在接受 ChAdOx1nCoV-19 疫苗(Covishield)的肝硬化患者和免疫功能正常的受者中体液和细胞免疫反应。

Humoral and cellular immune response in patients of liver cirrhosis and immunocompetent recipient of ChAdOx1nCoV-19 Vaccine (Covishield).

机构信息

Department of Internal Medicine, King George's Medical University, Lucknow, 226003, India.

Department of Hepatology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, 226014, India.

出版信息

Clin Exp Med. 2024 Jan 27;24(1):24. doi: 10.1007/s10238-023-01258-z.

Abstract

Despite the effectiveness of COVID-19 vaccination in reducing the severity of the disease, the demand for booster is increasing in vulnerable populations like elderly and immunocompromised individuals especially with each new wave of COVID-19 in different countries. There is limited data on the sustained immunity against COVID-19 in patients with liver cirrhosis. The study was aimed to compare the T cell and humoral immune response after 1 year of ChAdOx1nCoV-19 Vaccine in patients with liver cirrhosis and healthy health care workers (HCW). This was a prospective observational study including 36 HCW, 19 liver cirrhosis patients and 10 unvaccinated individuals. Anti-SARS-CoV-2S antibody, neutralizing antibody and memory T cell subsets were evaluated by ELISA and flow cytometry, respectively, in all three groups after 1 year of initial vaccination. Compared to HCW and unvaccinated individuals, liver cirrhosis patients had significantly depleted T cells, although CD4:CD8 + T cell ratio was normal. Both cirrhotic patients and HCW developed memory T cell subset [effector memory RA (P = 0.141, P < 0.001), effector memory (P < 0.001, P < 0.001), central memory (P < 0.001, P < 0.01), stem cell memory (P = 0.009, P = 0.08) and naïve (P < 0.001, P = 0.02)] compared to unvaccinated unexposed individuals of CD4 + T and CD8 + T, respectively. However, among HCW and cirrhotic group no difference was noted on central memory and stem cell memory cells on T cells. Patients with liver cirrhosis developed comparable memory T cells after vaccination which can evoke sustainable immune response on reinfection. Therefore, additional vaccine doses may not be necessary for cirrhosis patients.

摘要

尽管 COVID-19 疫苗在降低疾病严重程度方面非常有效,但在老年人和免疫功能低下等弱势群体中,对加强针的需求正在增加,尤其是在不同国家每一波 COVID-19 疫情中。目前关于肝硬化患者对 COVID-19 的持续免疫的数据有限。本研究旨在比较 ChAdOx1nCoV-19 疫苗接种 1 年后肝硬化患者和健康医护人员(HCW)的 T 细胞和体液免疫反应。这是一项前瞻性观察研究,纳入了 36 名 HCW、19 名肝硬化患者和 10 名未接种疫苗的个体。在初始接种 1 年后,通过 ELISA 和流式细胞术分别评估三组的抗 SARS-CoV-2S 抗体、中和抗体和记忆 T 细胞亚群。与 HCW 和未接种疫苗的个体相比,肝硬化患者的 T 细胞明显耗竭,尽管 CD4:CD8+T 细胞比值正常。肝硬化患者和 HCW 均产生了记忆 T 细胞亚群[效应记忆 RA(P=0.141,P<0.001)、效应记忆(P<0.001,P<0.001)、中央记忆(P<0.001,P<0.01)、干细胞记忆(P=0.009,P=0.08)和幼稚(P<0.001,P=0.02)],与未接种疫苗的未暴露个体相比,分别为 CD4+T 和 CD8+T 中的记忆 T 细胞。然而,在 HCW 和肝硬化组中,T 细胞上的中央记忆和干细胞记忆细胞没有差异。肝硬化患者接种疫苗后可产生类似的记忆 T 细胞,可在再次感染时引起持续的免疫反应。因此,肝硬化患者可能不需要额外的疫苗剂量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2e3/10821839/669255729cc6/10238_2023_1258_Fig1_HTML.jpg

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