肺移植受者对 SARS-CoV-2 mRNA 疫苗第三和第四剂加强的体液免疫反应。
Augmented humoral response to third and fourth dose of SARS-CoV-2 mRNA vaccines in lung transplant recipients.
机构信息
Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan; Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital, Japan.
Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan; Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital, Japan.
出版信息
Respir Investig. 2024 Sep;62(5):804-810. doi: 10.1016/j.resinv.2024.07.004. Epub 2024 Jul 13.
BACKGROUND
Since lung transplant recipients (LTRs) exhibit low immunogenicity after two doses of SARS-CoV-2 mRNA vaccines, optimal vaccine strategies for SARS-CoV-2 are required in LTRs. This study aimed to investigate the efficacy and safety of the third and fourth doses of the SARS-CoV-2 mRNA vaccines in LTRs.
METHODS
We conducted a single-center study of 73 LTRs and 23 healthy controls (HCs). Participants received two-to-four doses of SARS-CoV-2 mRNA vaccines. The LTRs were divided into three groups based on the number of vaccine dose. IgG titers against SARS-CoV-2 spike protein were measured, and adverse events were assessed. Factors associated with humoral response were analyzed using univariate and multivariate analyses.
RESULTS
The Dose 4 group (n = 27) had a higher humoral response rate (P = 0.018) and higher levels of anti-SARS-CoV-2 IgG antibody (P = 0.04) than the Dose 2 group (n = 14). The Dose 3 group (n = 32) had lower humoral response rates (P = 0.005) and levels of anti-SARS-CoV-2 IgG antibody (P = 0.0005) than the HCs (n = 23) even after the same dose. Systemic adverse events were milder in the LTRs than in the HCs (P < 0.05). Increased number of vaccine dose was identified as a predictor of positive humoral response (P = 0.021).
CONCLUSION
Booster doses of SARS-CoV-2 mRNA vaccines may enhance humoral response with mild adverse events in LTRs. Repeated vaccination might be warranted for LTRs to prevent SARS-CoV-2 infection.
背景
肺移植受者（LTR）在接种两剂 SARS-CoV-2 mRNA 疫苗后表现出低免疫原性，因此需要为 LTR 制定最佳的 SARS-CoV-2 疫苗接种策略。本研究旨在探讨 LTR 接种 SARS-CoV-2 mRNA 疫苗第三和第四针的效果和安全性。
方法
我们进行了一项单中心研究，纳入了 73 名 LTR 和 23 名健康对照（HC）。参与者接种了两到四剂 SARS-CoV-2 mRNA 疫苗。根据接种疫苗的剂数，LTR 被分为三组。测量针对 SARS-CoV-2 刺突蛋白的 IgG 滴度，并评估不良反应。使用单变量和多变量分析来分析与体液反应相关的因素。
结果
与剂量 2 组（n=14）相比，剂量 4 组（n=27）的体液反应率（P=0.018）和抗 SARS-CoV-2 IgG 抗体水平（P=0.04）更高。剂量 3 组（n=32）的体液反应率（P=0.005）和抗 SARS-CoV-2 IgG 抗体水平（P=0.0005）均低于 HCs（n=23），即使接种了相同的剂量。LTR 的全身不良反应比 HCs 更轻（P<0.05）。接种疫苗的剂数增加被确定为阳性体液反应的预测因子（P=0.021）。
结论
在 LTR 中，SARS-CoV-2 mRNA 疫苗的加强剂量可能会增强体液反应，且不良反应轻微。为预防 SARS-CoV-2 感染，可能需要对 LTR 进行重复接种。
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