Antibody Responses to SARS-CoV-2 After Infection or Vaccination in Children and Young Adults With Inflammatory Bowel Disease.
Antibody Responses to SARS-CoV-2 After Infection or Vaccination in Children and Young Adults With Inflammatory Bowel Disease.
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感染或接种疫苗后对SARS-CoV-2的抗体反应在患有炎症性肠病的儿童和年轻人中
DOI：
10.1093/ibd/izab207
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发表时间：
2022-07-01
影响因子：
4.9
通讯作者：
Hyams JS
中科院分区：
文献类型：
--
作者：
Dailey J;Kozhaya L;Dogan M;Hopkins D;Lapin B;Herbst K;Brimacombe M;Grandonico K;Karabacak F;Schreiber J;Liang BT;Salazar JC;Unutmaz D;Hyams JS
在接受生物治疗的炎症性肠病(IBD)儿童和年轻人中，确定SARS-CoV-2感染的中和抗体或接种疫苗是至关重要的。我们进行了一项前瞻性纵向队列研究，评估接受英夫利昔单抗或维多利单抗治疗的炎症性肠病患者的SARS-CoV-2刺激蛋白受体结合域(S-RBD)抗体阳性与临床症状的一致性。在用批准的疫苗免疫后，也获得了血清。针对SARS-CoV-2刺突蛋白结合区的抗体采用基于荧光微珠的免疫分析方法进行检测，该方法利用了流式细胞术中荧光分子的高动态范围。采用了一种灵敏和高通量的中和试验，将SARS-CoV-2刺突蛋白整合到慢病毒上，并测量了假病毒进入表达人胚胎肾脏293(HEK-293)的血管紧张素转换酶2(ACE2)细胞。共纳入436名患者(平均年龄17岁，范围2-26岁；58%为男性；71%为克罗恩病，29%为溃疡性结肠炎，IBD-未指明)。44例(10%)SARS-CoV-2 S-RBD抗体阳性。与非IBD成人(门诊)和住院的SARS-CoV-2感染的儿科患者相比，IBD队列中的S-RBDIg G抗体水平显著降低，到感染后6个月大多数患者缺乏中和抗体。接种疫苗后(n = 33)，患者的S冠状病毒抗体反应率是自然感染的15倍，所有患者都产生了对野生型和变异型SARS-CoV2的中和抗体。在接受生物制剂治疗的IBD患者中，对自然感染的SARS-CoV-2 S-RBD免疫球蛋白反应较低且耐受性较差，使他们面临再次感染的风险。对免疫的有力反应可能是保护性的。
Characterization of neutralization antibodies to SARS-CoV-2 infection or vaccination in children and young adults with inflammatory bowel disease (IBD) receiving biologic therapies is crucial. We performed a prospective longitudinal cohort study evaluating SARS-CoV-2 spike protein receptor binding domain (S-RBD) IgG positivity along with consistent clinical symptoms in patients with IBD receiving infliximab or vedolizumab. Serum was also obtained following immunization with approved vaccines. The IgG antibody to the spike protein binding domain of SARS-CoV-2 was assayed with a fluorescent bead-based immunoassay that takes advantage of the high dynamic range of fluorescent molecules using flow cytometry. A sensitive and high-throughput neutralization assay that incorporates SARS-CoV-2 spike protein onto a lentivirus and measures pseudoviral entry into ACE2-angiotensin converting enzyme 2 (ACE2) expressing human embryonic kidney 293 (HEK-293) cells was used. There were 436 patients enrolled (mean age, 17 years, range 2–26 years; 58% male; 71% Crohn’s disease, 29% ulcerative colitis, IBD-unspecified). Forty-four (10%) of enrolled subjects had SARS-CoV-2 S-RBD IgG antibodies. Compared to non-IBD adults (ambulatory) and hospitalized pediatric patients with PCR documented SARS-CoV-2 infection, S-RBD IgG antibody levels were significantly lower in the IBD cohort and by 6 months post infection most patients lacked neutralizing antibody. Following vaccination (n = 33), patients had a 15-fold higher S-RBD antibody response in comparison with natural infection, and all developed neutralizing antibodies to both wild type and variant SARS-CoV-2. The lower and less durable SARS-CoV-2 S-RBD IgG response to natural infection in IBD patients receiving biologics puts them at risk of reinfection. The robust response to immunization is likely protective.
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影响因子：
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影响因子：
27.4
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通讯作者：
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影响因子：
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作者：
deBruyn, Jennifer;Fonseca, Kevin;Wrobel, Iwona
通讯作者：
Wrobel, Iwona
影响因子：
24.5
作者：
Siegel CA;Melmed GY;McGovern DP;Rai V;Krammer F;Rubin DT;Abreu MT;Dubinsky MC;International Organization for the Study of Inflammatory Bowel Disease (IOIBD);International Organization for the Study of Inflammatory Bowel Diseases (IOIBD)
通讯作者：
International Organization for the Study of Inflammatory Bowel Diseases (IOIBD)