COVID-19 mRNA疫苗接种在接种者和突破性感染个体中引发的黏膜和血清中和免疫反应:来自路易斯维尔队列的纵向研究
Mucosal and Serum Neutralization Immune Responses Elicited by COVID-19 mRNA Vaccination in Vaccinated and Breakthrough-Infection Individuals: A Longitudinal Study from Louisville Cohort.
作者信息
Batra Lalit, Saxena Divyasha, Poddar Triparna, Zahin Maryam, Amraotkar Alok, Bezold Megan M, Kitterman Kathleen T, Deitz Kailyn A, Lasnik Amanda B, Keith Rachel J, Bhatnagar Aruni, Kong Maiying, Gabbard Jon D, Severson William E, Palmer Kenneth E
机构信息
Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, University of Louisville, Louisville, KY 40202, USA.
Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, KY 40202, USA.
出版信息
Vaccines (Basel). 2025 May 24;13(6):559. doi: 10.3390/vaccines13060559.
: The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus type-2 (SARS-CoV-2), has resulted in 777 million cases worldwide. Various vaccines have been approved to control the spread of COVID-19, with mRNA vaccines (Pfizer and Moderna) being widely used in the USA. We conducted a prospective longitudinal study to analyze the immune response elicited by two/three and four doses of monovalent mRNA vaccines in both vaccinated individuals and those who experienced breakthrough infections. Participants were stratified into different age groups: 18-40, 41-60, and over 60 years. : We assessed cross-variant neutralization responses in two cohorts-Cohort I: n = 167 (serum), Cohort II: n = 92 (serum and nasal swab) samples-using infectious virus microneutralization assay (MN) and antibody (IgG or IgA) binding ELISA titers to the spike protein receptor binding domain (RBD). Samples were collected from the Louisville Metro-Jefferson County Co-Immunity Project, a federally funded, population-based study for the surveillance of SARS-CoV-2 in Jefferson County, Kentucky during 2020-2022, involving both health care workers and a local community. : Individuals who received two doses of the mRNA vaccine exhibited reduced neutralization against Beta, Delta, and Omicron BA.1 variants compared to wildtype Wuhan, with further decline observed six months post-booster vaccination. However, individuals who experienced natural COVID-19 infection (breakthrough) after receiving two vaccine doses showed enhanced neutralization and antibody responses, particularly against Omicron BA.1. Following the 3rd dose, antibodies and neutralization responses were restored. Among triple-vaccinated individuals, reduced neutralization was observed against Omicron variants BA.1, BA.5, and BA.2 compared to Wuhan. Neutralization responses were better against BA.2 variant compared to BA.1 and BA.5. However, individuals who received three doses of vaccine and experienced a breakthrough infection (n = 45) elicited significantly higher neutralizing antibodies responses against all Omicron subvariants compared to vaccinated individuals. Interestingly, nasal swab samples collected from volunteers with breakthrough infection showed significantly elevated spike-reactive mucosal IgA antibodies and enhanced cross neutralization against BA.1, BA.2, and BA.5 compared to individuals who received only three vaccine doses. : mRNA vaccination elicits a strong systemic immune response by boosting serum neutralizing antibodies (NAb), although this protection wanes over time, allowing new variants to escape neutralization. Breakthrough individuals have extra enrichment in nasal NAb offering protection against emerging variants. This longitudinal immune profiling underscores the strengthening of pandemic preparedness and supports the development of durable mucosal vaccines against respiratory infectious disease.
由严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)引起的新冠疫情已在全球导致7.77亿例感染。多种疫苗已获批准用于控制新冠疫情传播,其中信使核糖核酸(mRNA)疫苗(辉瑞和莫德纳)在美国广泛使用。我们开展了一项前瞻性纵向研究,以分析接种两剂/三剂和四剂单价mRNA疫苗的个体以及发生突破性感染的个体所引发的免疫反应。参与者被分为不同年龄组:18 - 40岁、41 - 60岁以及60岁以上。我们在两个队列中评估了交叉变异中和反应——队列I:n = 167(血清样本),队列II:n = 92(血清和鼻拭子样本)——使用感染性病毒微量中和试验(MN)以及针对刺突蛋白受体结合域(RBD)的抗体(IgG或IgA)结合酶联免疫吸附测定(ELISA)滴度。样本取自路易斯维尔市杰斐逊县共同免疫项目,这是一项由联邦资助的、基于人群的研究,旨在2020 - 2022年期间对肯塔基州杰斐逊县的SARS-CoV-2进行监测,研究对象包括医护人员和当地社区居民。与野生型武汉毒株相比,接种两剂mRNA疫苗的个体对贝塔、德尔塔和奥密克戎BA.1变异株的中和作用减弱,在加强针接种六个月后中和作用进一步下降。然而,在接种两剂疫苗后经历自然新冠感染(突破性感染)的个体表现出增强的中和及抗体反应,尤其是针对奥密克戎BA.1变异株。在接种第三剂疫苗后,抗体和中和反应得以恢复。在接种三剂疫苗的个体中,与武汉毒株相比,对奥密克戎变异株BA.1、BA.5和BA.2的中和作用减弱。与BA.1和BA.5相比,对BA.2变异株的中和反应更好。然而,接种三剂疫苗并经历突破性感染的个体(n = 45)与仅接种疫苗的个体相比,对所有奥密克戎亚变异株引发的中和抗体反应显著更高。有趣的是,从发生突破性感染的志愿者采集的鼻拭子样本显示,与仅接种三剂疫苗的个体相比,刺突反应性黏膜IgA抗体显著升高,并且对BA.1、BA.2和BA.5的交叉中和作用增强。mRNA疫苗通过增强血清中和抗体(NAb)引发强烈的全身免疫反应,尽管这种保护作用会随着时间减弱,使得新变异株能够逃避中和。发生突破性感染的个体鼻内NAb额外富集,可提供针对新出现变异株的保护。这种纵向免疫分析强调了加强大流行防范,并支持开发针对呼吸道传染病的持久黏膜疫苗。