\u00e9ho podtypu ch\u0159ipky. Tyto znalosti mohou pomoci p\u0159i prevenci \u0161\u00ed\u0159en\u00ed epidemi\u00ed, zejm\u00e9na pokud je t\u0159eba rozd\u011blit omezen\u00fd po\u010det vakc\u00edn mezi obyvatelstvo. <\/p>\n

Tato studie nen\u00ed zam\u011b\u0159ena na hled\u00e1n\u00ed superl\u00e9k\u016f proti ch\u0159ipce jak\u00e9hokoli typu, a\u010dkoliv by to bylo skv\u011bl\u00e9. Zam\u011b\u0159uje se na to, co je v sou\u010dasnosti mnohem re\u00e1ln\u011bj\u0161\u00ed a d\u016fle\u017eit\u011bj\u0161\u00ed \u2013 prevenci \u0161\u00ed\u0159en\u00ed infekce. Pokud se nem\u016f\u017eeme okam\u017eit\u011b zbavit viru, mus\u00edme m\u00edt v\u0161echny mo\u017en\u00e9 n\u00e1stroje k jeho zadr\u017een\u00ed. Jedn\u00edm z nejspolehliv\u011bj\u0161\u00edch spojenc\u016f jak\u00e9koli epidemie je nedbal\u00fd p\u0159\u00edstup k n\u00ed, jak ze strany st\u00e1tu, tak ka\u017ed\u00e9ho jednotlivce. Panika samoz\u0159ejm\u011b nen\u00ed pot\u0159eba, nebo\u0165 od n\u00ed m\u016f\u017ee b\u00fdt jen h\u016f\u0159e, nicm\u00e9n\u011b bezpe\u010dnostn\u00ed opat\u0159en\u00ed nikdy neu\u0161kod\u00ed.<\/p>\n

D\u011bkuji za pozornost, z\u016fsta\u0148te zv\u011bdav\u00ed, chra\u0148te sebe i sv\u00e9 bl\u00edzk\u00e9 a m\u011bjte skv\u011bl\u00e9 v\u00edkendy, kluci! \ud83d\ude42<\/p>\n

Mal\u00e1 reklama \ud83d\ude42<\/h3>\n

\nD\u011bkujeme, \u017ee s n\u00e1mi z\u016fst\u00e1v\u00e1te. L\u00edb\u00ed se v\u00e1m na\u0161e \u010dl\u00e1nky? Chcete vid\u011bt v\u00edce zaj\u00edmav\u00fdch materi\u00e1l\u016f? Podpo\u0159te n\u00e1s objedn\u00e1vkou nebo doporu\u010den\u00edm zn\u00e1m\u00fdm, cloudov\u00e9 VPS pro v\u00fdvoj\u00e1\u0159e od 4,99 $<\/a><\/noindex>, unik\u00e1tn\u00ed alternativa entry-level server\u016f, kterou jsme pro v\u00e1s vymysleli:<\/b> V\u0161echny pravdy o VPS (KVM) E5-2697 v3 (6 jader) 10GB DDR4 480GB SSD 1Gbps od 19 $ nebo jak spr\u00e1vn\u011b rozd\u011blit server?<\/a><\/noindex> (k dispozici varianty s RAID1 a RAID10, a\u017e 24 jader a a\u017e 40GB DDR4).<\/p>\n

Dell R730xd je dvakr\u00e1t levn\u011bj\u0161\u00ed v datov\u00e9m centru Equinix Tier IV v Amsterdamu?<\/b> Jen u n\u00e1s 2 x Intel TetraDeca-Core Xeon 2x E5-2697v3 2.6GHz 14C 64GB DDR4 4x960GB SSD 1Gbps 100 TB od 199 $<\/a><\/noindex> v Nizozemsku! Dell R420 \u2014 2x E5-2430 2.2GHz 6C 128GB DDR3 2x960GB SSD 1Gbps 100TB \u2014 od 99 $!<\/b><\/b> \u010ct\u011bte o tom Jak postavit infrastrukturu podnikov\u00e9 t\u0159\u00eddy s pou\u017eit\u00edm server\u016f Dell R730xd E5-2650 v4 v hodnot\u011b 9000 eur za pakatel?<\/a><\/noindex>
\n
Zdroj: habr.com<\/a> <\/p>","protected":false,"gt_translate_keys":[{"key":"rendered","format":"html"}]},"excerpt":{"rendered":"

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