与 COVID-19 疫苗接种相关的免疫介导性脱发患者的临床特征和免疫特征。
Clinical characteristics and immune profiles of patients with immune-mediated alopecia associated with COVID-19 vaccinations.
机构信息
Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Tucheng and Keelung, Taiwan; Cancer Vaccine and Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital, Linkou, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Taiwan; Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China.
Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Tucheng and Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
出版信息
Clin Immunol. 2023 Oct;255:109737. doi: 10.1016/j.clim.2023.109737. Epub 2023 Aug 14.
BACKGROUND
The clinical characteristics and pathomechanism for immune-mediated alopecia following COVID-19 vaccinations are not clearly characterized.
OBJECTIVE
We investigated the causality and immune mechanism of COVID-19 vaccines-related alopecia areata (AA).
STUDY DESIGN
27 new-onset of AA patients after COVID-19 vaccinations and 106 vaccines-tolerant individuals were enrolled from multiple medical centers for analysis.
RESULTS
The antinuclear antibody, total IgE, granulysin, and PARC/CCL18 as well as peripheral eosinophil count were significantly elevated in the patients with COVID-19 vaccines-related AA compared with those in the tolerant individuals (P = 2.03 × 10-0.039). In vitro lymphocyte activation test revealed that granulysin, granzyme B, and IFN-γ released from the T cells of COVID-19 vaccines-related AA patients could be significantly increased by COVID-19 vaccine excipients (polyethylene glycol 2000 and polysorbate 80) or spike protein (P = 0.002-0.04).
CONCLUSIONS
Spike protein and excipients of COVID-19 vaccines could trigger T cell-mediated cytotoxicity, which contributes to the pathogenesis of immune-mediated alopecia associated with COVID-19 vaccines.
背景
COVID-19 疫苗接种后免疫介导性脱发的临床特征和发病机制尚不清楚。
目的
我们研究了 COVID-19 疫苗相关斑秃（AA）的病因和免疫机制。
研究设计
从多个医学中心招募了 27 例 COVID-19 疫苗接种后新发 AA 患者和 106 例疫苗耐受个体进行分析。
结果
与耐受个体相比，COVID-19 疫苗相关 AA 患者的抗核抗体、总 IgE、颗粒酶 B、PARC/CCL18 和外周嗜酸性粒细胞计数明显升高（P=2.03×10-0.039）。体外淋巴细胞激活试验显示，COVID-19 疫苗相关 AA 患者 T 细胞释放的颗粒酶 B、IFN-γ和颗粒酶 B 可被 COVID-19 疫苗赋形剂（聚乙二醇 2000 和聚山梨醇酯 80）或刺突蛋白显著增加（P=0.002-0.04）。
结论
COVID-19 疫苗的刺突蛋白和赋形剂可引发 T 细胞介导的细胞毒性，这有助于 COVID-19 疫苗相关免疫介导性脱发的发病机制。
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