Shostak Yael, Kramer Mordechai R, Edni Omer, Glusman Bendersky Ahinoam, Shafran Noa, Bakal Ilana, Heching Moshe, Rosengarten Dror, Shitenberg Dorit, Amor Shay M, Ben Zvi Haim, Pertzov Barak, Cohen Hila, Rotem Shahar, Elia Uri, Chitlaru Theodor, Erez Noam, Peysakhovich Yuri, D Barac Yaron, Shlomai Amir, Bar-Haim Erez, Shtraichman Osnat
Department of Medicine D, Beilinson Hospital, Petah Tikva 4941492, Israel.
Pulmonary Institute, Rabin Medical Center, Petach Tikva 4941492, Israel.
Vaccines (Basel). 2023 Apr 4;11(4):799. doi: 10.3390/vaccines11040799.
Two doses of mRNA SARS-CoV-2 vaccines elicit an attenuated humoral immune response among immunocompromised patients. Our study aimed to assess the immunogenicity of a third dose of the BNT162b2 vaccine among lung transplant recipients (LTRs). We prospectively evaluated the humoral response by measuring anti-spike SARS-CoV-2 and neutralizing antibodies in 139 vaccinated LTRs ~4-6 weeks following the third vaccine dose. The t-cell response was evaluated by IFNγ assay. The primary outcome was the seropositivity rate following the third vaccine dose. Secondary outcomes included: positive neutralizing antibody and cellular immune response rate, adverse events, and COVID-19 infections. Results were compared to a control group of 41 healthcare workers. Among LTRs, 42.4% had a seropositive antibody titer, and 17.2% had a positive t-cell response. Seropositivity was associated with younger age (t = 3.736, < 0.001), higher GFR (t = 2.355, = 0.011), and longer duration from transplantation (t = -1.992, = 0.024). Antibody titer positively correlated with neutralizing antibodies (r = 0.955, < 0.001). The current study may suggest the enhancement of immunogenicity by using booster doses. Since monoclonal antibodies have limited effectiveness against prevalent sub-variants and LTRs are prone to severe COVID-19 morbidity, vaccination remains crucial for this vulnerable population.
两剂新型冠状病毒mRNA疫苗在免疫功能低下的患者中引发的体液免疫反应减弱。我们的研究旨在评估第三剂BNT162b2疫苗在肺移植受者（LTR）中的免疫原性。我们前瞻性地评估了139名接种疫苗的LTR在第三剂疫苗接种后约4至6周时抗新冠病毒刺突蛋白抗体和中和抗体的体液反应。通过干扰素γ检测评估T细胞反应。主要结果是第三剂疫苗接种后的血清阳性率。次要结果包括：中和抗体阳性和细胞免疫反应率、不良事件以及新冠病毒感染。将结果与41名医护人员的对照组进行比较。在LTR中，42.4%的抗体滴度呈血清阳性，17.2%的T细胞反应呈阳性。血清阳性与年龄较小（t = 3.736，P < 0.001）、肾小球滤过率较高（t = 2.355，P = 0.011）以及移植后时间较长（t = -1.992，P = 0.024）相关。抗体滴度与中和抗体呈正相关（r = 0.955，P < 0.001）。当前研究可能提示通过使用加强剂量可增强免疫原性。由于单克隆抗体对流行的亚变体有效性有限，且LTR易患重症新冠病毒疾病，疫苗接种对这一脆弱人群仍然至关重要。
