PDF(Pubmed)
Abstract：
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with a high rate of mortality in kidney transplant recipients (KTRs). Current vaccine strategies for KTRs seem to be unable to provide effective protection against coronavirus disease 2019 (COVID-19), and the occurrence of severe disease in some vaccinated KTRs suggested a lack of immunity. We initially analyzed the antibody response in a group of 32 kidney transplant recipients (KTRs) followed at the nephrology and dialysis unit of the Hospital Pio XI of Desio, ASST-Brianza, Italy. Thus, we studied the differences in antibody levels between subjects who contracted SARS-CoV-2 after the booster (8 individuals) and those who did not contract it (24 individuals). Furthermore, we verified if the antibody response was in any way associated with creatinine and eGFR levels. We observed a significant increase in the antibody response pre-booster compared to post-booster using both a Roche assay and DIAPRO assay. In the latter, through immunotyping, we highlight that the major contribution to this increase is specifically due to IgG S1 IgM S2. We observed a significant increase in IgA S1 and IgA NCP (p = 0.045, 0.02) in the subjects who contracted SARS-CoV-2. We did not find significant associations for the p-value corrected for false discovery rate (FDR) between the antibody response to all assays and creatinine levels. This observation allows us to confirm that patients require additional vaccine boosters due to their immunocompromised status and therapy in order to protect them from infections related to viral variants. This is in line with the data reported in the literature, and it could be worthwhile to deeply explore these phenomena to better understand the role of IgA S1 and IgA NCP antibodies in SARS-CoV-2 infection.
摘要：
严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）与肾移植受者（KTR）的高死亡率有关。目前的KTRs疫苗策略似乎无法提供有效的预防2019年冠状病毒病(COVID-19)，和严重疾病的发生在一些接种KTRs表明缺乏免疫力。我们最初分析了一组32例肾移植受者（KTR）的抗体反应，随后在Desio医院PioXI的肾脏病学和透析部门进行了分析，ASST-Brianza,意大利。因此，我们研究了在加强治疗后感染SARS-CoV-2的受试者(8人)和未感染SARS-CoV-2的受试者(24人)之间抗体水平的差异.此外，我们验证了抗体应答是否与肌酐和eGFR水平相关.使用Roche测定和DIAPRO测定,我们观察到加强前的抗体应答与加强后相比显著增加。在后者中,通过免疫分型，我们强调，这种增加的主要贡献是由于IgGS1IgMS2。我们观察到感染SARS-CoV-2的受试者中IgAS1和IgANCP的显着增加（p=0.045，0.02）。我们没有发现针对所有测定的抗体应答与肌酸酐水平之间的错误发现率(FDR)校正的p值的显著关联。这一观察结果使我们能够确认患者由于其免疫受损状态和治疗而需要额外的疫苗加强剂，以保护他们免受与病毒变体相关的感染。这与文献报道的数据一致，深入研究这些现象，以更好地了解IgAS1和IgANCP抗体在SARS-CoV-2感染中的作用。
