SUMMARY Herpes Zoster (shingles) causes significant morbidity in immune compromised hosts and older adults. While a vaccine is available for prevention of shingles, its efficacy declines with age. To help to understand the mechanisms driving vaccinal responses, we constructed a multiscale, multifactorial response network (MMRN) of immunity in healthy young and older adults immunized with the live attenuated shingles vaccine Zostavax®. Vaccination induces robust antigen-specific antibody, plasmablasts and CD4+ T cells, yet limited CD8+ T cell and antiviral responses. The MMRN reveals striking associations between orthogonal datasets such as transcriptomic and metabolomics signatures, cell populations and cytokine levels, and identifies immune and metabolic correlates of vaccine immunity. Networks associated with inositol phosphate, glycerophospholipids and sterol metabolism are tightly coupled with immunity. Critically, the sterol regulatory binding protein 1 and its targets are key integrators of antibody and T follicular cell responses. Our approach is broadly applicable to study human immunity, and can help to identify predictors of efficacy as well as mechanisms controlling immunity to vaccination.

ET-743 is a promising new option for the management of several histologic subtypes of sarcoma. Durable objective responses were obtained in a subset of sarcoma patients with disease progression despite prior chemotherapy. Additionally, the relatively high survival rate noted in this series of previously treated patients further justifies development of this agent.