在实体器官移植受者和对照者中，首次接种 BNT162b2 疫苗 12 个月后的体液和 T 细胞反应：动力学、相关因素和 SARS-CoV-2 感染的作用。

Humoral and T-cell response 12 months after the first BNT162b2 vaccination in solid organ transplant recipients and controls: Kinetics, associated factors, and role of SARS-CoV-2 infection.

机构信息

Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

出版信息

Front Immunol. 2023 Jan 13;13:1075423. doi: 10.3389/fimmu.2022.1075423. eCollection 2022.

INTRODUCTION

We investigated humoral and T-cell responses within 12 months after first BNT162b2 vaccine in solid organ transplant (SOT) recipients and controls who had received at least three vaccine doses. Furthermore, we compared the immune response in participants with and without previous SARS-CoV-2 infection.

METHODS

We included adult liver, lung, and kidney transplant recipients, and controls were selected from a parallel cohort of healthcare workers.

RESULTS

At 12th-month, the IgG geometric mean concentrations (GMCs) (P<0.001), IgA GMCs (P=0.003), and median IFN-γ (P<0.001) were lower in SOT recipients than in controls. However, in SOT recipients and controls with previous infection, the neutralizing index was 99%, and the IgG, and IgA responses were comparable. After adjustment, female-sex (aOR: 3.6, P<0.009), kidney (aOR: 7.0, P= 0.008) or lung transplantation (aOR: 7.5, P= 0.014), and use of mycophenolate (aOR: 5.2, P=0.03) were associated with low IgG non response. Age (OR:1.4, P=0.038), time from transplantation to first vaccine (OR: 0.45, P<0.035), and previous SARS-CoV-2 infection (OR: 0.14, P<0.001), were associated with low IgA non response. Diabetes (OR:2.4, P=0.044) was associated with T-cell non response.

CONCLUSION

In conclusion, humoral and T-cell responses were inferior in SOT recipients without previous SARS-CoV-2 infection but comparable to controls in SOT recipients with previous infection.

简介

我们研究了首次接受 BNT162b2 疫苗接种后 12 个月内实体器官移植（SOT）受者和接受至少 3 剂疫苗的对照者的体液和 T 细胞反应。此外，我们比较了有和无既往 SARS-CoV-2 感染的参与者的免疫反应。

方法

我们纳入了成年肝、肺和肾移植受者，对照者选自平行队列的医护人员。

结果

在第 12 个月时，SOT 受者的 IgG 几何平均浓度（GMC）（P<0.001）、IgA GMC（P=0.003）和中位数 IFN-γ（P<0.001）均低于对照组。然而，在 SOT 受者和有既往感染的对照组中，中和指数为 99%，且 IgG 和 IgA 反应相当。调整后，女性（OR：3.6，P<0.009）、肾（OR：7.0，P=0.008）或肺移植（OR：7.5，P=0.014）和使用霉酚酸（OR：5.2，P=0.03）与低 IgG 无反应相关。年龄（OR：1.4，P=0.038）、从移植到首次接种疫苗的时间（OR：0.45，P<0.035）和既往 SARS-CoV-2 感染（OR：0.14，P<0.001）与低 IgA 无反应相关。糖尿病（OR：2.4，P=0.044）与 T 细胞无反应相关。