Cellular and humoral immunogenicity of the mRNA-1273 SARS-CoV-2 vaccine in patients with hematologic malignancies.
Cellular and humoral immunogenicity of the mRNA-1273 SARS-CoV-2 vaccine in patients with hematologic malignancies.
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DOI：
10.1182/bloodadvances.2021006101
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发表时间：
2022-02-08
期刊：
影响因子：
7.5
通讯作者：
Abrisqueta P
中科院分区：
文献类型：
--
作者：
Jiménez M;Roldán E;Fernández-Naval C;Villacampa G;Martinez-Gallo M;Medina-Gil D;Peralta-Garzón S;Pujadas G;Hernández C;Pagès C;Gironella M;Fox L;Orti G;Barba P;Pumarola T;Cabirta A;Catalá E;Valentín M;Marín-Niebla A;Orfao A;González M;Campins M;Ruiz-Camps I;Valcárcel D;Bosch F;Hernández M;Crespo M;Esperalba J;Abrisqueta P
SARS-CoV-2 mRNA-1273疫苗诱导抗CD20治疗患者的体液应答受损，但细胞应答保留。GVHD的免疫抑制治疗降低了细胞应答，对体液免疫原性没有影响。最近的研究表明，严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）的信使RNA（mRNA）疫苗诊断为血液恶性肿瘤患者的体液反应不佳;然而，有关细胞免疫原性的数据很少。本研究的目的是评价第二剂mRNA-1273疫苗后1个月的体液和细胞免疫原性。采用Elecsys和LIAISON抗SARS-CoV-2S抗体滴度测定法检测血清抗体滴度，采用γ-干扰素释放免疫分析技术检测T细胞应答。总体而言，76.3%（184/241）的患者出现体液免疫，细胞反应率为79%（184/233）。低丙种球蛋白血症、淋巴细胞减少症、积极的血液学治疗和过去6个月内的抗CD20治疗与较差的体液应答相关。相反，年龄> 65岁、活动性疾病、淋巴细胞减少和移植物抗宿主病（GVHD）的免疫抑制治疗与受损的细胞反应相关。在接受抗CD20治疗的患者中观察到体液应答和细胞应答之间存在显著分离（体液应答为17.5%，而细胞应答为71.1%）。在这些患者中，B细胞再生障碍性贫血得到证实，而T细胞计数得到保留。相反，在接受免疫抑制治疗的GVHD患者中观察到77.3%的体液应答，而只有52.4%的患者有细胞应答。恶性血液病患者对SARS-CoV-2 mRNA-1273疫苗的细胞和体液应答受到抗CD20治疗和免疫抑制剂等治疗的高度影响。这一观察结果对这些患者的进一步管理具有意义。
SARS-CoV-2 mRNA-1273 vaccine induces an impaired humoral response in patients under anti-CD20 therapy, but cellular response is preserved. Immunosuppressive therapy for GVHD reduces cellular response with no impact in humoral immunogenicity. Recent studies have shown a suboptimal humoral response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines in patients diagnosed with hematologic malignancies; however, data about cellular immunogenicity are scarce. The aim of this study was to evaluate both the humoral and cellular immunogenicity 1 month after the second dose of the mRNA-1273 vaccine. Antibody titers were measured by using the Elecsys and LIAISON anti–SARS-CoV-2 S assays, and T-cell response was assessed by using interferon-γ release immunoassay technology. Overall, 76.3% (184 of 241) of patients developed humoral immunity, and the cellular response rate was 79% (184 of 233). Hypogammaglobulinemia, lymphopenia, active hematologic treatment, and anti-CD20 therapy during the previous 6 months were associated with an inferior humoral response. Conversely, age >65 years, active disease, lymphopenia, and immunosuppressive treatment of graft-versus-host disease (GVHD) were associated with an impaired cellular response. A significant dissociation between the humoral and cellular responses was observed in patients treated with anti-CD20 therapy (the humoral response was 17.5%, whereas the cellular response was 71.1%). In these patients, B-cell aplasia was confirmed while T-cell counts were preserved. In contrast, humoral response was observed in 77.3% of patients undergoing immunosuppressive treatment of GVHD, whereas only 52.4% had a cellular response. The cellular and humoral responses to the SARS-CoV-2 mRNA-1273 vaccine in patients with hematologic malignancies are highly influenced by the presence of treatments such as anti-CD20 therapy and immunosuppressive agents. This observation has implications for the further management of these patients.
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BNT162B2 mRNA COVID-19疫苗的安全性和功效。
DOI：
10.1056/nejmoa2034577
发表时间：
2020-12-31
期刊：
The New England journal of medicine
影响因子：
--
作者：
Polack FP;Thomas SJ;Kitchin N;Absalon J;Gurtman A;Lockhart S;Perez JL;Pérez Marc G;Moreira ED;Zerbini C;Bailey R;Swanson KA;Roychoudhury S;Koury K;Li P;Kalina WV;Cooper D;Frenck RW Jr;Hammitt LL;Türeci Ö;Nell H;Schaefer A;Ünal S;Tresnan DB;Mather S;Dormitzer PR;Şahin U;Jansen KU;Gruber WC;C4591001 Clinical Trial Group
通讯作者：
C4591001 Clinical Trial Group
影响因子：
4.2
作者：
Agha ME;Blake M;Chilleo C;Wells A;Haidar G
通讯作者：
Haidar G
影响因子：
--
作者：
Roldan E;Perales MA;Barba P
通讯作者：
Barba P
影响因子：
3.9
作者：
Martínez-Gallo M;Esperalba J;Pujol-Borrell R;Sandá V;Arrese-Muñoz I;Fernández-Naval C;Antón A;Cardona V;Labrador-Horrillo M;Pumarola T;Hernandéz-González M
通讯作者：
Hernandéz-González M
DOI：
10.1056/nejmoa2035389
发表时间：
2021-02-04
期刊：
The New England journal of medicine
影响因子：
--
作者：
Baden LR;El Sahly HM;Essink B;Kotloff K;Frey S;Novak R;Diemert D;Spector SA;Rouphael N;Creech CB;McGettigan J;Khetan S;Segall N;Solis J;Brosz A;Fierro C;Schwartz H;Neuzil K;Corey L;Gilbert P;Janes H;Follmann D;Marovich M;Mascola J;Polakowski L;Ledgerwood J;Graham BS;Bennett H;Pajon R;Knightly C;Leav B;Deng W;Zhou H;Han S;Ivarsson M;Miller J;Zaks T;COVE Study Group
通讯作者：
COVE Study Group