The ROMANOV study found impaired humoral and cellular immune responses to SARS-CoV-2 mRNA vaccine in virus-unexposed patients receiving maintenance hemodialysis.
The ROMANOV study found impaired humoral and cellular immune responses to SARS-CoV-2 mRNA vaccine in virus-unexposed patients receiving maintenance hemodialysis.
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DOI：
10.1016/j.kint.2021.07.005
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发表时间：
2021-10
影响因子：
19.6
通讯作者：
Thaunat O
中科院分区：
文献类型：
--
作者：
Espi M;Charmetant X;Barba T;Koppe L;Pelletier C;Kalbacher E;Chalencon E;Mathias V;Ovize A;Cart-Tanneur E;Bouz C;Pellegrina L;Morelon E;Fouque D;Juillard L;Thaunat O
维持性血液透析 (MHD) 患者感染 SARS-CoV-2 病毒和因 COVID-19 死亡的风险较高，因此已优先接种疫苗。然而，由于他们被排除在关键研究之外并且免疫反应减弱，因此尚不清楚这些患者在接受“标准”两剂 mRNA 疫苗后是否受到保护。为了回答这个问题，我们对 106 名接受 MHD 的患者（其中 14 名有 COVID-19 病史）第二次注射 BNT162b2 疫苗后 10-14 天的循环中的抗尖峰受体结合域 (RBD) IgG 和产生干扰素 γ 的 CD4+ 和 CD8+ 特异性 T 细胞进行了测量，并与 30 名健康志愿者（4 名有 COVID-19 病史）进行了比较。接种疫苗后，大多数（72/80，90%）接受 MHD 病毒治疗的患者至少产生一种类型的免疫效应物，但他们的反应比健康志愿者更弱、更不完整。在多变量分析中，血液透析和免疫抑制治疗与抗 RBD IgG 和抗尖峰 CD8+ T 细胞的缺失显着相关。相比之下，接受 MHD 的患者既往有过 COVID-19 病史，这与两种类型的免疫效应物抗 RBD IgG 和抗尖峰 CD8+ T 细胞的生成相关，其水平与健康志愿者相似。接受过 SARS-Cov-2 MHD 治疗的患者在注射两剂 mRNA 疫苗后免疫反应减弱。因此，有 COVID-19 病史的接受 MHD 的患者对疫苗的良好反应表明，这些患者可能会从第三次疫苗注射中受益。
Patients on maintenance hemodialysis (MHD), which are at high risk of infection by SARS-CoV-2 virus and death due to COVID-19, have been prioritized for vaccination. However, because they were excluded from pivotal studies and have weakened immune responses, it is not known whether these patients are protected after the “standard” two doses of mRNA vaccines. To answer this, anti-spike receptor binding domain (RBD) IgG and interferon gamma-producing CD4+ and CD8+ specific-T cells were measured in the circulation 10-14 days after the second injection of BNT162b2 vaccine in 106 patients receiving MHD (14 with history of COVID-19) and compared to 30 healthy volunteers (four with history of COVID-19). After vaccination, most (72/80, 90%) patients receiving MHD naïve for the virus generated at least one type of immune effector, but their response was weaker and less complete than that of healthy volunteers. In multivariate analysis, hemodialysis and immunosuppressive therapy were significantly associated with absence of both anti-RBD IgGs and anti-spike CD8+ T cells. In contrast, previous history of COVID-19 in patients receiving MHD correlated with the generation of both types of immune effectors anti-RBD IgG and anti-spike CD8+ T cells at levels similar to healthy volunteers. Patients receiving MHD naïve for SARS-Cov-2 generate mitigated immune responses after two doses of mRNA vaccine. Thus, the good response to vaccine of patients receiving MHD with a history of COVID-19 suggest that these patients may benefit from a third vaccine injection.
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影响因子：
19.6
作者：
Ng, Jia H.;Hirsch, Jamie S.;Fishbane, Steven
通讯作者：
Fishbane, Steven
影响因子：
6
作者：
Glenn DA;Hegde A;Kotzen E;Walter EB;Kshirsagar AV;Falk R;Mottl A
通讯作者：
Mottl A
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：
2.7
作者：
FIRTH, D
通讯作者：
FIRTH, D
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