Liu Haolin, Aviszus Katja, Zelarney Pearlanne, Liao Shu-Yi, Gerber Anthony N, Make Barry, Wechsler Michael E, Marrack Philippa, Reinhardt R Lee
Department of Immunology and Genomic Medicine, National Jewish Health, Denver, CO, USA.
Research Informatics Services, National Jewish Health, Denver, CO, USA.
ERJ Open Res. 2023 Oct 16;9(5). doi: 10.1183/23120541.00400-2023. eCollection 2023 Sep.
While vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) provides significant protection from coronavirus disease 2019, the protection afforded to individuals with chronic lung disease is less well established. This study seeks to understand how chronic lung disease impacts SARS-CoV-2 vaccine-elicited immunity.
Deep immune phenotyping of humoral and cell-mediated responses to the SARS-CoV-2 vaccine was performed in patients with asthma, COPD and interstitial lung disease (ILD) compared to healthy controls.
48% of vaccinated patients with chronic lung diseases had reduced antibody titres to the SARS-CoV-2 vaccine antigen relative to healthy controls. Vaccine antibody titres were significantly reduced among asthma (p<0.035), COPD (p<0.022) and a subset of ILD patients as early as 3-4 months after vaccination, correlating with decreased vaccine-specific memory B-cells in circulation. Vaccine-specific memory T-cells were significantly reduced in patients with asthma (CD8 p<0.004; CD4 p<0.023) and COPD (CD8 p<0.008) compared to healthy controls. Impaired T-cell responsiveness was also observed in a subset of ILD patients (CD8 21.4%; CD4 42.9%). Additional heterogeneity between healthy and disease cohorts was observed among bulk and vaccine-specific follicular T-helper cells.
Deep immune phenotyping of the SARS-CoV-2 vaccine response revealed the complex nature of vaccine-elicited immunity and highlights the need for more personalised vaccination schemes in patients with underlying lung conditions.
虽然接种严重急性呼吸综合征冠状病毒2（SARS-CoV-2）疫苗可提供针对2019冠状病毒病的显著保护，但对慢性肺病患者的保护作用尚不明确。本研究旨在了解慢性肺病如何影响SARS-CoV-2疫苗诱导的免疫反应。
对哮喘、慢性阻塞性肺疾病（COPD）和间质性肺病（ILD）患者以及健康对照者进行了针对SARS-CoV-2疫苗的体液和细胞介导反应的深度免疫表型分析。
与健康对照相比，48%的慢性肺病接种疫苗患者对SARS-CoV-2疫苗抗原的抗体滴度降低。早在接种疫苗3 - 4个月后，哮喘患者（p<0.035）、COPD患者（p<0.022）和一部分ILD患者的疫苗抗体滴度就显著降低，这与循环中疫苗特异性记忆B细胞减少相关。与健康对照相比，哮喘患者（CD8 p<0.004；CD4 p<0.023）和COPD患者（CD8 p<0.008）的疫苗特异性记忆T细胞显著减少。在一部分ILD患者中也观察到T细胞反应性受损（CD8 21.4%；CD4 42.9%）。在总体和疫苗特异性滤泡辅助性T细胞中，健康和疾病队列之间还观察到其他异质性。
对SARS-CoV-2疫苗反应的深度免疫表型分析揭示了疫苗诱导免疫的复杂性，并强调了对有潜在肺部疾病的患者需要更个性化的疫苗接种方案。
