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肾移植受者加强免疫接种后SARS-CoV-2免疫力的部分恢复。

Partial recovery of SARS-CoV-2 immunity after booster vaccination in renal transplant recipients.

作者信息

Urra J M, Castro P, Jiménez N, Moral E, Vozmediano C

机构信息

Immunology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.

Facultad de Medicina de Ciudad Real, Universidad de Castilla La Mancha (UCLM), Spain.

出版信息

Clin Immunol Commun. 2023 Dec;3:1-5. doi: 10.1016/j.clicom.2022.12.001. Epub 2022 Dec 11.

Abstract

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.

摘要

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。

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本文引用的文献

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BNT162b2 Booster Vaccination Induced Immunity against SARS-CoV-2 Variants among Hemodialysis Patients.
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