Shen Chih-Lung, Wang Tso-Fu, Liu Chao-Zong, Wu Yi-Feng
Department of Hematology and Oncology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan.
College of Medicine, Tzu Chi University, Hualien 970, Taiwan.
Vaccines (Basel). 2023 Feb 16;11(2):456. doi: 10.3390/vaccines11020456.
Coronavirus disease 2019 (COVID-19) vaccines are associated with serious thromboembolic or thrombocytopenic events including vaccine-induced immune thrombocytopenia and thrombosis and immune thrombocytopenia, particularly AZD1222/ChAdOx1. According to the proposed mechanism, COVID-19 vaccines stimulate inflammation and platelet activation. In this study, we analyzed the role of AZD1222/ChAdOx1 vaccines in the activation of platelets and the release of anti-PF4 antibodies and inflammatory cytokines in a cohort of healthy donors without vaccine-induced immune thrombotic thrombocytopenia (VITT). Forty-eight healthy volunteers were enrolled in this study. Blood samples were collected from peripheral blood at three time points: before vaccination and 1 and 7 days after vaccination. Compared with the prevaccination data, a decrease in the leukocyte and platelet counts was observed 1 day after vaccination, which recovered 7 days after injection. The percentage of activated GPIIb/IIIa complex (PAC-1) under high ADP or thrombin receptor-activating peptide stimulation increased 1 day after vaccination. Furthermore, interleukin-8 (IL-8) and interferon-gamma-induced protein 10 (IP-10) increased significantly. Additionally, platelet activation and inflammation, with the release of cytokines, were observed; however, none of the individuals developed VITT. Mild thrombocytopenia with platelet activation and inflammation with an elevation of IL-8 and IP-10 were observed after AZ vaccination.
2019冠状病毒病（COVID-19）疫苗与严重血栓栓塞或血小板减少事件相关，包括疫苗诱导的免疫性血小板减少症和血栓形成以及免疫性血小板减少症，尤其是AZD1222/ChAdOx1疫苗。根据提出的机制，COVID-19疫苗会刺激炎症和血小板活化。在本研究中，我们分析了AZD1222/ChAdOx1疫苗在一组无疫苗诱导的免疫性血栓性血小板减少症（VITT）的健康供体中对血小板活化以及抗PF4抗体和炎性细胞因子释放的作用。48名健康志愿者参与了本研究。在三个时间点采集外周血样本：接种疫苗前、接种疫苗后1天和7天。与接种疫苗前的数据相比，接种疫苗后1天观察到白细胞和血小板计数下降，注射后7天恢复。在高ADP或凝血酶受体激活肽刺激下，活化的GPIIb/IIIa复合物（PAC-1）百分比在接种疫苗后1天增加。此外，白细胞介素-8（IL-8）和干扰素-γ诱导蛋白10（IP-10）显著增加。此外，观察到血小板活化和炎症以及细胞因子的释放；然而，没有个体发生VITT。接种AZ疫苗后观察到轻度血小板减少伴血小板活化以及炎症伴IL-8和IP-10升高。
