Humoral and cellular immunity to SARS-CoV-2 vaccination in renal transplant versus dialysis patients: A prospective, multicenter observational study using mRNA-1273 or BNT162b2 mRNA vaccine.
Humoral and cellular immunity to SARS-CoV-2 vaccination in renal transplant versus dialysis patients: A prospective, multicenter observational study using mRNA-1273 or BNT162b2 mRNA vaccine.
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DOI：
10.1016/j.lanepe.2021.100178
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发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Hugo C
中科院分区：
文献类型：
--
作者：
Stumpf J;Siepmann T;Lindner T;Karger C;Schwöbel J;Anders L;Faulhaber-Walter R;Schewe J;Martin H;Schirutschke H;Barnett K;Hüther J;Müller P;Langer T;Pluntke T;Anding-Rost K;Meistring F;Stehr T;Pietzonka A;Escher K;Cerny S;Rothe H;Pistrosch F;Seidel H;Paliege A;Beige J;Bast I;Steglich A;Gembardt F;Kessel F;Kröger H;Arndt P;Sradnick J;Frank K;Klimova A;Mauer R;Grählert X;Anft M;Blazquez-Navarro A;Westhoff TH;Stervbo U;Tonn T;Babel N;Hugo C
透析和肾移植患者是新冠肺炎相关疾病和死亡率的易感人群。我们进行了一项前瞻性研究，探讨了3100多名参与者对SARS-CoV-2加强疫苗接种的8周时间进程(干扰素-γ释放试验和流式细胞术)或/和体液免疫反应(ELISA)，其中包括医务人员、透析患者和使用BNT162b2或mRNA1273基因疫苗的肾移植受者。在透析患者中，接种SARS-CoV-2疫苗引起的血清转换效果与医务人员相似(95%)，但在肾移植受者中明显受损(42%)。T细胞免疫在很大程度上模仿了体液免疫结果。血清转换失败的主要危险因素是免疫抑制药物的数量和类型(贝拉塔塞特、MMF-MPA、钙调神经磷酸酶抑制剂)以及疫苗类型(BNT162b2mRNA)。与BNT162b2疫苗相比，透析患者和移植患者的血清转换率分别为97%~88%(P<0.001)和49%~26%。与BNT162b2(85%，p<0.001)相比，mRNA1273mRNA-1273mR免疫组(95%)显著高于BNT162b2组(85%，P<0.05)。接种疫苗似乎是安全和高效的，表明在加强接种疫苗后几乎完全没有症状性新冠肺炎病，并且在透析患者的第三次大流行期间疾病发病率停止。在加强免疫接种后，透析患者的血清转换率高达95%，而大多数移植受者的体液反应受损。免疫抑制药物的数量和类型以及疫苗类型(BNT162b2)是透析和移植患者血清转换失败的主要决定因素，提示免疫监测和疫苗接种方案的适应。
Dialysis and kidney transplant patients are vulnerable populations for COVID-19 related disease and mortality. We conducted a prospective study exploring the eight week time course of specific cellular (interferon-γ release assay and flow cytometry) or/and humoral immune responses (ELISA) to SARS-CoV-2 boost vaccination in more than 3100 participants including medical personnel, dialysis patients and kidney transplant recipients using mRNA vaccines BNT162b2 or mRNA-1273. SARS-CoV-2-vaccination induced seroconversion efficacy in dialysis patients was similar to medical personnel (> 95%), but markedly impaired in kidney transplant recipients (42%). T-cellular immunity largely mimicked humoral results. Major risk factors of seroconversion failure were immunosuppressive drug number and type (belatacept, MMF-MPA, calcineurin-inhibitors) as well as vaccine type (BNT162b2 mRNA). Seroconversion rates induced by mRNA-1273 compared to BNT162b2 vaccine were 97% to 88% (p < 0.001) in dialysis and 49% to 26% in transplant patients, respectively. Specific IgG directed against the new binding domain of the spike protein (RDB) were significantly higher in dialysis patients vaccinated by mRNA-1273 (95%) compared to BNT162b2 (85%, p < 0.001). Vaccination appeared safe and highly effective demonstrating an almost complete lack of symptomatic COVID-19 disease after boost vaccination as well as ceased disease incidences during third pandemic wave in dialysis patients. Dialysis patients exhibit a remarkably high seroconversion rate of 95% after boost vaccination, while humoral response is impaired in the majority of transplant recipients. Immunosuppressive drug number and type as well as vaccine type (BNT162b2) are major determinants of seroconversion failure in both dialysis and transplant patients suggesting immune monitoring and adaption of vaccination protocols.
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影响因子：
64.5
作者：
Sette A;Crotty S
通讯作者：
Crotty S
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：
5
作者：
Padoan, Andrea;Sciacovelli, Laura;Plebani, Mario
通讯作者：
Plebani, Mario
影响因子：
18.2
作者：
Nance KD;Meier JL
通讯作者：
Meier JL
影响因子：
16.1
作者：
Batty CJ;Heise MT;Bachelder EM;Ainslie KM
通讯作者：
Ainslie KM