Division of Allergy-Immunology, Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Department of Microbiology, Immunology and Tropical Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Ann Allergy Asthma Immunol. 2023 Jun;130(6):743-751.e3. doi: 10.1016/j.anai.2023.01.025. Epub 2023 Feb 2.
Clinical trials of the mRNA coronavirus disease 2019 (COVID-19) vaccines excluded individuals with primary antibody deficiencies.
To evaluate whether antibody and T-cell responses to mRNA COVID-19 vaccination in patients with common variable immunodeficiency (CVID) and specific antibody deficiency (SAD) were comparable to those in healthy controls.
We measured antibody responses against the spike glycoprotein and the receptor-binding domain (RBD) in addition to severe acute respiratory syndrome coronavirus 2 specific T-cell responses using peripheral blood mononuclear cells 2 to 8 weeks after the subjects completed the primary 2-dose vaccine series.
The study comprised 12 patients with CVID, 7 patients with SAD, and 10 controls. Individuals with CVID had lower immunoglobulin (Ig) G and Ig A levels against spike glycoprotein than did both individuals with SAD (P = .27 and P = .01, respectively) and controls (P = .01 and P = .004, respectively). The CVID group developed lower IgG titers against the RBD epitope than did the control group (P = .01). Participants with CVID had lower neutralizing titers than did the control group (P = .002). All participants with SAD developed neutralizing titers. All 3 groups (SAD, CVID, and control) developed antigen-specific CD4 and CD8 T-cell responses after vaccination.
Our results suggest that patients with CVID may have impaired antibody responses to COVID-19 vaccination but intact T-cell responses, whereas patients with SAD would be expected to have both intact antibody and T-cell responses to vaccination.
针对 2019 年冠状病毒病（COVID-19）mRNA 疫苗的临床试验排除了原发性抗体缺陷患者。
评估普通可变免疫缺陷（CVID）和特异性抗体缺陷（SAD）患者对 mRNA COVID-19 疫苗的抗体和 T 细胞反应是否与健康对照者相当。
我们在完成初级 2 剂疫苗系列接种后 2 至 8 周，使用外周血单核细胞测量针对刺突糖蛋白和受体结合域（RBD）的抗体反应以及针对严重急性呼吸系统综合征冠状病毒 2 的特异性 T 细胞反应。
该研究纳入了 12 例 CVID 患者、7 例 SAD 患者和 10 例对照者。CVID 个体针对刺突糖蛋白的免疫球蛋白（Ig）G 和 IgA 水平低于 SAD 个体（P 分别为.27 和 P 分别为.01）和对照者（P 分别为.01 和 P 分别为.004）。CVID 组针对 RBD 表位的 IgG 滴度低于对照组（P 分别为.01）。与对照组相比，CVID 组的中和滴度较低（P 分别为.002）。所有 SAD 患者均产生了中和滴度。所有 3 组（SAD、CVID 和对照组）在接种疫苗后均产生了抗原特异性 CD4 和 CD8 T 细胞反应。
我们的研究结果表明，CVID 患者对 COVID-19 疫苗接种的抗体反应可能受损，但 T 细胞反应完整，而 SAD 患者预计对疫苗接种具有完整的抗体和 T 细胞反应。
