SARS-CoV-2 neutralizing antibody response after three doses of mRNA1273 vaccine and COVID-19 in hemodialysis patients.
SARS-CoV-2 neutralizing antibody response after three doses of mRNA1273 vaccine and COVID-19 in hemodialysis patients.
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DOI：
10.3389/fneph.2022.926635
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发表时间：
2022-01-01
期刊：
影响因子：
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通讯作者：
Kotanko, Peter
中科院分区：
文献类型：
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作者：
Wang, Xiaoling;Han, Maggie;Kotanko, Peter
背景：血液透析患者经常接种第三次疫苗，以增强对 2019 年冠状病毒病 (COVID-19) 的保护。然而，新出现的 B.1.1.159 (Omicron) 变种可能比以前的菌株更容易逃避疫苗保护。更好地了解这些大多数免疫功能低下的患者在接种加强疫苗或感染 COVID-19 后对严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 变体的中和活性具有临床意义。方法：2021 年 6 月至 2022 年 2 月期间招募了来自四个透析中心的血液透析患者。每位患者平均提供了 6 个血清样本。使用金斯瑞 SARS-CoV-2 替代病毒中和测试试剂盒测量针对野生型 (WT) 或 Omicron 的 SARS-CoV-2 中和抗体 (nAb)。结果：42 名患者接受了三剂 mRNA1273。与第三次给药前的水平相比，第三次给药后，nAb-WT 增加了 18 倍（第 23 天达到峰值），nAb-Omicron 增加了 23 倍（第 24 天达到峰值）。 nAb-WT 峰值超过 nAb-Omicron 峰值 27 倍。 2021 年 12 月 24 日至 2022 年 2 月 2 日期间，有 21 名患者感染了 COVID-19。在出现 COVID-19 后，nAb-WT 和 nAb-Omicron 分别增加了 12 倍和 40 倍。虽然疫苗和新冠肺炎后的 nAb-WT 水平相当，但新冠肺炎后的 nAb-Omicron 水平比各自峰值疫苗 nAb-Omicron 高 3.2。四名患有终末期肾病以外原因的免疫功能低下患者在第三剂疫苗或 COVID-19 后，其 nAb 水平非常低甚至没有。结论：我们的结果表明，大多数血液透析患者对第三剂疫苗接种有强烈的体液反应，并且在 COVID-19 后的体液反应甚至更强。然而，nAb 水平随着时间的推移明显下降。这些发现可能为正在进行的关于血液透析患者第四次疫苗接种的讨论提供信息。
Background: In hemodialysis patients, a third vaccination is frequently administered to augment protection against coronavirus disease 2019 (COVID-19). However, the newly emerged B.1.1.159 (Omicron) variant may evade vaccinal protection more easily than previous strains. It is of clinical interest to better understand the neutralizing activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants after booster vaccine or COVID-19 infection in these mostly immunocompromised patients.Methods: Hemodialysis patients from four dialysis centers were recruited between June 2021 and February 2022. Each patient provided a median of six serum samples. SARS-CoV-2 neutralizing antibodies (nAbs) against wild type (WT) or Omicron were measured using the GenScript SARS-CoV-2 Surrogate Virus Neutralization Test Kit.Results: Forty-two patients had three doses of mRNA1273. Compared to levels prior to the third dose, nAb-WT increased 18-fold (peak at day 23) and nAb-Omicron increased 23-fold (peak at day 24) after the third dose. Peak nAb-WT exceeded peak nAb-Omicron 27-fold. Twenty-one patients had COVID-19 between December 24, 2021, and February 2, 2022. Following COVID-19, nAb-WT and nAb-Omicron increased 12- and 40-fold, respectively. While levels of vaccinal and post-COVID nAb-WT were comparable, post-COVID nAb-Omicron levels were 3.2 higher than the respective peak vaccinal nAb-Omicron. Four immunocompromised patients having reasons other than end-stage kidney disease have very low to no nAb after the third dose or COVID-19.Conclusions: Our results suggest that most hemodialysis patients have a strong humoral response to the third dose of vaccination and an even stronger post-COVID-19 humoral response. Nevertheless, nAb levels clearly decay over time. These findings may inform ongoing discussions regarding a fourth vaccination in hemodialysis patients.