On June 28, 2024, the Doctoral Program in Medical Science of FMUB celebrated the graduation of one of its students, Dr. Andrea Aprilia, SpPK. The presentation of her dissertation results and future perspectives by Dr. Andrea Aprilia, SpPK was held in the FMUB Auditorium, and the newly appointed Doctor has successfully published two articles in reputable international journals. Dr. Andrea is a lecturer serving in the Department of Clinical Pathology at FKIK Atma Jaya Jakarta. In her presentation, Dr. Andrea focused on the topic “The Correlation of T Cell Aging, Zinc Deficiency, and Magnesium Deficiency with the Immune Response After COVID-19 Vaccination in the Geriatric Population”.
Summary Disertasi Dr Andrea:
The presence of immunosenescence is characterized by an immune risk profile (IRP). One of the characteristics of immunosenescence is changes in T cells. Previous studies have found soluble markers that can be used to replace IRP indicating T cell aging, namely increased levels of sCD28, sCD80, and sCTLA-4. Zinc (Zn) and magnesium (Mg) are two important minerals that have a homeostatic function in various body cells including the immune system. Deficiency of Zn or Mg can reduce the function of the immune system which resembles immunosenescence. Zn and Mg deficiencies are common in geriatrics but are often undetected because the symptoms are not specific. One strategy to reduce mortality and morbidity in geriatrics is by administering vaccines. In the COVID-19 pandemic, the most widely used vaccine for this population is CoronaVac. However, geriatrics have a worse immune response to vaccination due to immunosenescence. In addition, geriatrics are thought to be a population group that is susceptible to Zn and Mg deficiencies which worsen the immune system in geriatrics. The immune response to the vaccine can be a cellular immune response that can be measured by examining serum CXCL10 and neopterin as well as a humoral immune response that can be measured by examining sCD40L and SARS-CoV-2 anti-S-RBD IgG antibodies.
The research question is whether there is an effect of T cell aging, Zn deficiency, and Mg deficiency on the decrease in cellular and humoral immune responses after COVID-19 vaccination in geriatrics. The purpose of this study was to prove the existence of Zn and Mg deficiencies in the geriatric population, to prove the effect of T cell aging, Zn deficiency, and Mg deficiency on the decrease in cellular and humoral immune responses after COVID-19 vaccination.
This study is an analytical observational study to prove the effect of T cell aging, Zn deficiency, and Mg deficiency on the response of the second dose of CoronaVac vaccine, both cellular and humoral immunity in the geriatric population. The number of subjects studied was 88 geriatric individuals who had received two doses of CoronaVac. Cellular immunity activity was measured with CXCL10 and neopterin while humoral immunity with sCD40L and anti-S-RBD SARS-CoV-2 IgG antibodies. Subjects were measured for sCD28, sCD80, sCTLA-4, Zn, Mg levels before vaccination while CXCL10, neopterin, sCD40L, and anti-S-RBD antibodies were examined at 6 and 24 weeks post-vaccination. Examination of sCD28, sCD80, and sCTLA-4 using ELISA, examination of Zn and Mg with ICP-MS, examination of neopterin and anti-S-RBD Ig-G antibodies with ELISA, and examination of CXCL10 and sCD40L with ELISA panel. The results will be tested for data normality, difference test, correlation test, and multiple linear regression test.
There was T cell aging in all geriatric subjects which was indicated by an increase in sCD28, sCD80, and sCTLA-4 levels. In addition, almost all subjects experienced Zn deficiency or insufficiency as well as Mg deficiency. 50% of geriatric subjects experiencedcell aging as well as Zn and Mg deficiency and 37.5% of subjects experienced T cell aging with deficiency of one of Zn or Mg. This proves that in geriatrics there is an increased risk of nutritional deficiency, especially Zn and Mg. This Zn and Mg deficiency is thought to be mainly caused by low intake due to low Zn and Mg contained in food or due to low bioavailability of Zn and Mg. In addition, there are changes in the intestines and kidneys due to aging which also reduce absorption and increase excretion of Zn and Mg.
In relation to the post-vaccine immune response, the presence of T cell aging causes a significant decrease in the post-vaccine immune response, both cellular and humoral immunity, which is indicated by a decrease in neopterin and sCD40L levels between weeks 6 and 24 post-vaccine. In addition, Mg deficiency also causes a decrease in cellular immunity, which is indicated by a decrease in neopterin. Zn deficiency was found not to cause a decrease in the post-vaccine immune response. If there is a condition of T cell aging accompanied by Zn and Mg deficiency, there is an effect of more than 30% on the decrease in the cellular immune response. T cell aging plays a greater role in the decrease in the post-vaccine immune response.