肝移植受者对不同 SARS-CoV-2 疫苗的体液免疫反应。
Humoral response to different SARS-CoV-2 vaccines in orthotopic liver transplant recipients.
机构信息
Neurology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico.
Liver Transplant Unit and Gastroenterology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico.
出版信息
Vaccine. 2022 Sep 9;40(38):5621-5630. doi: 10.1016/j.vaccine.2022.08.027. Epub 2022 Aug 22.
BACKGROUND
The safety and efficacy data of the different types of available vaccines is still needed. The goal of the present analysis was to evaluate the humoral response to the COVID-19 vaccines in orthotopic liver transplant (OLT) recipients.
METHODS
Participants were included from February to September 2021. No prioritized vaccination roll call applied for OLT patients. Controls were otherwise healthy people. Blood samples were drawn after 15 days of the complete vaccine doses. The samples were analyzed according to the manufacturer's instructions using the Liaison XL platform from DiaSorin (DiaSorin S.p.A., Italy), and SARS-COV-2 IgG II Quant (Abbott Diagnostics, IL, USA).
RESULTS
A total of 187 participants (133 OLT, 54 controls, median age: 60 years, 58.8% women) were included for the analysis; 74.3% had at least one comorbidity. The serologic response in OLT patients was lower than in controls (median 549 AU/mL vs. 3450 AU/mL, respectively; p = 0.001). A positive humoral response was found in 133 OLT individuals: 89.2% with BNT162b2 (Pfizer-BioNTech), 60% ChAdOx1 nCOV-19 (Oxford-AstraZeneca), 76.9% with CoronaVac (Sinovac, Life Sciences, China), 55.6% Ad5-nCov (Cansino, Biologics), 68.2% Gam-COVID-Vac (Sputnik V) and 100% with mRNA-1273. In controls the serological response was 100%, except for Cansino (75%). In a multivariable model, personal history of COVID-19 and BNT162b2 inoculation were associated with the serologic response, while the use of prednisone (vs. other immunosuppressants) reduced this response.
CONCLUSION
The serologic response to COVID-19 vaccines in OLT patients is lower than in healthy controls. The BNT162b2 vaccine was associated with a higher serologic response.
背景
仍需要评估不同类型可用疫苗的安全性和有效性数据。本分析的目的是评估原位肝移植（OLT）受者对 COVID-19 疫苗的体液反应。
方法
参与者于 2021 年 2 月至 9 月入选。OLT 患者未进行优先疫苗接种。对照组为其他健康人群。在完成疫苗全剂量接种后 15 天采集血样。根据制造商的说明，使用 DiaSorin（意大利 DiaSorin S.p.A.）的 Liaison XL 平台和 Abbott Diagnostics（美国伊利诺伊州）的 SARS-COV-2 IgG II Quant 对样本进行分析。
结果
共纳入 187 名参与者（OLT 患者 133 名，对照组 54 名，中位年龄 60 岁，女性占 58.8%）进行分析；74.3%的患者至少有一种合并症。OLT 患者的血清学反应低于对照组（中位数分别为 549 AU/mL 和 3450 AU/mL，p=0.001）。在 133 名 OLT 个体中发现了阳性体液反应：133 名接受 BNT162b2（辉瑞-生物技术公司）的个体中 89.2%、接受 ChAdOx1 nCOV-19（牛津-阿斯利康）的个体中 60%、接受 CoronaVac（科兴中维，中国生物技术股份有限公司）的个体中 76.9%、接受 Ad5-nCov（康希诺，康希诺生物股份公司）的个体中 55.6%、接受 Gam-COVID-Vac（卫星 V）的个体中 68.2%和接受 mRNA-1273 的个体中 100%。对照组的血清学反应为 100%，但康希诺除外（75%）。在多变量模型中，COVID-19 个人史和 BNT162b2 接种与血清学反应相关，而使用泼尼松（与其他免疫抑制剂相比）会降低这种反应。
结论
OLT 患者对 COVID-19 疫苗的血清学反应低于健康对照组。BNT162b2 疫苗与更高的血清学反应相关。
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