Neutralizing Antibodies and Cytokines in Breast Milk After Coronavirus Disease 2019 (COVID-19) mRNA Vaccination.
Neutralizing Antibodies and Cytokines in Breast Milk After Coronavirus Disease 2019 (COVID-19) mRNA Vaccination.
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DOI：
10.1097/aog.0000000000004661
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发表时间：
2022-02-01
影响因子：
7.2
通讯作者：
Arcaro KF
中科院分区：
文献类型：
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作者：
Narayanaswamy V;Pentecost BT;Schoen CN;Alfandari D;Schneider SS;Baker R;Arcaro KF
对基于mRNA的2019冠状病毒病（COVID-19）疫苗接种的体液和细胞免疫反应存在于大多数女性的母乳中，并为哺乳期婴儿提供被动免疫。评估对母乳中存在的2019冠状病毒病（COVID-19）mRNA疫苗的免疫反应以及免疫反应对母乳喂养婴儿的转移。在这项队列研究中，我们招募了30名哺乳期女性，她们在2021年1月至4月期间接受了基于mRNA的COVID-19疫苗。女性提供了系列乳汁样本，包括接种前、首次接种后2-3周和第二次接种后3周挤出的乳汁。女性在第一次给药后19天和第二次给药后21天提供了他们的血液，点在卡片上（干血点）。在母亲第二次接种疫苗后21天收集母乳喂养婴儿的粪便样本。大流行前的牛奶、干血斑和婴儿粪便样本被用作对照。通过酶联免疫吸附试验检测牛奶、干血斑和婴儿粪便中的受体结合域（RBD）特异性免疫球蛋白（IG）A和IgG。检测乳汁样本中是否存在针对加标物和四种关注变体的中和抗体：D 614 G、α（B.1.1.7）、β（B.1.351）和γ（P.1）。在乳汁样品中测量10种细胞因子的水平。来自COVID-19免疫妇女的牛奶中和了主要由抗RBD IgG驱动的峰值和四种令人担忧的变体。牛奶中的免疫应答还包括干扰素-γ的显著升高。母乳喂养的婴儿反映了母亲接种疫苗的免疫反应：分别在33%和30%的婴儿粪便样本中检测到抗RBD IgG和抗RBD伊加。婴儿粪便中的抗RBD抗体水平与母体疫苗副作用相关。在大流行前的牛奶和婴儿粪便样本中，抗RBD抗体水平中位数低于阳性临界值。对基于mRNA的COVID-19疫苗接种的体液和细胞免疫反应存在于大多数女性的母乳中。牛奶抗RBD抗体可以中和严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）的刺突和变异。抗RBD抗体转移到母乳喂养的婴儿，有可能赋予针对SARS-CoV-2的被动免疫。
Humoral and cellular immune responses to mRNA-based coronavirus disease 2019 (COVID-19) vaccination are present in the breast milk of most women and confer passive immunity to the nursing infant. To evaluate immune responses to coronavirus disease 2019 (COVID-19) mRNA-based vaccines present in breast milk and transfer of the immune responses to breastfeeding infants. We enrolled 30 lactating women who received mRNA-based COVID-19 vaccines from January through April 2021 in this cohort study. Women provided serial milk samples, including milk expressed before vaccination, across 2–3 weeks after the first dose, and across 3 weeks after the second dose. Women provided their blood, spotted on cards (dried blood spots), 19 days after the first dose and 21 days after the second dose. Stool samples from the breastfed infants were collected 21 days after mothers' second vaccination. Prepandemic samples of milk, dried blood spots, and infant stool were used as controls. Milk, dried blood spots, and infant stool were tested by enzyme-linked immunosorbent assay for receptor-binding domain (RBD)–specific immunoglobulin (Ig)A and IgG. Milk samples were tested for the presence of neutralizing antibodies against the spike and four variants of concern: D614G, Alpha (B.1.1.7), Beta (B.1.351), and Gamma (P.1). Levels of 10 cytokines were measured in milk samples. Milk from COVID-19-immunized women neutralized the spike and four variants of concern, primarily driven by anti-RBD IgG. The immune response in milk also included significant elevation of interferon-γ. The immune response to maternal vaccination was reflected in breastfed infants: anti-RBD IgG and anti-RBD IgA were detected in 33% and 30% of infant stool samples, respectively. Levels of anti-RBD antibodies in infant stool correlated with maternal vaccine side effects. Median antibody levels against RBD were below the positive cutoffs in prepandemic milk and infant stool samples. Humoral and cellular immune responses to mRNA-based COVID-19 vaccination are present in most women’s breast milk. The milk anti-RBD antibodies can neutralize severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike and variants of concern. Anti-RBD antibodies are transferred to breastfed infants, with the potential to confer passive immunity against SARS-CoV-2.