Accelerated waning of the humoral response to COVID-19 vaccines in obesity.

Autor:	van der Klaauw AA; University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome-Medical Research Council (MRC) Institute of Metabolic Science, University of Cambridge, Cambridge, UK., Horner EC; MRC Toxicology Unit, University of Cambridge, Cambridge, UK., Pereyra-Gerber P; Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, UK.; Department of Medicine, University of Cambridge, Cambridge, UK., Agrawal U; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK., Foster WS; Babraham Institute, Babraham Research Campus, Cambridge, UK., Spencer S; MRC Toxicology Unit, University of Cambridge, Cambridge, UK., Vergese B; University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome-Medical Research Council (MRC) Institute of Metabolic Science, University of Cambridge, Cambridge, UK.; NIHR Cambridge Clinical Research Facility, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Smith M; University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome-Medical Research Council (MRC) Institute of Metabolic Science, University of Cambridge, Cambridge, UK., Henning E; University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome-Medical Research Council (MRC) Institute of Metabolic Science, University of Cambridge, Cambridge, UK., Ramsay ID; Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, UK.; Department of Medicine, University of Cambridge, Cambridge, UK.; Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Smith JA; Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, UK.; Department of Medicine, University of Cambridge, Cambridge, UK., Guillaume SM; Babraham Institute, Babraham Research Campus, Cambridge, UK., Sharpe HJ; Babraham Institute, Babraham Research Campus, Cambridge, UK., Hay IM; Babraham Institute, Babraham Research Campus, Cambridge, UK.; Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK., Thompson S; Babraham Institute, Babraham Research Campus, Cambridge, UK., Innocentin S; Babraham Institute, Babraham Research Campus, Cambridge, UK., Booth LH; MRC Toxicology Unit, University of Cambridge, Cambridge, UK., Robertson C; Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK., McCowan C; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK., Kerr S; Usher Institute, University of Edinburgh, Edinburgh, UK., Mulroney TE; MRC Toxicology Unit, University of Cambridge, Cambridge, UK., O'Reilly MJ; MRC Toxicology Unit, University of Cambridge, Cambridge, UK., Gurugama TP; MRC Toxicology Unit, University of Cambridge, Cambridge, UK., Gurugama LP; MRC Toxicology Unit, University of Cambridge, Cambridge, UK., Rust MA; MRC Toxicology Unit, University of Cambridge, Cambridge, UK., Ferreira A; MRC Toxicology Unit, University of Cambridge, Cambridge, UK., Ebrahimi S; Immunology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.; Clinical Biochemistry, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Ceron-Gutierrez L; Immunology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.; Clinical Biochemistry, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Scotucci J; University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome-Medical Research Council (MRC) Institute of Metabolic Science, University of Cambridge, Cambridge, UK., Kronsteiner B; Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK., Dunachie SJ; Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.; NDM Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK.; NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.; Translational Gastroenterology Unit, University of Oxford, Oxford, UK.; Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand., Klenerman P; Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.; NDM Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK.; NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.; Translational Gastroenterology Unit, University of Oxford, Oxford, UK., Park AJ; Clinical Biochemistry, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Rubino F; Department of Diabetes, King's College London and King's College Hospital NHS Foundation Trust, London, UK., Lamikanra AA; NHS Blood and Transplant, Oxford, UK.; Radcliffe Department of Medicine, University of Oxford, Oxford, UK., Stark H; NIHR BioResource, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Kingston N; NIHR BioResource, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Estcourt L; NHS Blood and Transplant, Oxford, UK.; Radcliffe Department of Medicine, University of Oxford, Oxford, UK., Harvala H; NHS Blood and Transplant, London, UK., Roberts DJ; NHS Blood and Transplant, Oxford, UK.; Radcliffe Department of Medicine, University of Oxford, Oxford, UK., Doffinger R; Immunology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.; Clinical Biochemistry, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Linterman MA; Babraham Institute, Babraham Research Campus, Cambridge, UK., Matheson NJ; Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, UK.; Department of Medicine, University of Cambridge, Cambridge, UK.; Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.; NHS Blood and Transplant, Cambridge, UK., Sheikh A; Usher Institute, University of Edinburgh, Edinburgh, UK. aziz.sheikh@ed.ac.uk., Farooqi IS; University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome-Medical Research Council (MRC) Institute of Metabolic Science, University of Cambridge, Cambridge, UK. isf20@cam.ac.uk., Thaventhiran JED; MRC Toxicology Unit, University of Cambridge, Cambridge, UK. jedt2@cam.ac.uk.
Jazyk:	angličtina
Zdroj:	Nature medicine [Nat Med] 2023 May; Vol. 29 (5), pp. 1146-1154. Date of Electronic Publication: 2023 May 11.
DOI:	10.1038/s41591-023-02343-2
Abstrakt:	Obesity is associated with an increased risk of severe Coronavirus Disease 2019 (COVID-19) infection and mortality. COVID-19 vaccines reduce the risk of serious COVID-19 outcomes; however, their effectiveness in people with obesity is incompletely understood. We studied the relationship among body mass index (BMI), hospitalization and mortality due to COVID-19 among 3.6 million people in Scotland using the Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 (EAVE II) surveillance platform. We found that vaccinated individuals with severe obesity (BMI > 40 kg/m 2 ) were 76% more likely to experience hospitalization or death from COVID-19 (adjusted rate ratio of 1.76 (95% confidence interval (CI), 1.60-1.94). We also conducted a prospective longitudinal study of a cohort of 28 individuals with severe obesity compared to 41 control individuals with normal BMI (BMI 18.5-24.9 kg/m 2 ). We found that 55% of individuals with severe obesity had unquantifiable titers of neutralizing antibody against authentic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus compared to 12% of individuals with normal BMI (P = 0.0003) 6 months after their second vaccine dose. Furthermore, we observed that, for individuals with severe obesity, at any given anti-spike and anti-receptor-binding domain (RBD) antibody level, neutralizing capacity was lower than that of individuals with a normal BMI. Neutralizing capacity was restored by a third dose of vaccine but again declined more rapidly in people with severe obesity. We demonstrate that waning of COVID-19 vaccine-induced humoral immunity is accelerated in individuals with severe obesity. As obesity is associated with increased hospitalization and mortality from breakthrough infections, our findings have implications for vaccine prioritization policies. (© 2023. The Author(s).)
Databáze:	MEDLINE
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