Toda Masataro, Yoshifuji Ayumi, Nakayama Tetsuo, Mise-Omata Setsuko, Oyama Emi, Uwamino Yoshifumi, Namkoong Ho, Komatsu Motoaki, Yoshimura Akihiko, Hasegawa Naoki, Kikuchi Kan, Ryuzaki Munekazu
Department of Nephrology, Tokyo Saiseikai Central Hospital, Tokyo 108-0073, Japan.
Department of Infectious Diseases, Keio University School of Medicine, Tokyo 160-8582, Japan.
Vaccines (Basel). 2023 Jul 6;11(7):1214. doi: 10.3390/vaccines11071214.
Coronavirus disease 2019 (COVID-19) following primary immunization (breakthrough infection) has been reported in hemodialysis patients; however, their post-infection immune status remains unclear. We evaluated the humoral and cellular immunity of hemodialysis patients after breakthrough infection. Hemodialysis patients who had received primary immunization against COVID-19 at least six months prior to the study but developed mild/moderate COVID-19 before a booster dose (breakthrough infection group) and hemodialysis patients who were not infected with COVID-19 but received a booster dose (booster immunization group) were recruited. In both groups, SARS-CoV-2 antigen-specific cytokines and IgG levels were measured three weeks after infection or three weeks after receiving a booster dose. Memory T and B cells were also counted in the breakthrough infection group using flow cytometry three weeks after infection. Significantly higher SARS-CoV-2 antigen-specific IgG, IFN-γ, IL-5, TNF-α, and IL-6 levels occurred in the breakthrough infection group compared to the booster immunization group ( = 0.013, 0.039, 0.024, 0.017, and 0.039, respectively). The SARS-CoV-2 antigen-specific IgG and cytokine levels were not significantly different between the two groups. The breakthrough infection group had significantly higher percentages of central and effector memory T cells and regulatory T cells than the comparison group ( = 0.008, 0.031, and 0.026, respectively). Breakthrough infections may induce stronger cellular and humoral immune responses than booster immunizations in hemodialysis patients.
血液透析患者中已报告有2019冠状病毒病（COVID-19）在初次免疫后发生突破性感染；然而，他们感染后的免疫状态仍不清楚。我们评估了突破性感染后血液透析患者的体液免疫和细胞免疫。招募了在研究前至少六个月接受过COVID-19初次免疫但在加强剂量前发生轻度/中度COVID-19的血液透析患者（突破性感染组）以及未感染COVID-19但接受了加强剂量的血液透析患者（加强免疫组）。在两组中，在感染后三周或接受加强剂量后三周测量SARS-CoV-2抗原特异性细胞因子和IgG水平。在突破性感染组中，感染后三周还使用流式细胞术对记忆T细胞和B细胞进行计数。与加强免疫组相比，突破性感染组中SARS-CoV-2抗原特异性IgG、IFN-γ、IL-5、TNF-α和IL-6水平显著更高（分别为 = 0.013、0.039、0.024、0.017和0.039）。两组之间SARS-CoV-2抗原特异性IgG和细胞因子水平无显著差异。突破性感染组的中枢记忆T细胞、效应记忆T细胞和调节性T细胞百分比显著高于对照组（分别为 = 0.008、0.031和0.026）。在血液透析患者中，突破性感染可能比加强免疫诱导更强的细胞免疫和体液免疫反应。
