Bermejo-Gómez Amanda, Tarancon-Diez Laura, Lazaro-Martin Beatriz, Santiago-Garcia Begoña, Gil Villanueva Nuria, Alonso Roberto, Muñoz-Fernández Mª Ángeles, Camino López Manuela, Hernanz-Lobo Alicia, Navarro Gómez María Luisa
Pediatric Infectious Diseases Unit, Department of Pediatrics, Gregorio Marañón University Hospital, Madrid, Spain.
Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain.
Heliyon. 2024 Dec 31;11(1):e41584. doi: 10.1016/j.heliyon.2024.e41584. eCollection 2025 Jan 15.
The aim of this prospective cohort study is to analyse the humoral and cellular vaccine responses in paediatric heart transplant recipients (HTR, n = 12), and compare it with the response in healthy controls (HC, n = 14). All participants were 5-18 years old and vaccinated with mRNA vaccine against SARS-CoV-2 between December 2021 and May 2022.
The humoral response was measured by quantifying antibody titers against SARS-CoV-2 spike protein (anti-S). The T-lymphocyte phenotype and SARS-CoV2-specific CD4 and CD8 T-cell response was studied by multiparametric flow cytometry through peripheral blood mononuclear cells by the quantification of degranulation markers (CD107a) and intracellular cytokines (IFN-γ, TNF-α and IL-2) after stimulation with SARS-CoV-2 peptides from structural proteins (S, M, N, E) and non-structural viral proteins.
After vaccination, humoral response was found in all HTR, although they showed lower levels of anti-S IgG compared to HC ( = 0.003). However, in terms of cellular response, no significant differences were obtained in the prevalence of responders and magnitude of responses between groups. In addition, anti-S IgG levels directly correlated with a higher SARS-CoV-2 specific T-cell response (rho = 0.43; = 0.027 and rho = 0.45; = 0.02 for IFN-γ and TNF-α production of CD8 T-cells, respectively). Activated T-cell phenotype in HTR was associated with a lower humoral response to SARS-CoV-2 vaccine.
HTR had humoral response after vaccination, although they showed lower levels of specific anti-S antibodies compared to HC. There were no significant differences in the SARS-CoV2-specific cellular response between the two groups. Obtaining satisfactory data on this type of response could potentially challenge the current vaccine guideline recommendations.
这项前瞻性队列研究旨在分析小儿心脏移植受者（HTR，n = 12）的体液和细胞疫苗反应，并将其与健康对照者（HC，n = 14）的反应进行比较。所有参与者年龄在5至18岁之间，于2021年12月至2022年5月期间接种了针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的信使核糖核酸（mRNA）疫苗。
通过定量针对SARS-CoV-2刺突蛋白（抗S）的抗体滴度来测量体液反应。通过多参数流式细胞术，利用外周血单个核细胞，在使用来自结构蛋白（S、M、N、E）和非结构病毒蛋白的SARS-CoV-2肽刺激后，通过定量脱颗粒标志物（CD107a）和细胞内细胞因子（干扰素-γ、肿瘤坏死因子-α和白细胞介素-2），研究T淋巴细胞表型以及SARS-CoV-2特异性CD4和CD8 T细胞反应。
接种疫苗后，所有HTR均出现了体液反应，尽管与HC相比，他们的抗S IgG水平较低（P = 0.003）。然而，在细胞反应方面，两组之间在反应者的患病率和反应强度上未获得显著差异。此外，抗S IgG水平与更高的SARS-CoV-2特异性T细胞反应直接相关（分别针对CD8 T细胞产生干扰素-γ和肿瘤坏死因子-α，斯皮尔曼相关系数rho = 0.43，P = 0.027；rho = 0.45，P = 0.02）。HTR中活化的T细胞表型与对SARS-CoV-2疫苗的较低体液反应相关。
HTR接种疫苗后出现了体液反应，尽管与HC相比，他们的特异性抗S抗体水平较低。两组之间在SARS-CoV-2特异性细胞反应方面没有显著差异。获取关于此类反应的满意数据可能会对当前的疫苗指南建议构成挑战。
