SARS-CoV-2 疫苗诱导的免疫反应在腹膜透析患者中持续 6 个月以上的情况，以及加强剂量在维持血清阳性中的作用。

Waning of SARS-CoV-2 Vaccine-Induced Immune Response over 6 Months in Peritoneal Dialysis Patients and the Role of a Booster Dose in Maintaining Seropositivity.

机构信息

Division of Nephrology, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.

Department of Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.

出版信息

Nephron. 2022;146(6):559-563. doi: 10.1159/000524658. Epub 2022 May 20.

DOI:10.1159/000524658

PMID:35598596

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9393771/

Abstract

INTRODUCTION

Although lower than general population, newly developed SARS-CoV-2 vaccines generate immune responses in end-stage kidney disease patients. However, the persistence of immune responses in the long term is not known yet. This study aimed to evaluate humoral immune responses in peritoneal dialysis (PD) patients over 6 months and to analyze the effects of the booster dose.

METHODS

Humoral immune responses of PD patients were measured after initial SARS-CoV-2 vaccinations and after 6 months following initial vaccinations. Immune responses were compared between patients who received and did not receive booster doses. PD patients were compared with 41 hemodialysis (HD) patients and 61 healthy controls. Humoral immune responses were measured by a commercial test that detects antibodies toward the receptor-binding domain of the spike protein of SARS-CoV-2.

RESULTS

Twenty PD patients were evaluated over 6 months. The initial seropositivity rate was 90.9% with inactivated vaccine and 100% with mRNA vaccine. Seropositivity decreased to 44.4% after 6 months, and a booster dose helped in maintaining the 100% of seropositivity (p = 0.005). Magnitude of humoral response at the 6th month was also higher in patients who received the third dose (1,132.8 ± 769.6 AU/mL vs. 400.0 ± 294.6 AU/mL; p = 0.015). Among patients who did not receive the third dose, those who got mRNA vaccine could maintain higher seropositivity than others who got inactivated vaccine (75% vs. 40% for PD, 81.8% vs. 50% for HD). Seropositivity and antibody levels were similar for PD and HD patients after 6 months (p = 0.24 and 0.56) but lower than healthy controls (p = 0.0013).

CONCLUSION

SARS-CoV-2 vaccine-induced antibody levels and seropositivity of PD patients significantly fall after 6 months. A booster dose after around 3 months following initial immunization might help in maintaining seropositivity.

摘要

简介

尽管低于一般人群，新开发的 SARS-CoV-2 疫苗会在终末期肾病患者中产生免疫反应。然而，目前尚不清楚免疫反应在长期内的持续情况。本研究旨在评估腹膜透析（PD）患者在 6 个月内的体液免疫反应，并分析加强剂量的效果。

方法

在初始 SARS-CoV-2 疫苗接种后和初始接种后 6 个月，测量 PD 患者的体液免疫反应。比较接受和未接受加强剂量的患者之间的免疫反应。将 PD 患者与 41 名血液透析（HD）患者和 61 名健康对照进行比较。通过商业检测来测量体液免疫反应，该检测检测针对 SARS-CoV-2 刺突蛋白受体结合域的抗体。

结果

20 名 PD 患者在 6 个月内进行了评估。初始血清阳性率为 90.9%（灭活疫苗）和 100%（mRNA 疫苗）。6 个月后血清阳性率下降至 44.4%，加强剂量有助于维持 100%的血清阳性率（p = 0.005）。接受第三剂的患者在第 6 个月的体液反应幅度也更高（1,132.8 ± 769.6 AU/mL 与 400.0 ± 294.6 AU/mL；p = 0.015）。在未接受第三剂的患者中，接受 mRNA 疫苗的患者比接受灭活疫苗的患者能维持更高的血清阳性率（75%比 PD 患者中的 40%，81.8%比 HD 患者中的 50%）。6 个月后，PD 和 HD 患者的血清阳性率和抗体水平与健康对照组相似（p = 0.24 和 0.56），但低于健康对照组（p = 0.0013）。