Carter Immunology Center, University of Virginia, Charlottesville, VA 22908, USA.
Division of Infectious Disease and International Health, Department of Medicine, University of Virginia, Charlottesville, VA 22908, USA.
Sci Immunol. 2022 Oct 28;7(76):eadd4853. doi: 10.1126/sciimmunol.add4853. Epub 2022 Oct 21.
SARS-CoV-2 mRNA vaccination induces robust humoral and cellular immunity in the circulation; however, it is currently unknown whether it elicits effective immune responses in the respiratory tract, particularly against variants of concern (VOCs), including Omicron. We compared the SARS-CoV-2 S-specific total and neutralizing antibody responses, and B and T cell immunity, in the bronchoalveolar lavage fluid (BAL) and blood of COVID-19-vaccinated individuals and hospitalized patients. Vaccinated individuals had significantly lower levels of neutralizing antibody against D614G, Delta (B.1.617.2), and Omicron BA.1.1 in the BAL compared with COVID-19 convalescents despite robust S-specific antibody responses in the blood. Furthermore, mRNA vaccination induced circulating S-specific B and T cell immunity, but in contrast to COVID-19 convalescents, these responses were absent in the BAL of vaccinated individuals. Using a mouse immunization model, we demonstrated that systemic mRNA vaccination alone induced weak respiratory mucosal neutralizing antibody responses, especially against SARS-CoV-2 Omicron BA.1.1 in mice; however, a combination of systemic mRNA vaccination plus mucosal adenovirus-S immunization induced strong neutralizing antibody responses not only against the ancestral virus but also the Omicron BA.1.1 variant. Together, our study supports the contention that the current COVID-19 vaccines are highly effective against severe disease development, likely through recruiting circulating B and T cell responses during reinfection, but offer limited protection against breakthrough infection, especially by the Omicron sublineage. Hence, mucosal booster vaccination is needed to establish robust sterilizing immunity in the respiratory tract against SARS-CoV-2, including infection by the Omicron sublineage and future VOCs.
SARS-CoV-2 mRNA 疫苗接种可在循环系统中诱导强烈的体液和细胞免疫;然而,目前尚不清楚它是否在呼吸道中引发有效的免疫反应,特别是针对关切的变异株(VOCs),包括奥密克戎。我们比较了 COVID-19 疫苗接种者和住院患者支气管肺泡灌洗液(BAL)和血液中的 SARS-CoV-2 S 特异性总抗体和中和抗体反应,以及 B 和 T 细胞免疫。尽管血液中存在强烈的 S 特异性抗体反应,但与 COVID-19 恢复期患者相比,疫苗接种者 BAL 中针对 D614G、Delta(B.1.617.2)和奥密克戎 BA.1.1 的中和抗体水平显著较低。此外,mRNA 疫苗接种可诱导循环 S 特异性 B 和 T 细胞免疫,但与 COVID-19 恢复期患者不同,这些反应在疫苗接种者的 BAL 中不存在。使用小鼠免疫模型,我们证明了单独的全身 mRNA 疫苗接种仅诱导微弱的呼吸道黏膜中和抗体反应,特别是针对 SARS-CoV-2 奥密克戎 BA.1.1 的反应;然而,全身 mRNA 疫苗接种加黏膜腺病毒-S 免疫的组合不仅诱导针对原始病毒的强烈中和抗体反应,还诱导针对奥密克戎 BA.1.1 变体的强烈中和抗体反应。总之,我们的研究支持这样一种观点,即当前的 COVID-19 疫苗对严重疾病的发展非常有效,可能是通过在再次感染时招募循环 B 和 T 细胞反应,但对突破性感染的保护作用有限,特别是针对奥密克戎亚系。因此,需要黏膜加强疫苗接种来在呼吸道中建立针对 SARS-CoV-2 的强大杀菌免疫,包括感染奥密克戎亚系和未来的 VOCs。
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