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新型冠状病毒疫苗在肺移植受者中的免疫原性、疗效和安全性。

Vaccination Against SARS-CoV-2 in Lung Transplant Recipients: Immunogenicity, Efficacy and Safety.

机构信息

Third Department of Surgery, Prague Lung Transplant Program, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.

Department of Immunology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.

出版信息

Front Immunol. 2022 Jun 1;13:906225. doi: 10.3389/fimmu.2022.906225. eCollection 2022.

Abstract

Lung transplant (LuTx) recipients are considered to be at higher risk of developing serious illness from COVID-19. COVID-19 vaccines were shown in randomized clinical trials to substantially reduce the severity of COVID-19, however, patients receiving immunosuppressants were excluded from these trials. Observational studies report a proportion of solid organ transplant (SOT) recipients being able to mount sufficient titers of SARS-CoV-2 specific IgG antibodies, however, other studies demonstrate that more than 90% of the SOT recipients elicit neither humoral nor cellular immune response after vaccination. Currently, the third booster dose of the COVID-19 vaccines was shown to elicit strong immune responses and may, thus, represent a potent tool in the prevention of severe COVID-19 infection in SOT recipients, including patients after lung transplantation. To address the main challenges of SARS-CoV-2 vaccination in LuTx recipients in the era of COVID-19, we have closely collected all available data on the immunogenicity, efficacy and safety of COVID-19 vaccines in LuTx recipients.

摘要

肺移植(LuTx)受者被认为患 COVID-19 后发生严重疾病的风险更高。随机临床试验表明,COVID-19 疫苗可显著降低 COVID-19 的严重程度,但这些试验排除了接受免疫抑制剂治疗的患者。观察性研究报告了一部分实体器官移植(SOT)受者能够产生足够滴度的 SARS-CoV-2 特异性 IgG 抗体,但其他研究表明,超过 90%的 SOT 受者在接种疫苗后既未产生体液免疫反应,也未产生细胞免疫反应。目前,COVID-19 疫苗的第三剂加强针已被证明能引发强烈的免疫反应,因此可能成为预防 SOT 受者(包括肺移植后患者)严重 COVID-19 感染的有力工具。为了应对 COVID-19 时代 LuTx 受者中 SARS-CoV-2 疫苗接种的主要挑战,我们密切收集了所有关于 LuTx 受者 COVID-19 疫苗的免疫原性、疗效和安全性的现有数据。

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