接受脏移植的接受者对疫苗接种和增强的反应
Walter D Park1, Sumi S Nair2, Hani M Wadei3
1Department of Surgery and Immunology, Mayo Clinic, Rochester, MN, USA.
Mayo Clinic proceedings
|July 15, 2025
概括
低抗体水平的移植接受者 (KTRs) 对异质增强剂 (HB) 疫苗反应良好. 然而,那些没有检测到的水平的人表现出有限的反应,突出显示了在免疫受损患者中需要量身定制的COVID-19疫苗接种策略.
科学领域:
- 免疫学 免疫学 免疫学
- 疫苗学 疫苗学 疫苗学
- 移植 移植 移植 移植
背景情况:
- 移植接受者 (KTRs) 往往对疫苗接种有不理想的免疫反应.
- 评估Janssen Ad26.COV2.S疫苗异质增强 (HB) 的有效性对于改善mRNA疫苗接种后抗体水平较低的KTRs中COVID-19保护至关重要.
研究的目的:
- 为了评估使用詹森Ad26.COV2.S疫苗的异质增强剂 (HB) 在移植接受者 (KTRs) 中的有效性,在mRNA COVID-19疫苗接种后抗体水平不足.
主要方法:
- 一项涉及KTRs的多中心研究,使用两剂或更多剂的mRNA疫苗.
- 患有低 (LL) 或不可检测 (UL) 抗尖峰抗体水平的患者接受了詹森HB疫苗,UL患者随机分配到具有或没有免疫抑制调整的HB.
- 主要终点:达到高抗体水平 (>250 IU/mL) 在HB后28天. 亚组分析包括免疫细胞分析.
主要成果:
- 在419个KTR中,80%的mRNA接种后抗体水平高 (HL). 在LL患者中,62.9%的人在Janssen HB之后获得了HL.
- 在UL患者中,45%的患者达到LL,但没有人达到HL,即使调整了免疫抑制.
- 无法检测的抗体水平与减少的T细胞,B细胞和记忆B细胞数量相关.
结论:
- 用Janssen Ad26.COV2.S进行异质增强对许多在mRNA COVID-19疫苗接种后抗体水平较低的KTRs有效.
- 具有无法检测的抗体水平的KTRs表现出严重受损的免疫反应,限制了疫苗的疗效.
- 移植前的疫苗接种可能会产生更持久的抗体反应. 监测抗体水平是确定需要替代预防的KTRs的关键.
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