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1273-mRNA 新冠病毒疫苗接种后长期血液透析患者中产生强烈细胞和体液免疫应答。

Development of Potent Cellular and Humoral Immune Responses in Long-Term Hemodialysis Patients After 1273-mRNA SARS-CoV-2 Vaccination.

机构信息

Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.

Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States.

出版信息

Front Immunol. 2022 Mar 23;13:845882. doi: 10.3389/fimmu.2022.845882. eCollection 2022.

Abstract

Long-term hemodialysis (HD) patients are considered vulnerable and at high-risk of developing severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection due to their immunocompromised condition. Since COVID-19 associated mortality rates are higher in HD patients, vaccination is critical to protect them. The response towards vaccination against COVID-19 in HD patients is still uncertain and, in particular the cellular immune response is not fully understood. We monitored the humoral and cellular immune responses by analysis of the serological responses and Spike-specific cellular immunity in COVID-19-recovered and naïve HD patients in a longitudinal study shortly after vaccination to determine the protective effects of 1273-mRNA vaccination against SARS-CoV-2 in these high-risk patients. In naïve HD patients, the cellular immune response measured by IL-2 and IFN-ɣ secretion needed a second vaccine dose to significantly increase, with a similar pattern for the humoral response. In contrast, COVID-19 recovered HD patients developed a potent and rapid cellular and humoral immune response after the first vaccine dose. Interestingly, when comparing COVID-19 recovered healthy volunteers (HV), previously vaccinated with BNT162b2 vaccine to HD patients vaccinated with 1273-mRNA, these exhibited a more robust immune response that is maintained longitudinally. Our results indicate that HD patients develop strong cellular and humoral immune responses to 1273-mRNA vaccination and argue in favor of personalized immune monitoring studies in HD patients, especially if COVID-19 pre-exposed, to adapt COVID-19 vaccination protocols for this immunocompromised population.

摘要

长期接受血液透析(HD)的患者由于免疫功能低下,被认为易感染严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2),且感染后发生重症的风险较高。由于 COVID-19 相关的死亡率在 HD 患者中较高,因此疫苗接种对于保护他们至关重要。HD 患者对 COVID-19 疫苗接种的反应仍不确定,特别是细胞免疫反应尚未完全了解。我们通过分析 COVID-19 恢复期和初治 HD 患者的血清学反应和 Spike 特异性细胞免疫,监测体液和细胞免疫反应,在接种疫苗后不久进行了一项纵向研究,以确定 1273-mRNA 疫苗对这些高危患者的 SARS-CoV-2 保护作用。在初治 HD 患者中,通过白细胞介素 2(IL-2)和干扰素 γ(IFN-γ)分泌测量的细胞免疫反应需要第二次疫苗接种才能显著增加,其体液反应也呈现相似的模式。相比之下,COVID-19 恢复期的 HD 患者在接种第一剂疫苗后就产生了强大而迅速的细胞和体液免疫反应。有趣的是,当将 COVID-19 恢复期的健康志愿者(HV)与 HD 患者进行比较时,这些志愿者之前已接种 BNT162b2 疫苗,而 HD 患者接种的是 1273-mRNA,他们表现出更强大的免疫反应,并能在纵向监测中保持。我们的结果表明,HD 患者对 1273-mRNA 疫苗接种产生强烈的细胞和体液免疫反应,这支持对 HD 患者进行个性化免疫监测研究,尤其是对于 COVID-19 预先暴露的患者,以便为免疫功能低下的人群制定 COVID-19 疫苗接种方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4446/8983822/ccba5443a8d4/fimmu-13-845882-g001.jpg

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