Adler Amanda L, Waghmare Alpana, Smith Jodi, Kelton Megan, Dickerson Jane A, Reed Jonathan C, Greninger Alexander L, Kehoe Leanne, Fairlie Tarayn, Hagen Melissa Briggs, Midgley Claire M, Lacombe Kirsten, Englund Janet A
Seattle Children's Research Institute, Seattle, Washington, USA.
Department of Pediatrics, University of Washington, Seattle, Washington, USA.
Pediatr Transplant. 2025 Mar;29(2):e70050. doi: 10.1111/petr.70050.
Limited data are available regarding the development and durability of immune responses following COVID-19 infection or vaccination in pediatric solid-organ transplant (SOT) recipients.
Renal, liver, or intestinal transplant recipients < 21 years of age followed at Seattle Children's Hospital were enrolled from August 2020 to May 2021. Blood samples were collected at ~6-month intervals for up to 3 years and tested for antinucleocapsid (N) antibodies. COVID-19 vaccination data were collected from the Washington State Immunization Information System and/or the medical record. Semi-quantitative anti-S IgG testing was performed on all postvaccine samples using the Abbott Architect platform. We further evaluated a subset of postvaccine samples using variant-specific quantitative binding (Meso Scale Discovery, MSD) immunoassays and pseudovirus-neutralization assays. Antibody levels were compared over time and by vaccine category.
We followed 83 SOT recipients for a median of 12.5 months (IQR 7.0, 28.3). Overall, 16 (19.3%) participants had evidence of SARS-CoV-2 infection based on anti-N antibody detection. Forty-six (55%) participants had a blood sample collected > 14 days after receipt of a vaccination. Serum IgG to spike antigens (anti-S antibody) increased following vaccination and increased with the number of vaccine doses received as assessed by both the Abbott and MSD assays. Neutralizing activity was significantly lower against the Omicron subvariants compared to the ancestral strain.
Pediatric SOT recipients demonstrated strong antibody responses following SARS-CoV-2 vaccination, with higher anti-S antibody responses following > 2 doses of vaccine. Our study offers unique longitudinal immune response data in this vulnerable patient population.
关于儿童实体器官移植（SOT）受者感染新冠病毒或接种疫苗后免疫反应的发展和持久性，可用数据有限。
2020年8月至2021年5月，招募了西雅图儿童医院随访的21岁以下肾、肝或肠移植受者。每隔约6个月采集血样，持续3年，检测抗核衣壳（N）抗体。从华盛顿州免疫信息系统和/或病历中收集新冠病毒疫苗接种数据。使用雅培Architect平台对所有疫苗接种后的样本进行半定量抗S IgG检测。我们进一步使用变异体特异性定量结合（Meso Scale Discovery，MSD）免疫测定法和假病毒中和测定法对一部分疫苗接种后的样本进行了评估。比较不同时间和不同疫苗类别的抗体水平。
我们对83名SOT受者进行了中位时间为12.5个月（四分位间距7.0，28.3）的随访。总体而言，16名（19.3%）参与者基于抗N抗体检测有新冠病毒感染的证据。46名（55%）参与者在接种疫苗14天以上后采集了血样。接种疫苗后，血清中针对刺突抗原的IgG（抗S抗体）增加，并且如通过雅培和MSD测定法所评估的，随着接种疫苗剂量的增加而增加。与原始毒株相比，对奥密克戎亚变体的中和活性显著降低。
儿童SOT受者在接种新冠病毒疫苗后表现出强烈的抗体反应，接种超过2剂疫苗后抗S抗体反应更高。我们的研究为这一脆弱患者群体提供了独特的纵向免疫反应数据。
