Urra J M, Castro P, Jiménez N, Moral E, Vozmediano C
Immunology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.
Facultad de Medicina de Ciudad Real, Universidad de Castilla La Mancha (UCLM), Spain.
Clin Immunol Commun. 2023 Dec;3:1-5. doi: 10.1016/j.clicom.2022.12.001. Epub 2022 Dec 11.
The pandemic caused by the SARS-CoV-2 coronavirus has been especially detrimental to patients with end-stage renal disease. History with other vaccines suggests that patients with renal disease may not respond adequately to the SARS-CoV-2 vaccine. The aim of this study is to evaluate the immunity to SARS-CoV-2 mRNA vaccines in renal patients. Post SARS-CoV-2 vaccination first, and after the booster dose, antibodies and cellular immunity were studied in patients on hemodialysis ( 20), peritoneal dialysis ( 10) and renal transplantation ( 10). After the two doses of vaccine, there was an effective immunity in dialysis patients, with 100% seroconversion and 87% detection of cellular immunity (85% in hemodialysis and 90% in peritoneal dialysis). In contrast, in renal transplant recipients there was only 50% seroconversion and cellular immunity was detected in 30% of patients. After the booster dose, all dialysis patients achieved a cellular and antibody immunity, whereas in transplant patients, despite improvement, 20% did not produce antibodies and in 37.5% cellular immunity could not be detected. The mRNA vaccine plus booster performs excellently in dialysis patients, whereas in kidney transplant recipients, despite the booster, complete immunization is not achieved.
由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的大流行对终末期肾病患者尤其有害。其他疫苗的使用史表明,肾病患者可能对SARS-CoV-2疫苗反应不佳。本研究的目的是评估肾病患者对SARS-CoV-2 mRNA疫苗的免疫情况。首先对SARS-CoV-2疫苗接种后以及加强剂量后,对接受血液透析的患者(20例)、腹膜透析的患者(10例)和肾移植患者(10例)的抗体和细胞免疫进行了研究。两剂疫苗接种后,透析患者产生了有效的免疫反应,血清转化率为100%,细胞免疫检测率为87%(血液透析患者为85%,腹膜透析患者为90%)。相比之下,肾移植受者的血清转化率仅为50%,30%的患者检测到细胞免疫。加强剂量后,所有透析患者均获得了细胞免疫和抗体免疫,而在移植患者中,尽管有所改善,但仍有20%的患者未产生抗体,37.5%的患者未检测到细胞免疫。mRNA疫苗加加强剂量在透析患者中表现出色,而在肾移植受者中,尽管进行了加强接种,但仍未实现完全免疫。