Immunogenicity of SARS-CoV-2 vaccines in patients treated with chronic double filtration plasmapheresis

IF 1.4 4区医学 Q4 HEMATOLOGY Journal of Clinical Apheresis Pub Date : 2024-06-26 DOI:10.1002/jca.22136

Emilie Pambrun, Paul Loubet, Thomas Fourneron, Olivier Moranne

{"title":"Immunogenicity of SARS-CoV-2 vaccines in patients treated with chronic double filtration plasmapheresis","authors":"Emilie Pambrun, Paul Loubet, Thomas Fourneron, Olivier Moranne","doi":"10.1002/jca.22136","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The impact of chronic therapeutic plasmapheresis on humoral response following COVID-19 vaccination is poorly documented, especially among patients treated with double filtration plasmapheresis (DFPP).</p>\n </section>\n \n <section>\n \n <h3> Objective<b>s</b></h3>\n \n <p>This retrospective single-center study evaluated the humoral response after SARS-CoV-2 vaccination and studied anti-SPIKE seropositivity and antibody dynamics in patients with chronic DFPP at our institution.</p>\n </section>\n \n <section>\n \n <h3> Method</h3>\n \n <p>All patients undergoing chronic DFPP at a tertiary center in France from December 2020 to November 2022 were included. We defined one patient subgroup as Group 1 to evaluate anti-SPIKE seropositivity after vaccination, with three groups based on their anti-SPIKE titers: (Group 1A) nonresponders (<0.8 UI/mL), (Group 1B) weak responders (0.8 to <250 binding antibody unit [BAU]/mL), and (Group 1C) strong responders (>250 BAU/mL). Group 2 served to evaluate antibody dynamics with anti-SPIKE levels measured 3 months after initial vaccination, Group 2A having a sustained level and Group 2B a declining pattern.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The 21 patients included had a median age of 63 years, and 13 (56%) were male. The indications for chronic DFPP mainly included dysimmune pathologies (15; 71%) and familial dyslipidemia (6; 29%). For the humoral response to vaccination in Patient Group 1, the only nonresponder was a patient who had undergone kidney transplantation 30 months earlier and was on immunosuppressive medication. For Patient Group 2, the median follow-up of antibody titers was 13 months [12–13]. Two distinct patterns of anti-SPIKE dynamics were observed: a rapid decline in anti-SPIKE antibody titers within 6 months following the initial vaccination or booster dose (<i>n</i> = 10 [71.4%] Group 2A) and stable anti-SPIKE levels above 250 BAU/mL over >6 months (<i>n</i> = 4 [28.6%] Group 2B) with more patients with familial dyslipidemia in the former.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Humoral response to SARS-CoV-2 vaccination appears robust in patients undergoing chronic DFPP and may be linked to patients' immune status rather than DFPTP itself. Our results support current recommendations for administering three doses of vaccine with a booster every 6 months.</p>\n </section>\n </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jca.22136","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Apheresis","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jca.22136","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"HEMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

The impact of chronic therapeutic plasmapheresis on humoral response following COVID-19 vaccination is poorly documented, especially among patients treated with double filtration plasmapheresis (DFPP).

Objectives

This retrospective single-center study evaluated the humoral response after SARS-CoV-2 vaccination and studied anti-SPIKE seropositivity and antibody dynamics in patients with chronic DFPP at our institution.

Method

All patients undergoing chronic DFPP at a tertiary center in France from December 2020 to November 2022 were included. We defined one patient subgroup as Group 1 to evaluate anti-SPIKE seropositivity after vaccination, with three groups based on their anti-SPIKE titers: (Group 1A) nonresponders (<0.8 UI/mL), (Group 1B) weak responders (0.8 to <250 binding antibody unit [BAU]/mL), and (Group 1C) strong responders (>250 BAU/mL). Group 2 served to evaluate antibody dynamics with anti-SPIKE levels measured 3 months after initial vaccination, Group 2A having a sustained level and Group 2B a declining pattern.

Results

The 21 patients included had a median age of 63 years, and 13 (56%) were male. The indications for chronic DFPP mainly included dysimmune pathologies (15; 71%) and familial dyslipidemia (6; 29%). For the humoral response to vaccination in Patient Group 1, the only nonresponder was a patient who had undergone kidney transplantation 30 months earlier and was on immunosuppressive medication. For Patient Group 2, the median follow-up of antibody titers was 13 months [12–13]. Two distinct patterns of anti-SPIKE dynamics were observed: a rapid decline in anti-SPIKE antibody titers within 6 months following the initial vaccination or booster dose (n = 10 [71.4%] Group 2A) and stable anti-SPIKE levels above 250 BAU/mL over >6 months (n = 4 [28.6%] Group 2B) with more patients with familial dyslipidemia in the former.

Conclusions

Humoral response to SARS-CoV-2 vaccination appears robust in patients undergoing chronic DFPP and may be linked to patients' immune status rather than DFPTP itself. Our results support current recommendations for administering three doses of vaccine with a booster every 6 months.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

慢性双滤过血浆置换术患者接种 SARS-CoV-2 疫苗的免疫原性。

背景：慢性治疗性浆细胞分离对接种COVID-19疫苗后体液反应的影响鲜有记载，尤其是在接受双滤过性浆细胞分离（DFPP）治疗的患者中：这项回顾性单中心研究评估了我院慢性 DFPP 患者接种 SARS-CoV-2 疫苗后的体液反应，并研究了抗 SIKE 血清阳性率和抗体动态：纳入 2020 年 12 月至 2022 年 11 月期间在法国一家三级中心接受慢性 DFPP 的所有患者。我们将一个患者亚组定义为第1组，以评估接种疫苗后抗SPIKE血清阳性率，根据抗SPIKE滴度分为三组：（第1A组）无应答者（250 BAU/mL）。第 2 组用于评估抗体动态，在首次接种疫苗 3 个月后测量抗SPIKE 水平，第 2A 组具有持续水平，而第 2B 组则呈下降趋势：结果：21 名患者的中位年龄为 63 岁，其中 13 人（56%）为男性。慢性 DFPP 的适应症主要包括免疫障碍性疾病（15 例，占 71%）和家族性血脂异常（6 例，占 29%）。在患者 1 组的疫苗接种体液反应中，唯一没有反应的患者是一名在 30 个月前接受过肾移植手术并正在服用免疫抑制药物的患者。对于患者 2 组，抗体滴度的中位随访时间为 13 个月 [12-13]。观察到两种不同的抗 SIKE 动态模式：抗 SIKE 抗体滴度在首次接种或加强剂量后 6 个月内迅速下降（n = 10 [71.4%] 组 2A），抗 SIKE 水平在超过 6 个月后稳定在 250 BAU/mL 以上（n = 4 [28.6%] 组 2B），前者中家族性血脂异常患者较多：结论：慢性 DFPP 患者对 SARS-CoV-2 疫苗接种的体液反应似乎很强，这可能与患者的免疫状况而非 DFPTP 本身有关。我们的研究结果支持目前关于接种三剂疫苗并每 6 个月加强一次的建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Journal of Clinical Apheresis 医学-血液学

CiteScore

2.80

自引率

13.30%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Clinical Apheresis publishes articles dealing with all aspects of hemapheresis. Articles welcomed for review include those reporting basic research and clinical applications of therapeutic plasma exchange, therapeutic cytapheresis, therapeutic absorption, blood component collection and transfusion, donor recruitment and safety, administration of hemapheresis centers, and innovative applications of hemapheresis technology. Experimental studies, clinical trials, case reports, and concise reviews will be welcomed.