保护免疫受损者:针对初级和二级免疫缺陷患者的COVID-19预防策略
Giulio Olivieri1, Donato Amodio2, Emma Concetta Manno3
1Clinical Immunology and Vaccinology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy; PhD Program in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy.
COVID-19疫苗在免疫功能低下的患者中显示出可变的疗效,包括那些患有天生的免疫错误 (IEI) 的患者. 未来的流行病准备需要在临床试验中包括弱势群体,以制定定制的,有效的策略.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 免疫功能低下的患者,包括具有先天性免疫缺陷 (IEI) 的患者,移植接受者和接受免疫抑制疗法的患者,面临SARS-CoV-2感染的严重风险.
- COVID-19疫苗至关重要,但这些脆弱人群的免疫反应和有效性往往不理想,需要进一步研究.
- 对于免疫受损群体的现有疫苗和单克隆抗体 (mAb) 数据有限,需要集中研究.
研究的目的:
- 审查COVID-19疫苗和mAbs在免疫受损患者的疗效和安全性,重点关注IEI患者.
- 突出需要在未来与流行病相关的临床试验中包括脆弱人群 (VPs).
- 为风险群体制定量身定制的免疫战略和指导方针提供信息.
主要方法:
- 关于COVID-19疫苗和mAb在免疫受损人群中的有效性和安全性的综合文献综述.
- 分析原发性和二次性免疫缺陷患者的免疫反应,包括特定的幽默反应.
- 检查监管方面的考虑和包括VP在临床试验中的重要性.
主要成果:
- 对COVID-19疫苗的免疫反应在免疫功能低下的患者中是可变的,导致潜在的保护减少.
- 关于疫苗和mAbs在特定免疫受损子组 (如IEI患者) 的有效性和安全性的数据仍在发展.
- 有关在这些人群中最佳使用对策的证据存在关键差距.
结论:
- 免疫功能低下患者的疫苗接种策略需要仔细考虑,因为免疫反应不足.
- 在疫苗和mAb试验中包括脆弱人群对于开发有效和公平的流行病反应至关重要.
- 未来的研究和试验设计必须优先考虑免疫受损个体的纳入,以确保充分保护和改善患者护理.
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