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免疫功能低下的炎症性肠病患者接种 SARS-CoV-2 疫苗后的 T 细胞反应。

T Cell Response After SARS-CoV-2 Vaccination in Immunocompromised Patients with Inflammatory Bowel Disease.

机构信息

Jena University Hospital, Department of Internal Medicine IV, Jena, Germany.

Institute for Immunology, Jena University Hospital, Jena, Germany.

出版信息

J Crohns Colitis. 2022 Feb 23;16(2):251-258. doi: 10.1093/ecco-jcc/jjab147.

Abstract

BACKGROUND

Vaccination is a promising strategy to protect vulnerable groups like immunocompromised inflammatory bowel disease [IBD] patients from an infection with SARS-CoV-2. These patients may have lower immune responses. Little is known about the cellular and humoral immune response after a SARS-CoV-2 vaccination in IBD patients.

METHODS

Totals of 28 patients with IBD and 27 age- and sex-matched healthy controls were recruited at Jena University Hospital. Blood samples were taken before, after the first, and in a subgroup of 11 patients after second dose of a SARS-CoV-2 vaccination. Cellular immune response, including IFN-γ and TNF-α response and antibody titres, were analysed.

RESULTS

Overall, 71.4% of the IBD patients and 85.2% of the controls showed levels of anti-SARS-CoV-2 antibodies above the cutoff of 33.8 BAU/ml [p = 0.329] after the first dose. Even in the absence of SARS-CoV-2 antibodies, IBD patients showed significant T cell responses after first SARS-CoV-2 vaccination compared with healthy controls, which was not influenced by different immunosuppressive regimens. Associated with the vaccination, we could also detect a slight increase of the TNF production among SARS-CoV-2-reactive TH cells in healthy donorsn [HD] and IBD patients. After the second dose of vaccination, in IBD patients a further increase of humoral immune response in all but one patient was observed.

CONCLUSIONS

Already after the first dose of a SARS-CoV-2 vaccination, cellular immune response in IBD patients is comparable to controls, indicating a similar efficacy. However, close monitoring of long-term immunity in these patients should be considered.

摘要

背景

疫苗接种是保护免疫功能低下的炎症性肠病(IBD)等脆弱群体免受 SARS-CoV-2 感染的一种有前途的策略。这些患者的免疫反应可能较低。关于 IBD 患者接种 SARS-CoV-2 疫苗后的细胞和体液免疫反应知之甚少。

方法

共招募了 28 名 IBD 患者和 27 名年龄和性别匹配的健康对照者在耶拿大学医院。在接种 SARS-CoV-2 疫苗前、第一剂后以及 11 名患者的亚组中第二次接种后采集血样。分析细胞免疫反应,包括 IFN-γ 和 TNF-α 反应和抗体滴度。

结果

总体而言,在第一次接种后,71.4%的 IBD 患者和 85.2%的对照组的抗 SARS-CoV-2 抗体水平高于 33.8 BAU/ml 的临界值 [p = 0.329]。即使没有 SARS-CoV-2 抗体,与健康对照者相比,IBD 患者在第一次 SARS-CoV-2 接种后仍表现出显著的 T 细胞反应,而不同的免疫抑制方案并没有影响这种反应。与接种相关,我们还可以在健康供体 [HD] 和 IBD 患者中检测到 SARS-CoV-2 反应性 TH 细胞中 TNF 产生的轻微增加。在第二次接种疫苗后,除了一名患者外,所有 IBD 患者的体液免疫反应均进一步增加。

结论

即使在接种 SARS-CoV-2 疫苗第一剂后,IBD 患者的细胞免疫反应也与对照组相当,表明疗效相似。然而,应考虑密切监测这些患者的长期免疫情况。

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