与多发性骨髓瘤患者对SARS-CoV-2双价增剂疫苗接种的亚最佳免疫反应相关的细胞机制
Adolfo Aleman1, Morgan van Kesteren2, Ariel Kogan Zajdman3
1Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
双对应的COVID-19疫苗在多发性骨髓瘤患者中提高了保护力,但有些患者仍然容易受到新变种的攻击. 某些疗法会损害免疫反应,强调需要个性化疫苗接种策略.
科学领域:
- 免疫学 免疫学 免疫学
- 病毒学 病毒学
- 在瘤学瘤学.
背景情况:
- 双价疫苗 (野生型和Omicron BA.5) 对免疫功能低下的多发性髓瘤 (MM) 患者的影响在很大程度上是未知的.
- 在MM患者的双价增强剂后,对幽默和细胞免疫反应的表征对于理解对当前变异的保护至关重要 (XBB1.16,EG5).
研究的目的:
- 评估多发性骨髓瘤患者在双价性COVID-19增强疫苗接种之前和之后的幽默和细胞免疫反应.
- 确定与MM患者对当前SARS-CoV-2变异的脆弱性相关的免疫反应模式.
主要方法:
- 研究了48名MM患者,测量了Spike结合IgG抗体水平和对活体SARS-CoV-2的中和能力.
- 通过使用QuantiFERON和流细胞计,评估尖端特异性T细胞功能.
- 在38名患者中利用高维流细胞测量来识别与抗体生产不足相关的免疫细胞子集.
主要成果:
- 双相接种疫苗显著增强了MM患者对Omicron变异的保护,反应因治疗而异.
- 许多MM患者表现出对具有尖端蛋白突变的新变体的持续脆弱性.
- 发现抗CD38和抗BCMA疗法损害了负责产生抗体的免疫机制.
结论:
- 双对应的COVID-19疫苗接种在MM患者中引起了不同的免疫反应.
- 一组接受抗CD38和抗BCMA治疗的MM患者表现出免疫细胞功能受损 (DCs,B细胞,NK细胞,TFH细胞),阻碍了对疫苗接种的充分幽默和细胞反应.
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