在患有多发性硬化症的人群中,三剂COVID-19疫苗的免疫性
Marianne J Shawe-Taylor1,2, David Greenwood1, Anna He3,4
1The Francis Crick Institute, London, UK.
BMJ neurology open
|December 22, 2025
概括
患有多发性硬化症 (pwMS) 的B细胞耗尽疗法的人在三次mRNA COVID-19疫苗剂量后显示出有限的抗体反应. 尽管免疫原性较低,但严重的结局不存在,这表明对这些患者进行修订的保护值.
科学领域:
- 免疫学 免疫学 免疫学
- 神经科学是一个神经科学.
- 病毒学 病毒学
背景情况:
- 患有多发性硬化症 (pwMS) 的B细胞耗尽疾病修饰疗法 (BCD-DMT) 的人面临严重COVID-19的高风险.
- 在BCD-DMT上的pwMS中关于COVID-19疫苗免疫性数据有限.
- 在2020-2022年期间,SARS-CoV-2变种迅速演变.
研究的目的:
- 为了比较pwMS和健康接种疫苗的成年人 (HVA) 在三次mRNA疫苗注射后的COVID-19疫苗反应.
- 调查BCD-DMTs对pwMS疫苗免疫性的影响.
- 评估针对各种SARS-CoV-2变体的中和抗体标位 (nAbT).
主要方法:
- 对226名pwMS和匹配的HVA进行前性观察队列研究.
- 使用活病毒试验对祖先,阿尔法,三角形,奥米克朗BA.1,BA.2和BA.5的SARS-CoV-2变体进行nAbT的量化.
- 在BCD-DMT上的pwMS,在非耗尽的DMT上的pwMS和HVA之间对nAbT进行比较.
主要成果:
- 在第三剂疫苗注射之前,nAbTs在BCD治疗中的pWMS显著低于HVA或B细胞充满pWMS.
- 接种疫苗在BCD治疗的pwMS中没有显著增加nAbTs.
- 充满B细胞的pwMS显示了与HVA可比的nAbTs,在接种疫苗后得到了增强,从而放大了B细胞充满和耗尽的pwMS之间的差异.
- 该队列中没有发生COVID-19住院或死亡.
- 来自pwMS的流行前血清显示了对季节性冠状病毒和SARS-CoV-2变种的预先存在的中和活性.
结论:
- 在BCD治疗中的PwMS在重复接种COVID-19疫苗后表现出减少的抗体增强.
- 尽管免疫原性降低,但pwMS中没有严重的COVID-19结局,这表明有效保护值较低.
- 这些发现支持在BCD-DMT上对pwMS的更细致的临床风险分层.
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