From the Department of Paediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
the Clinical and Research Centre for Inflammatory Bowel Disease ISCARE and First Faculty of Medicine, Charles University, Prague, Czech Republic.
J Pediatr Gastroenterol Nutr. 2023 Feb 1;76(2):e36-e44. doi: 10.1097/MPG.0000000000003661. Epub 2022 Nov 23.
We prospectively compared the postvaccination immunity to messenger ribonucleic acid BNT162b2 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine of our pediatric patients over 12 years old with inflammatory bowel disease (IBD) to that of healthy controls and looked for predictors of its robustness.
Anti-receptor binding domain, anti-spike S2, and anti-nucleocapsid immunoglobin-G (IgG) and immunoglobin-A levels were measured in 139 pediatric patients with IBD [65 fully vaccinated (2 doses), median age 16.3, interquartile range (IQR) 15.2-17.8 years, median time from vaccination (IQR) 61.0 (42.0-80.0) days] and 1744 controls (46, 37-57 years) using microblot array.
All IBD and control patients developed positive anti-receptor binding domain IgG antibodies at comparable titers. The proportion of observations with positive anti-spike S2 IgG was higher in patients with IBD than in controls [63% vs 21%, odds ratio 2.99 (1.51-5.90)], as was its titer [median (IQR) 485 (92-922) vs 79 [33-180] IU/mL]. Anti-receptor binding domain and anti-spike S2 IgG levels were associated with IBD status. We found an association between anti-spike S2 IgG levels and time since vaccination (β -4.85, 95% CI -7.14 to 2.71, P = 0.0001), history of SARS-CoV-2 polymerase chain reaction positivity (206.76, 95% CI 39.93-374.05, P = 0.0213), and anti-tumor necrosis factor treatment (-239.68, 95% CI -396.44-83.55, P = 0.0047). Forty-three percent of patients reported vaccination side effects (mostly mild). Forty-six percent of observations with positive anti-nucleocapsid IgG had a history of SARS-CoV-2 infection.
Patients with IBD produced higher levels of postvaccination anti-spike S2 antibodies than controls. Previous SARS-CoV-2 infection is associated with higher production of postvaccination antibodies and anti-tumor necrosis factor treatment with lower production.
我们前瞻性比较了 12 岁以上患有炎症性肠病（IBD）的儿科患者与健康对照者接种信使核糖核酸 BNT162b2 严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）疫苗后的疫苗后免疫反应，并寻找其稳健性的预测因素。
使用微阵列对 139 名患有 IBD 的儿科患者[65 名完全接种（2 剂），中位年龄 16.3 岁，四分位距（IQR）15.2-17.8 岁，接种后中位时间（IQR）61.0（42.0-80.0）天]和 1744 名对照者（46 岁，37-57 岁）的抗受体结合域、抗刺突 S2 和抗核衣壳免疫球蛋白 G（IgG）和免疫球蛋白 A 水平进行了测量。
所有 IBD 和对照患者均以可比滴度产生了阳性的抗受体结合域 IgG 抗体。与对照组相比，IBD 患者中抗刺突 S2 IgG 阳性的比例更高[63%比 21%，优势比 2.99（1.51-5.90）]，其滴度也更高[中位数（IQR）485（92-922）比 79 [33-180] IU/mL]。抗受体结合域和抗刺突 S2 IgG 水平与 IBD 状态相关。我们发现抗刺突 S2 IgG 水平与接种后时间之间存在关联（β-4.85，95%CI-7.14 至 2.71，P=0.0001），与 SARS-CoV-2 聚合酶链反应阳性史（206.76，95%CI39.93-374.05，P=0.0213）和抗肿瘤坏死因子治疗（-239.68，95%CI-396.44-83.55，P=0.0047）相关。43%的患者报告了疫苗副作用（大多为轻度）。46%抗核衣壳 IgG 阳性的观察结果有 SARS-CoV-2 感染史。
与对照组相比，IBD 患者产生了更高水平的疫苗接种后抗刺突 S2 抗体。先前的 SARS-CoV-2 感染与更高水平的疫苗接种后抗体产生相关，而抗肿瘤坏死因子治疗与较低水平的抗体产生相关。
