免疫抑制疗法改变了一组肾移植受者在四剂 mRNA 疫苗接种后的抗刺突 IgG 亚类分布。

Immunosuppressive Therapy Modifies Anti-Spike IgG Subclasses Distribution After Four Doses of mRNA Vaccination in a Cohort of Kidney Transplant Recipients.

作者信息

Juarez Ignacio, Pérez-Flores Isabel, Aiffil Meneses Arianne S, Lopez-Gomez Ana, Calvo Romero Natividad, Rodríguez-Cubillo Beatriz, Moreno de la Higuera María Angeles, Peix-Jiménez Belén, Gonzalez-Garcia Raquel, Amorós-Pérez Beatriz, Rivas-Pardo Benigno, Baos-Muñoz Elvira, Arribi Vilela Ana, Gómez Del Moral Manuel, Sánchez-Fructuoso Ana Isabel, Martínez-Naves Eduardo

机构信息

Immunology Department, Complutense University of Madrid, 28040 Madrid, Spain.

Nephrology Department, Institute San Carlos for Medical Research (Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC)), San Carlos Clinical University Hospital, 28040 Madrid, Spain.

出版信息

Vaccines (Basel). 2025 Jan 25;13(2):123. doi: 10.3390/vaccines13020123.

Abstract

: IgG4 is the least immunogenic subclass of IgG. Immunization with mRNA vaccines against SARS-CoV-2, unlike other vaccines, induces an increase in IgG4 against the spike protein in healthy populations. This study investigated whether immunosuppressive therapy affects the immune response, focusing on IgG subclass changes, to four doses of mRNA vaccine in kidney transplant recipients (KTRs). : This study includes 146 KTRs and 23 dialysis patients (DPs) who received three mRNA-1273 vaccine doses and a BNT162b2 booster. We evaluated anti-spike IgG titers and subclasses, T-CD4+ and T-CD8+ cellular responses, and serum neutralizing activity (SNA). : At the fourth dose, 75.8% of COVID-19 naïve KTRs developed humoral and cellular responses (vs. 95.7% in DPs). There was a correlation between anti-spike IgG titers/subclasses and SNA ( < 0.001). IgG subclass kinetics after the third/fourth dose differed between COVID-19 naïve KTRs and DPs. Immunosuppressive therapy influenced IgG subclasses: mTOR inhibitors (mTORi) positively influenced IgG1 and IgG3 ( < 0.05), while mycophenolic acid negatively affected IgG1, IgG3, and IgG4 ( < 0.05). SNA is correlated with breakthrough infections after four doses of vaccine in KTRs. mTORi was the only factor associated with SNA > 65% in naïve KTRs [4.29 (1.21-15.17), = 0.024]. : KTRs show weaker cellular and humoral immune responses to mRNA vaccines and a class shift towards non-inflammatory anti-S IgG4 upon booster doses. IgG subclasses show a positive correlation with SNA and are influenced by immunosuppression. Increased SNA after four doses of vaccine is protective against infection. mTORi may benefit non-responding KTRs.

摘要

IgG4是IgG中免疫原性最低的亚类。与其他疫苗不同,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)疫苗免疫接种会导致健康人群中针对刺突蛋白的IgG4增加。本研究调查了免疫抑制治疗是否会影响肾移植受者(KTR)对四剂mRNA疫苗的免疫反应,重点关注IgG亚类变化。:本研究纳入了146名接受三剂mRNA-1273疫苗和一剂BNT162b2加强针的KTR以及23名透析患者(DP)。我们评估了抗刺突IgG滴度和亚类、T辅助细胞(T-CD4+)和细胞毒性T细胞(T-CD8+)的细胞反应以及血清中和活性(SNA)。:在第四剂接种后,75.8%的未感染过冠状病毒病2019(COVID-19)的KTR产生了体液和细胞反应(而DP中这一比例为95.7%)。抗刺突IgG滴度/亚类与SNA之间存在相关性(<0.001)。未感染过COVID-19的KTR和DP在第三/四剂接种后的IgG亚类动力学有所不同。免疫抑制治疗会影响IgG亚类:雷帕霉素靶蛋白(mTOR)抑制剂对IgG1和IgG3有正向影响(<0.05),而霉酚酸则对IgG1、IgG3和IgG4有负面影响(<0.05)。在KTR中,四剂疫苗接种后的SNA与突破性感染相关。mTOR抑制剂是未感染过COVID-19的KTR中SNA>65%的唯一相关因素[4.29(1.21 - 15.17),P = 0.024]。:KTR对mRNA疫苗的细胞和体液免疫反应较弱,加强针接种后会出现向非炎性抗S IgG4的类别转换。IgG亚类与SNA呈正相关,并受免疫抑制的影响。四剂疫苗接种后SNA增加可预防感染。mTOR抑制剂可能对无反应的KTR有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ba0/11860609/15bc9681dba9/vaccines-13-00123-g001.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索