SARS-CoV-2-specific immune responses and clinical outcomes after COVID-19 vaccination in patients with immune-suppressive disease.

Autor: Barnes E; Nuffield Department of Medicine, University of Oxford, Oxford, UK.; Oxford University Hospitals NHS Foundation Trust, Oxford, UK., Goodyear CS; College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK., Willicombe M; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, Hammersmith Campus, London, UK., Gaskell C; Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Edgbaston, Birmingham, UK., Siebert S; College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK., I de Silva T; Department of Infection, Immunity and Cardiovascular Disease, The Medical School, The University of Sheffield, Sheffield, UK., Murray SM; Nuffield Department of Medicine, University of Oxford, Oxford, UK., Rea D; Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Edgbaston, Birmingham, UK., Snowden JA; Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK., Carroll M; Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK., Pirrie S; Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Edgbaston, Birmingham, UK., Bowden SJ; Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Edgbaston, Birmingham, UK., Dunachie SJ; Nuffield Department of Medicine, University of Oxford, Oxford, UK.; Oxford University Hospitals NHS Foundation Trust, Oxford, UK., Richter A; Clinical Immunology Service, University of Birmingham, Edgbaston, Birmingham, UK., Lim Z; Nuffield Department of Medicine, University of Oxford, Oxford, UK., Satsangi J; Nuffield Department of Medicine, University of Oxford, Oxford, UK., Cook G; National Institute for Health Research, Leeds MIC, University of Leeds, Leeds, UK., Pope A; Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Edgbaston, Birmingham, UK., Hughes A; Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Edgbaston, Birmingham, UK., Harrison M; Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Edgbaston, Birmingham, UK., Lim SH; Centre for Cancer Immunology, University of Southampton, Southampton, UK., Miller P; British Society of Blood and Marrow Transplantation and Cellular Therapy, Guy's Hospital, London, UK., Klenerman P; Nuffield Department of Medicine, University of Oxford, Oxford, UK.; Oxford University Hospitals NHS Foundation Trust, Oxford, UK., Basu N; College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK., Gilmour A; College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK., Irwin S; Nuffield Department of Medicine, University of Oxford, Oxford, UK., Meacham G; Nuffield Department of Medicine, University of Oxford, Oxford, UK., Marjot T; Nuffield Department of Medicine, University of Oxford, Oxford, UK., Dimitriadis S; Nuffield Department of Medicine, University of Oxford, Oxford, UK., Kelleher P; Department of Infectious Diseases, Imperial College London, School of Medicine Chelsea and Westminster Hospital, London, UK., Prendecki M; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, Hammersmith Campus, London, UK., Clarke C; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, Hammersmith Campus, London, UK., Mortimer P; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, Hammersmith Campus, London, UK., McIntyre S; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, Hammersmith Campus, London, UK., Selby R; Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK., Meardon N; Department of Infection, Immunity and Cardiovascular Disease, The Medical School, The University of Sheffield, Sheffield, UK., Nguyen D; Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK., Tipton T; Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK., Longet S; Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK., Laidlaw S; Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK., Orchard K; Department of Haematology, University Hospital Southampton NHS Foundation Trust, Southampton, UK., Ireland G; UK Health Security Agency (UKHSA), Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, UK., Thomas D; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, Hammersmith Campus, London, UK., Kearns P; Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Edgbaston, Birmingham, UK.; National Institute for Health Research Birmingham Biomedical Research Centre, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK., Kirkham A; Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Edgbaston, Birmingham, UK., McInnes IB; College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK. Iain.McInnes@glasgow.ac.uk.
Jazyk: angličtina
Zdroj: Nature medicine [Nat Med] 2023 Jul; Vol. 29 (7), pp. 1760-1774. Date of Electronic Publication: 2023 Jul 06.
DOI: 10.1038/s41591-023-02414-4
Abstrakt: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immune responses and infection outcomes were evaluated in 2,686 patients with varying immune-suppressive disease states after administration of two Coronavirus Disease 2019 (COVID-19) vaccines. Overall, 255 of 2,204 (12%) patients failed to develop anti-spike antibodies, with an additional 600 of 2,204 (27%) patients generating low levels (<380 AU ml -1 ). Vaccine failure rates were highest in ANCA-associated vasculitis on rituximab (21/29, 72%), hemodialysis on immunosuppressive therapy (6/30, 20%) and solid organ transplant recipients (20/81, 25% and 141/458, 31%). SARS-CoV-2-specific T cell responses were detected in 513 of 580 (88%) patients, with lower T cell magnitude or proportion in hemodialysis, allogeneic hematopoietic stem cell transplantation and liver transplant recipients (versus healthy controls). Humoral responses against Omicron (BA.1) were reduced, although cross-reactive T cell responses were sustained in all participants for whom these data were available. BNT162b2 was associated with higher antibody but lower cellular responses compared to ChAdOx1 nCoV-19 vaccination. We report 474 SARS-CoV-2 infection episodes, including 48 individuals with hospitalization or death from COVID-19. Decreased magnitude of both the serological and the T cell response was associated with severe COVID-19. Overall, we identified clinical phenotypes that may benefit from targeted COVID-19 therapeutic strategies.
(© 2023. The Author(s).)
Databáze: MEDLINE
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