Department of Clinical Microbiology and Immunology, Sackler School of Medicine Tel Aviv University, Tel Aviv, Israel.
Sackler School, Medicine Tel Aviv University, Tel Aviv, Israel.
Front Immunol. 2023 Mar 27;14:1131965. doi: 10.3389/fimmu.2023.1131965. eCollection 2023.
Protective immunity against COVID-19 is orchestrated by an intricate network of innate and adaptive anti-viral immune responses. Several vaccines have been rapidly developed to combat the destructive effects of COVID-19, which initiate an immunological cascade that results in the generation of neutralizing antibodies and effector T cells towards the SARS-CoV-2 spike protein. Developing optimal vaccine-induced anti-SARS- CoV-2 protective immunity depends on a fully competent immune response. Some evidence was gathered on the effects of vaccination outcomes in immunocompromised adult individuals. Nonetheless, protective immunity elicited by the Pfizer Biontech BNT162b2 vaccine in immunocompromised adolescents received less attention and was mainly focused on the antibody response and their neutralization potential. The overall immune response, including T-cell activities, was largely understudied. In this study, we characterized the immune response of vaccinated immunocompromised adolescents. We found that immunocompromised adolescents, which may fail to elicit a humoral response and develop antibodies, may still develop cellular T-cell immunity towards SARS-CoV-2 infections. Furthermore, most immunocompromised adolescents due to genetic disorders or drugs (Kidney and liver transplantation) still develop either humoral, cellular or both arms of immunity towards SARS-CoV-2 infections. We also demonstrate that most patients could mount a cellular or humoral response even after six months post 2 vaccination. The findings that adolescents immunocompromised patients respond to some extent to vaccination are promising. Finally, they question the necessity for additional vaccination boosting regimens for this population who are not at high risk for severe disease, without further testing of their post-vaccination immune status.
针对 COVID-19 的保护性免疫是由先天和适应性抗病毒免疫反应的复杂网络所调控的。为了对抗 COVID-19 的破坏性影响，已经迅速开发了几种疫苗，这些疫苗会引发免疫级联反应，导致针对 SARS-CoV-2 刺突蛋白产生中和抗体和效应 T 细胞。开发最佳的疫苗诱导的抗 SARS-CoV-2 保护性免疫取决于完全有效的免疫反应。已经有一些证据表明疫苗接种对免疫功能低下的成年个体的影响。尽管如此，针对免疫功能低下青少年的辉瑞 Biontech BNT162b2 疫苗所引发的保护性免疫的研究较少，主要集中在抗体反应及其中和潜力上。整体免疫反应，包括 T 细胞活性，在很大程度上仍未得到充分研究。在这项研究中，我们对免疫功能低下的青少年进行了疫苗接种后的免疫反应的特征描述。我们发现，免疫功能低下的青少年可能无法引发体液反应和产生抗体，但仍可能对 SARS-CoV-2 感染产生细胞 T 细胞免疫。此外，由于遗传疾病或药物（肾脏和肝脏移植）而导致免疫功能低下的大多数青少年仍然对 SARS-CoV-2 感染产生体液、细胞或两者的免疫反应。我们还证明，即使在接种疫苗后 6 个月，大多数患者仍能产生细胞或体液反应。这些发现表明，免疫功能低下的青少年患者在某种程度上对疫苗接种有反应，这是令人鼓舞的。最后，他们质疑对于那些没有患重病高风险的青少年患者，是否需要进行额外的疫苗接种增强方案，而无需进一步测试他们的接种后免疫状态。
