Differential T-cell and antibody responses induced by mRNA versus adenoviral vectored COVID-19 vaccines in patients with immunodeficiencies.
Differential T-cell and antibody responses induced by mRNA versus adenoviral vectored COVID-19 vaccines in patients with immunodeficiencies.
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DOI：
10.1016/j.jacig.2023.100091
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发表时间：
2023-05
期刊：
影响因子：
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通讯作者：
Baxendale, Helen
中科院分区：
文献类型：
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作者：
Aguinam, Ernest T;Nadesalingam, Angalee;Chan, Andrew;Smith, Peter;Paloniemi, Minna;Cantoni, Diego;Gronlund, Jessica;Gronlund, Helen;Carnell, George W;Castillo-Olivares, Javier;Temperton, Nigel;Blacklaws, Barbara;Heeney, Jonathan L;Baxendale, Helen
免疫缺陷患者 (IDP) 感染 2019 年严重冠状病毒病 (COVID-19) 的风险较高。实施有针对性的疫苗接种策略，增强疫苗诱导的保护作用。然而，在这一人群中，临床效果存在差异，且保护持续时间未知。我们试图更好地了解免疫缺陷患者对 mRNA 和腺病毒载体 COVID-19 疫苗的细胞和体液免疫反应。在 112 名初次感染的国内流离失所者和 131 名健康医护人员（作为对照）接种 2 剂同源 ChAdOx1-nCoV-19 或 BNT162b2 疫苗后，评估了对严重急性呼吸综合征冠状病毒 2 尖峰的免疫反应。研究了疫苗反应的预测因素。对疫苗接种的免疫反应较低，尽管许多境内流离失所者的结合反应滴度较高，但未检测到抗体对病毒的中和作用。在那些表现出反应的人中，IDP 中特异性 T 细胞反应的频率与对照组相似，而抗体反应较低。确定了持续的疫苗特异性差异：与 BNT162b2 免疫的 IDP 相比，ChAdOx1-nCoV-19 中的 T 细胞反应更强，并且所有用 BNT162b2 免疫的队列中的抗体结合和中和更强。 T 细胞和抗体反应之间的正相关性很弱，并且随着随后的疫苗接种而增加。免疫缺陷患者对 mRNA 和病毒载体 COVID-19 疫苗的免疫反应受损，这似乎受到疫苗配方的影响。需要了解 T 细胞和抗体介导的保护的相对作用以及异源初免和加强免疫方案的潜力，以优化这些高危人群的疫苗接种方法。
Immunodeficient patients (IDPs) are at higher risk of contracting severe coronavirus disease 2019 (COVID-19). Targeted vaccination strategies have been implemented to enhance vaccine-induced protection. In this population, however, clinical effectiveness is variable and the duration of protection unknown. We sought to better understand the cellular and humoral immune responses to mRNA and adenoviral vectored COVID-19 vaccines in patients with immunodeficiency. Immune responses to severe acute respiratory syndrome coronavirus 2 spike were assessed after 2 doses of homologous ChAdOx1-nCoV-19 or BNT162b2 vaccines in 112 infection-naive IDPs and 131 healthy health care workers as controls. Predictors of vaccine responsiveness were investigated. Immune responses to vaccination were low, and virus neutralization by antibody was not detected despite high titer binding responses in many IDPs. In those exhibiting response, the frequency of specific T-cell responses in IDPs was similar to controls, while antibody responses were lower. Sustained vaccine specific differences were identified: T-cell responses were greater in ChAdOx1-nCoV-19– compared to BNT162b2-immunized IDPs, and antibody binding and neutralization were greater in all cohorts immunized with BNT162b2. The positive correlation between T-cell and antibody responses was weak and increased with subsequent vaccination. Immunodeficient patients have impaired immune responses to mRNA and viral vector COVID-19 vaccines that appear to be influenced by vaccine formulation. Understanding the relative roles of T-cell– and antibody-mediated protection as well as the potential of heterologous prime and boost immunization protocols is needed to optimize the vaccination approach in these high-risk groups.