Department of Medical Science and Cardiorenal Medicine, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
Center for Nobel and Exploratory Clinical Trials (Y-NEXT), Yokohama City University, Yokohama, Kanagawa, Japan.
Clin Exp Nephrol. 2022 Oct;26(10):988-996. doi: 10.1007/s10157-022-02243-8. Epub 2022 Jun 25.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is shown to prevent severe illness and death in hemodialysis (HD) patients, but the immune response to vaccines is reduced in this population. This study compared SARS-CoV-2 spike protein antibody titers between HD patients and healthy controls in Japan for up to 6 months following vaccination.
A multi-institutional retrospective study at five clinics in Japan was conducted using 412 HD patients and 156 healthy controls who received two doses of the BNT162b2 (Pfizer-BioNTech) mRNA vaccine. Anti-SARS-CoV-2 spike protein S1 IgG antibody titers were measured at 1, 3, and 6 months after the second dose. The attenuation speed was calculated as slope (i.e., -β) using a linear mixed-effects model toward the log-transformed antibody titers.
The HD group had significantly lower month 1 antibody titers (Ab-titer-1) than the controls, and these remained lower through month 6 (95% CI: 2617.1 (1296.7, 5240.8) vs. 7285.4 (4403.9, 11,000.0) AU/mL at Ab-titer-1, and 353.4 (178.4, 656.3) vs. 812.0 (498.3, 1342.7) AU/mL at Ab-titer-6 (p < 0.001, respectively)). Lower log Ab-titer-1 levels in the HD group were significantly associated with a lower log Ab-titer-6 (0.90 [0.83, 0.97], p < 0.001). The -β values in the HD patients and healthy controls were -4.7 ± 1.1 and -4.7 ± 1.4 (year), respectively.
SARS-CoV-2 spike protein antibody titers were significantly lower in HD patients than in healthy controls at 1 (peak) and 6 months after the second vaccination. Low peak antibody titers contributed to low 6-month antibody titers.
严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）疫苗已被证明可预防血液透析（HD）患者的重症和死亡，但该人群对疫苗的免疫反应降低。本研究比较了日本五家诊所的 412 名 HD 患者和 156 名健康对照者接种两剂 BNT162b2（辉瑞-生物科技）mRNA 疫苗后长达 6 个月的 SARS-CoV-2 刺突蛋白抗体滴度。在第二次接种后 1、3 和 6 个月测量抗 SARS-CoV-2 刺突蛋白 S1 IgG 抗体滴度。使用线性混合效应模型，根据对数转换后的抗体滴度计算衰减速度（即-β）。
这是一项在日本五家诊所进行的多机构回顾性研究，纳入了 412 名 HD 患者和 156 名健康对照者，他们均接种了两剂 BNT162b2（辉瑞-生物科技）mRNA 疫苗。在第二次接种后 1、3 和 6 个月测量抗 SARS-CoV-2 刺突蛋白 S1 IgG 抗体滴度。使用线性混合效应模型，根据对数转换后的抗体滴度计算衰减速度（即-β）。
HD 组在接种后第 1 个月（Ab-titer-1）的抗体滴度明显低于对照组，且在第 6 个月仍较低（Ab-titer-1 时分别为 2617.1（1296.7，5240.8）与 7285.4（4403.9，11,000.0）AU/mL；Ab-titer-6 时分别为 353.4（178.4，656.3）与 812.0（498.3，1342.7）AU/mL，p<0.001）。HD 组较低的 log Ab-titer-1 水平与较低的 log Ab-titer-6 水平显著相关（0.90[0.83，0.97]，p<0.001）。HD 患者和健康对照组的-β值分别为-4.7±1.1 和-4.7±1.4（年）。
HD 患者在第二次接种后第 1（峰值）和 6 个月的 SARS-CoV-2 刺突蛋白抗体滴度明显低于健康对照组。较低的峰值抗体滴度导致 6 个月时的抗体滴度较低。
