移植受者新冠肺炎疫苗反应分析。

Q3 Medicine ImmunoHorizons Pub Date : 2023-10-01 DOI:10.4049/immunohorizons.2300071
Tanusya Murali Murali, Bhuvaneshwari Shunmuganathan, Emma Li-Lin Trueman, Rashi Gupta, Rebecca See Weng Tan, Hersharan Kaur Sran, Matthew Ross D'Costa, Emmett Tsz-Yeung Wong, Yue Gu, Jianzhou Cui, Koh Wee Kun, Amy Qiao Hui Lim, Xinlei Qian, Kiren Purushotorman, Jinmiao Chen, Paul Anthony MacAry, Anantharaman Vathsala
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摘要

新冠肺炎疫苗接种降低了感染的严重程度,降低了住院率,降低了健康人的发病率/死亡率,从而对全球大流行产生了重大影响。然而,疫苗对接受维持性免疫抑制的肾移植受者的保护程度仍不明确。当我们考虑到严重急性呼吸系统综合征冠状病毒2型变异毒株(VOCs)的出现时,这一点尤为重要,这些变种定义了降低Ab反应针对最广泛使用的疫苗形式中使用的祖先武汉-Hu-1变种的刺突Ags的有效性的突变。在这项研究中,我们描述了129名接受过三剂Pfizer-BioNTech新冠肺炎疫苗(BNT162b2)的肾移植受者对多种SARS-CoV-2 VOCs的中和抗体反应的定性纵向分析。我们的研究结果显示,与健康对照组相比,移植受者的疫苗诱导血清学反应在质量和数量上都有所减少,其中只有51.9%(67/129)的人产生了可测量的疫苗诱导IgG反应,41.1%(53/129)表现出显著的中和抗体滴度(基于假病毒中和测试值>50%)。对挥发性有机物的分析显示,对野生型Wuhan-Hu-1和德尔塔变异株的结合最强,但对测试的两种奥密克戎变异株(BA1和BA2)都没有。此外,年龄较大的移植受者和那些在维持治疗中使用麦考酚酸的人,其所有分析的疫苗诱导的免疫相关性都显著降低。随着新冠肺炎在我们的人群中流行,这些数据对我们未来如何监测和管理移植患者具有重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Analyzing COVID-19 Vaccine Responses in Transplant Recipients.

COVID-19 vaccination has significantly impacted the global pandemic by reducing the severity of infection, lowering rates of hospitalization, and reducing morbidity/mortality in healthy individuals. However, the degree of vaccine-induced protection afforded to renal transplant recipients who receive forms of maintenance immunosuppression remains poorly defined. This is particularly important when we factor in the emergence of SARS-CoV-2 variants of concern (VOCs) that have defined mutations that reduce the effectiveness of Ab responses targeting the Spike Ags from the ancestral Wuhan-Hu-1 variants employed in the most widely used vaccine formats. In this study, we describe a qualitative, longitudinal analysis of neutralizing Ab responses against multiple SARS-CoV-2 VOCs in 129 renal transplant recipients who have received three doses of the Pfizer-BioNTech COVID-19 vaccine (BNT162b2). Our results reveal a qualitative and quantitative reduction in the vaccine-induced serological response in transplant recipients versus healthy controls where only 51.9% (67 of 129) made a measurable vaccine-induced IgG response and 41.1% (53 of 129) exhibited a significant neutralizing Ab titer (based on a pseudovirus neutralization test value >50%). Analysis on the VOCs revealed strongest binding toward the wild-type Wuhan-Hu-1 and Delta variants but none with both of the Omicron variants tested (BA1 and BA2). Moreover, older transplant recipients and those who are on mycophenolic acid as part of their maintenance therapy exhibited a profound reduction in all of the analyzed vaccine-induced immune correlates. These data have important implications for how we monitor and manage transplant patients in the future as COVID-19 becomes endemic in our populations.

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