Ducasa Nicolás, Benencio Paula, Mauro Ezequiel, Anders Margarita, Mazzitelli Bianca, Bleichmar Lucía, Quiroga Maria Florencia, Barbero Manuel, Cairo Fernando, Alter Adriana, Etcheves Patricia, Scarton Giampaolo, Sobenko Natalia, Biglione Mirna, Mendizabal Manuel
Instituto de Investigaciones Biomédicas en Retrovirus y SIDA, CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina.
Instituto de Investigaciones Biomédicas en Retrovirus y SIDA, CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina.
Vaccine. 2023 Dec 18;41(52):7663-7670. doi: 10.1016/j.vaccine.2023.11.039. Epub 2023 Nov 25.
Solid organ transplant recipients (SOTR) commonly develop an unsatisfactory humoral response to vaccines compared to immunocompetent individuals (IC). We have previously evaluated the humoral response in liver transplant recipients (LTR) who received two-dose vaccines against SARS-CoV-2 and reported that 38 % of LTR did not produce anti-Spike antibodies. Thus, we set out to evaluate the humoral response after the third dose of SARS-CoV-2 vaccines. For this purpose, samples from a cohort of 81 LTR and 27 IC were extracted between 21 and 90 days after the third dose. Serology for anti-Spike IgG antibodies and neutralizing antibodies against Wuhan, Delta and Omicron variants were evaluated. We found that 73.5 % of LTR were responders for anti-Spike IgG, while all the IC mounted a measurable response. LTR who responded to the third dose showed significantly lower anti-Spike IgG levels and neutralizing antibodies than IC. We found that there is less neutralization in LTR compared to IC across all variants. Specifically, the neutralization titers in both groups decrease when encountering the Delta variant, and this decline is even more pronounced with the Omicron variant, compared to the Wuhan variant. Furthermore, we identified that the use of high doses of mycophenolate and advanced age were factors that negatively affected the development of anti-Spike IgG antibodies. Regarding vaccine regimes, the regime viral vector/mRNA/mRNA elicited significantly higher responses in LTR compared to other vaccine schemes. In addition to the recommended and necessary booster doses in this population, strategies that achieve adequate immunization should be evaluated.
与免疫功能正常的个体（IC）相比，实体器官移植受者（SOTR）通常对疫苗产生的体液免疫反应不佳。我们之前评估了接受两剂SARS-CoV-2疫苗的肝移植受者（LTR）的体液免疫反应，并报告称38%的LTR未产生抗刺突抗体。因此，我们着手评估第三剂SARS-CoV-2疫苗后的体液免疫反应。为此，在第三剂疫苗接种后21至90天内，从81名LTR和27名IC的队列中提取样本。评估了抗刺突IgG抗体的血清学以及针对武汉、德尔塔和奥密克戎变体的中和抗体。我们发现73.5%的LTR是抗刺突IgG的应答者，而所有IC都产生了可测量的反应。对第三剂有反应的LTR的抗刺突IgG水平和中和抗体明显低于IC。我们发现，与IC相比，LTR在所有变体中中和作用都较小。具体而言，两组在遇到德尔塔变体时中和滴度都会降低，与武汉变体相比，奥密克戎变体导致的这种下降更为明显。此外，我们确定使用高剂量霉酚酸酯和高龄是对抗刺突IgG抗体产生有负面影响的因素。关于疫苗接种方案，与其他疫苗方案相比，病毒载体/信使核糖核酸/信使核糖核酸方案在LTR中引发的反应明显更高。除了在该人群中推荐和必要的加强剂量外，还应评估实现充分免疫的策略。
