Abstract：
OBJECTIVE: Novel mRNA-based vaccines have been proven to be powerful tools in combating the global pandemic caused by SARS-CoV-2 protecting individuals, especially the immunocompromised, from COVID-19. Still, it remains largely unknown how solid organ transplant and different immunosuppressive medications affect development of vaccine-induced immunity.
METHODS: In this work, we monitored humoral and cellular memory responses after mRNA SARS-CoV-2 two-doses and booster doses vaccination in cystic fibrosis lung transplanted patients (CFT) and compared them with both cystic fibrosis patients without lung transplant (CF) and with kidney transplant recipients (KT). In particular, we investigated the effects of immunosuppressive regimens on immune memory to SARS-CoV-2 after mRNA SARS-CoV-2 vaccine in transplanted patients.
RESULTS: Our results showed that immunocompromised transplanted patients displayed a weak cellular and humoral memory to SARS-CoV-2 mRNA vaccination. In addition, obtained data clearly demonstrate that immunosuppressive therapy regimen including antimetabolites, further reduces patients\' ability to respond to vaccination at both humoral and cell-mediated level. Notably, patient treated with antimetabolites showed a lower humoral and cellular response also after a booster dose vaccination.
CONCLUSIONS: These results, even if obtained on a small patient\'s cohort, question whether immunocompromised patients need interventions to improve vaccine SARS-CoV-2 mRNA vaccine response such as additional jab or modulation of immunosuppressive therapy.
METHODS: In this work, we monitored humoral and cellular memory responses after mRNA SARS-CoV-2 two-doses and booster doses vaccination in cystic fibrosis lung transplanted patients (CFT) and compared them with both cystic fibrosis patients without lung transplant (CF) and with kidney transplant recipients (KT). In particular, we investigated the effects of immunosuppressive regimens on immune memory to SARS-CoV-2 after mRNA SARS-CoV-2 vaccine in transplanted patients.
RESULTS: Our results showed that immunocompromised transplanted patients displayed a weak cellular and humoral memory to SARS-CoV-2 mRNA vaccination. In addition, obtained data clearly demonstrate that immunosuppressive therapy regimen including antimetabolites, further reduces patients\' ability to respond to vaccination at both humoral and cell-mediated level. Notably, patient treated with antimetabolites showed a lower humoral and cellular response also after a booster dose vaccination.
CONCLUSIONS: These results, even if obtained on a small patient\'s cohort, question whether immunocompromised patients need interventions to improve vaccine SARS-CoV-2 mRNA vaccine response such as additional jab or modulation of immunosuppressive therapy.
摘要：
目的：新型基于mRNA的疫苗已被证明是对抗SARS-CoV-2引起的全球大流行的有力工具，尤其是免疫功能低下的人，来自COVID-19。尽管如此，实体器官移植和不同的免疫抑制药物如何影响疫苗诱导免疫的发展,目前仍不清楚.
方法：在这项工作中，我们在囊性纤维化肺移植患者(CFT)中监测了SARS-CoV-2双剂和加强剂mRNA疫苗接种后的体液和细胞记忆反应,并将其与未进行肺移植(CF)的囊性纤维化患者和肾移植受者(KT)进行了比较.特别是,我们研究了免疫抑制方案对移植患者SARS-CoV-2mRNA疫苗后对SARS-CoV-2免疫记忆的影响。
结果：我们的结果表明，免疫受损的移植患者对SARS-CoV-2mRNA疫苗接种表现出较弱的细胞和体液记忆。此外,获得的数据清楚地表明，包括抗代谢物在内的免疫抑制治疗方案，进一步降低了患者在体液和细胞介导水平上对疫苗接种应答的能力。值得注意的是,接受抗代谢物治疗的患者在加强剂量疫苗接种后也表现出更低的体液和细胞反应.
结论：这些结果，即使是在一个小病人队列中获得的，质疑免疫功能低下的患者是否需要干预措施来改善疫苗SARS-CoV-2mRNA疫苗的反应，例如额外的注射或免疫抑制治疗的调节。
方法：在这项工作中，我们在囊性纤维化肺移植患者(CFT)中监测了SARS-CoV-2双剂和加强剂mRNA疫苗接种后的体液和细胞记忆反应,并将其与未进行肺移植(CF)的囊性纤维化患者和肾移植受者(KT)进行了比较.特别是,我们研究了免疫抑制方案对移植患者SARS-CoV-2mRNA疫苗后对SARS-CoV-2免疫记忆的影响。
结果：我们的结果表明，免疫受损的移植患者对SARS-CoV-2mRNA疫苗接种表现出较弱的细胞和体液记忆。此外,获得的数据清楚地表明，包括抗代谢物在内的免疫抑制治疗方案，进一步降低了患者在体液和细胞介导水平上对疫苗接种应答的能力。值得注意的是,接受抗代谢物治疗的患者在加强剂量疫苗接种后也表现出更低的体液和细胞反应.
结论：这些结果，即使是在一个小病人队列中获得的，质疑免疫功能低下的患者是否需要干预措施来改善疫苗SARS-CoV-2mRNA疫苗的反应，例如额外的注射或免疫抑制治疗的调节。
