Foresto Renato Demarchi, Souza Roberto Matias, Dos Anjos Gustavo Rodrigues, Nakamura Mônica Rika, Goulart Haryanne de Souza, Sampaio Rayra, França Daniela Pereira, Marques Emanuelle Ferreira, Lucena Elisabeth França, Cristelli Marina Pontello, Tedesco Silva Helio, Requião-Moura Lúcio, Pestana José Medina
Nephrology Division, Universidade Federal de São Paulo, 960 Borges Lagoa Street, São Paulo 04038-002, Brazil.
Hospital do Rim, Fundação Oswaldo Ramos, São Paulo 04039-000, Brazil.
Vaccines (Basel). 2024 Oct 3;12(10):1135. doi: 10.3390/vaccines12101135.
The effect of initial immunosuppressive therapy on the kinetics of the SARS-CoV-2 vaccine-induced humoral response is unknown. Here, we compared the kinetics of SARS-CoV-2 vaccine-induced humoral response in chronic kidney disease patients undergoing kidney transplantation (KTRs) and compared to patients remaining on dialysis during the Omicron circulation. This prospective, non-randomized, real-world study included 113 KTRs and 108 patients on dialysis. Those with previous COVID-19 or negative IgG at screening were excluded. Blood samples were collected to assess SARS-CoV-2 IgG titers and neutralizing antibodies at months (M) 1, 3, 6, and 12. Seroreversion occurred in one KTR and in three patients on dialysis. KTRs had lower IgG titers over time (M1: 10,809.3 ± 12,621.7 vs. 15,267.8 ± 16,096.2 AU/mL; M3: 12,215.5 ± 12,885.8 vs. 15,016.2 ± 15,346.1 AU/mL; M6: 12,540.4 ± 13,010.7 vs. 18,503.5 ± 14,581.0 AU/mL; = 0.005), but neutralizing antibodies were similar (M1: 94.0 vs. 90.3%; M3: 92.9 vs. 90.5%; M6: 99.0 vs. 95.5%; M12: 98.9 vs. 97.5%; = 0.812). During follow-up, KTRs received more vaccines (141 vs. 73; < 0.001) and contracted more COVID-19 (32.7% vs. 14.8%; = 0.002). Compared to patients on dialysis, KTRs had lower SARS-CoV-2 IgG titers and similar rates of seroreversion and neutralizing antibodies over time. Although KTRs received more boosters, they had a higher incidence of COVID-19.
初始免疫抑制治疗对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）疫苗诱导的体液反应动力学的影响尚不清楚。在此，我们比较了接受肾脏移植的慢性肾脏病患者（KTRs）中SARS-CoV-2疫苗诱导的体液反应动力学，并与在奥密克戎流行期间仍接受透析的患者进行了比较。这项前瞻性、非随机、真实世界研究纳入了113例KTRs和108例透析患者。排除既往有新冠病毒病（COVID-19）或筛查时IgG阴性的患者。在第1、3、6和12个月采集血样，以评估SARS-CoV-2 IgG滴度和中和抗体。1例KTRs和3例透析患者发生了血清转化。随着时间的推移，KTRs的IgG滴度较低（第1个月：10,809.3±12,621.7 vs. 15,267.8±16,096.2 AU/mL；第3个月：12,215.5±12,885.8 vs. 15,016.2±15,346.1 AU/mL；第6个月：12,540.4±13,010.7 vs. 18,503.5±14,581.0 AU/mL；P = 0.005），但中和抗体相似（第1个月：94.0% vs. 90.3%；第3个月：92.9% vs. 90.5%；第6个月：99.0% vs. 95.5%；第12个月：98.9% vs. 97.5%；P = 0.812）。在随访期间，KTRs接种了更多疫苗（141剂 vs. 73剂；P < 0.001），感染COVID-19的病例更多（32.7% vs. 14.8%；P = 0.002）。与透析患者相比，KTRs的SARS-CoV-2 IgG滴度较低，随着时间的推移，血清转化和中和抗体发生率相似。尽管KTRs接种了更多加强针，但他们的COVID-19发病率较高。
