接种疫苗后人乳中的抗 SARS-CoV-2 IgA 和 IgG 取决于疫苗类型和先前 SARS-CoV-2 暴露情况：一项纵向研究。

Anti-SARS-CoV-2 IgA and IgG in human milk after vaccination is dependent on vaccine type and previous SARS-CoV-2 exposure: a longitudinal study.

机构信息

Department of Biotechnology, Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), 46980, Paterna, Valencia, Spain.

Department of Nursing, Nursing Research Group, Universitat Jaume I, Castellón, Spain.

出版信息

Genome Med. 2022 Apr 21;14(1):42. doi: 10.1186/s13073-022-01043-9.

DOI:10.1186/s13073-022-01043-9

PMID:35449030

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9022055/

Abstract

BACKGROUND

Breast milk is a vehicle to transfer protective antibodies from the lactating mother to the neonate. After SARS-CoV-2 infection, virus-specific IgA and IgG have been identified in breast milk, however, there are limited data on the impact of different COVID-19 vaccine types in lactating women. This study is aimed to evaluate the time course of induction of SARS-CoV-2-specific IgA and IgG in breast milk after vaccination.

METHODS

In this prospective observational study in Spain, 86 lactating women from priority groups receiving the vaccination against SARS-CoV-2 were included. Breast milk samples were collected longitudinally at seven or eight-time points (depending on vaccine type). A group with confirmed SARS-CoV-2 infection (n=19) and a group of women from pre-pandemic time (n=20) were included for comparison.

RESULTS

Eighty-six vaccinated lactating women [mean age, 34.6 ± 3.7 years] of whom 96% were Caucasian and 92% were healthcare workers. A total number of 582 milk samples were included, and vaccine distribution was BioNTech/Pfizer (BNT162b2, n=34), Moderna (mRNA-1273, n=20), and AstraZeneca (ChAdOx1 nCoV-19, n=32). For each vaccine, 7 and 8 longitudinal time points were collected from baseline up to 30 days after the second dose for mRNA vaccines and adenovirus-vectored vaccines, respectively. A strong reactivity was observed for IgG and IgA after vaccination mainly after the 2 dose. The presence and persistence of specific SARS-CoV-2 antibodies in breast milk were dependent on the vaccine type, with higher IgG and IgA levels in mRNA-based vaccines when compared to AstraZeneca, and on previous virus exposure. High intra- and inter-variability were observed, being relevant for IgA antibodies. In milk from vaccinated women, anti-SARS-CoV-2 IgG was significantly higher while IgA levels were lower than in milk from COVID-19-infected women. Women with previous COVID-19 increased their IgG antibodies levels after the first dose to a similar level observed in vaccinated women after the second dose.

CONCLUSIONS

COVID-19 vaccination induced anti-SARS-CoV-2 IgA and IgG in breast milk with higher levels after the 2 dose. Levels of anti-SARS-CoV-2 IgA and IgG are dependent on the vaccine type. Further studies are warranted to demonstrate the protective antibody effect against COVID-19 in infants from vaccinated and infected mothers.

TRIAL REGISTRATION

NCT04751734 (date of registration is on February 12, 2021).

摘要

背景

母乳是从哺乳期母亲向新生儿传递保护性抗体的载体。在感染 SARS-CoV-2 后，母乳中已鉴定出病毒特异性 IgA 和 IgG，但关于哺乳期妇女接种不同类型 COVID-19 疫苗的影响的数据有限。本研究旨在评估接种疫苗后母乳中 SARS-CoV-2 特异性 IgA 和 IgG 的诱导时间过程。

方法

本研究为西班牙的一项前瞻性观察性研究，纳入了 86 名来自优先接种人群的哺乳期妇女，这些妇女正在接种 SARS-CoV-2 疫苗。根据疫苗类型，在七个或八个时间点（取决于疫苗类型）纵向采集母乳样本。纳入了一组已确诊的 SARS-CoV-2 感染的妇女（n=19）和一组来自大流行前的妇女（n=20）进行比较。

结果

86 名接种疫苗的哺乳期妇女[平均年龄，34.6±3.7 岁]，其中 96%为白种人，92%为医护人员。共纳入 582 份母乳样本，疫苗分布为 BioNTech/Pfizer（BNT162b2，n=34）、Moderna（mRNA-1273，n=20）和阿斯利康（ChAdOx1 nCoV-19，n=32）。对于每种疫苗，mRNA 疫苗在第二剂后 30 天内从基线采集了 7 个和 8 个纵向时间点，而腺病毒载体疫苗则采集了 8 个和 9 个纵向时间点。接种疫苗后，主要在第二剂后观察到 IgG 和 IgA 的强烈反应。母乳中 SARS-CoV-2 特异性抗体的存在和持续时间取决于疫苗类型，与阿斯利康相比，基于 mRNA 的疫苗的 IgG 和 IgA 水平更高，且与之前的病毒暴露有关。观察到高度的内和间变异性，这与 IgA 抗体有关。与 COVID-19 感染妇女的母乳相比，接种疫苗妇女的母乳中的抗 SARS-CoV-2 IgG 显著升高，而 IgA 水平降低。有 COVID-19 既往感染史的妇女在接种第一剂后将其 IgG 抗体水平提高至与接种第二剂后接种疫苗妇女相似的水平。