CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, China.
University of Chinese Academy of Sciences, Beijing, China.
Front Immunol. 2022 Jul 18;13:947724. doi: 10.3389/fimmu.2022.947724. eCollection 2022.
Asthma patients potentially have impaired adaptive immunity to virus infection. The levels of SARS-CoV-2-specific adaptive immunity between COVID-19 survivors with and without asthma are presently unclear.
COVID-19 survivors (patients with asthma n=11, with allergies n=8, and COVID-19 only n=17) and non-COVID-19 individuals (asthmatic patients n=10 and healthy controls n=9) were included. The COVID-19 patients were followed up at about 8 months and 16 months after discharge. The clinical characteristics, lymphocyte subsets, memory T cells, and humoral immunity including SARS-CoV-2 specific antibodies, SARS-CoV-2 pseudotyped virus neutralization assay, and memory B cells were analyzed in these subjects.
The strength of virus-specific T cell response in COVID-19 survivors was positively correlated with the percentage of blood eosinophils and Treg cells (r=0.4007, p=0.0188; and r=0.4435, p=0.0086 respectively) at 8-month follow-up. There were no statistical differences in the levels of SARS-CoV-2-specific T cell response between the COVID-19 survivors with, and without, asthma. Compared to those without asthma, the COVID-19 with asthma survivors had higher levels of SARS-CoV-2-specific neutralizing antibodies (NAbs) at the 8-month follow-up (p<0.05). Moreover, the level of NAbs in COVID-19 survivors was positively correlated with the percentage of Treg and cTfh2 cells (r=0.5037, p=0.002; and r=0.4846, p=0.0141), and negatively correlated with the percentage of Th1 and Th17 cells (r=-0.5701, p=0.0003; and r=-0.3656, p=0.0308), the ratio of Th1/Th2, Th17/Treg, and cTfh1/cTfh2 cell (r=-0.5356, r=-0.5947, r=-0.4485; all p<0.05). The decay rate of NAbs in the COVID-19 survivors with asthma was not significantly different from that of those without asthma at 16-month follow-up.
The level of SARS-CoV-2-specific NAbs in COVID-19 survivors with asthma was higher than that of those without asthma at 8-month follow-up. The SARS-CoV-2-specific T cell immunity was associated with blood eosinophils and Treg percentages. The SARS-CoV-2-specific humoral immunity was closely associated with cTfh2/cTfh1 imbalance and Treg/Th17 ratio. According to the findings, asthmatic patients in COVID-19 convalescent period may benefit from an enhanced specific humoral immunity, which associates with skewed Th2/Th1 and Treg/Th17 immune.
哮喘患者可能对病毒感染的适应性免疫受损。目前尚不清楚 COVID-19 幸存者中合并和不合并哮喘的 SARS-CoV-2 特异性适应性免疫水平。
纳入 COVID-19 幸存者（哮喘患者 n=11，过敏患者 n=8，COVID-19 患者 n=17）和非 COVID-19 个体（哮喘患者 n=10 和健康对照 n=9）。COVID-19 患者在出院后约 8 个月和 16 个月进行随访。分析这些受试者的临床特征、淋巴细胞亚群、记忆 T 细胞和体液免疫，包括 SARS-CoV-2 特异性抗体、SARS-CoV-2 假型病毒中和测定和记忆 B 细胞。
COVID-19 幸存者中病毒特异性 T 细胞反应的强度与 8 个月随访时血液嗜酸性粒细胞和 Treg 细胞的百分比呈正相关（r=0.4007，p=0.0188；r=0.4435，p=0.0086）。COVID-19 幸存者中哮喘患者与无哮喘患者之间的 SARS-CoV-2 特异性 T 细胞反应水平无统计学差异。与无哮喘患者相比，COVID-19 合并哮喘幸存者在 8 个月随访时 SARS-CoV-2 特异性中和抗体（NAb）水平更高（p<0.05）。此外，COVID-19 幸存者的 NAb 水平与 Treg 和 cTfh2 细胞的百分比呈正相关（r=0.5037，p=0.002；r=0.4846，p=0.0141），与 Th1 和 Th17 细胞的百分比呈负相关（r=-0.5701，p=0.0003；r=-0.3656，p=0.0308），Th1/Th2、Th17/Treg 和 cTfh1/cTfh2 比值（r=-0.5356，r=-0.5947，r=-0.4485；均 p<0.05）。COVID-19 合并哮喘幸存者的 NAb 衰减率在 16 个月随访时与无哮喘幸存者无显著差异。
COVID-19 幸存者中哮喘患者的 SARS-CoV-2 特异性 NAb 水平在 8 个月随访时高于无哮喘患者。SARS-CoV-2 特异性 T 细胞免疫与血液嗜酸性粒细胞和 Treg 百分比有关。SARS-CoV-2 特异性体液免疫与 cTfh2/cTfh1 失衡和 Treg/Th17 比值密切相关。根据这些发现，COVID-19 恢复期的哮喘患者可能受益于增强的特异性体液免疫，这与偏倚的 Th2/Th1 和 Treg/Th17 免疫有关。
