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在感染新冠病毒变异株的透析患者中,由中和抗体建立的保护血清学关联存在差异。

Serological Correlate of Protection Established by Neutralizing Antibodies Differs Among Dialysis Patients with SARS-CoV-2 Variants of Concern.

作者信息

Rostoker Guy, Rouanet Stéphanie, Merzoug Myriam, Chakaroun Hiba, Griuncelli Mireille, Loridon Christelle, Boulahia Ghada, Gagnon Luc

机构信息

Department of Nephrology and Dialysis, Hôpital Privé Claude Galien-Ramsay Santé, 91480 Quincy-sous-Sénart, France.

Collège de Médecine des Hôpitaux de Paris, 75610 Paris, France.

出版信息

Vaccines (Basel). 2025 May 13;13(5):518. doi: 10.3390/vaccines13050518.

Abstract

The 2019 coronavirus disease (COVID-19) pandemic had a severe impact on frail, end-stage kidney disease (ESKD) patients, either on dialysis or transplanted, with a high mortality rate in the early waves. Vaccination against SARS-CoV-2 with mRNA vaccines has led to reduced hospitalization and mortality rates in the general population and ESKD patients. Neutralizing antibodies (NAbs) are a valuable correlate of protection after vaccination, and IgG anti-spike antibodies are considered a surrogate marker of protection. This study investigated the correlates of protection brought by NAb and anti-spike IgG antibodies against SARS-CoV-2 wild-type Wuhan strain and variants of concern in a cohort of 128 French patients on dialysis after vaccination with the BNT162b2 mRNA vaccine. The correlate was assessed using Receiver Operating Characteristic curves. The level of protection for IgG anti-spike antibodies was set at 917 BAU/mL for the original Wuhan strain and 980 BAU/mL and 1450 BAU/mL, respectively, for the Delta and Omicron BA.1 variants. The level of protection can be regularly monitored by measuring IgG anti-spike antibody concentrations to allow tailored boosters of SARS-CoV-2 vaccination in this frail and immunocompromised ESKD population.

摘要

2019冠状病毒病(COVID-19)大流行对体弱的终末期肾病(ESKD)患者产生了严重影响,这些患者要么正在接受透析,要么接受了肾移植,在疫情早期死亡率很高。使用信使核糖核酸(mRNA)疫苗接种严重急性呼吸综合征冠状病毒2(SARS-CoV-2)已导致普通人群和ESKD患者的住院率和死亡率降低。中和抗体(NAbs)是疫苗接种后保护作用的一个重要相关指标,而免疫球蛋白G(IgG)抗刺突抗体被视为保护作用的替代标志物。本研究在128名接种BNT162b2 mRNA疫苗后的法国透析患者队列中,调查了NAb和抗刺突IgG抗体针对SARS-CoV-2野生型武汉毒株及相关变异株所带来的保护作用的相关指标。使用受试者操作特征曲线评估相关指标。对于原始武汉毒株,IgG抗刺突抗体的保护水平设定为917 BAU/mL,对于德尔塔和奥密克戎BA.1变异株,分别设定为980 BAU/mL和1450 BAU/mL。通过测量IgG抗刺突抗体浓度可以定期监测保护水平,以便在这个体弱且免疫功能低下的ESKD人群中针对性地加强接种SARS-CoV-2疫苗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a26d/12115770/f81f3c137909/vaccines-13-00518-g001.jpg

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