Immunity, Cellular

豁免权,移动通信
  • 文章类型: Journal Article
    背景:癌症患者的免疫系统通常会减弱,导致对疫苗的反应降低,尤其是那些接受免疫抑制肿瘤治疗(OT)。我们旨在评估OT对实体和血液肿瘤患者接种COVID-19后对B.1谱系和Omicron变体的体液和T细胞反应的影响。
    方法:我们对癌症患者进行了一项前瞻性研究,分为OT和非OT组,他接受了两剂系列的COVID-19mRNA疫苗,并在六个月后加强了疫苗接种。测量的结果是针对B.1谱系和Omicron变体的体液(抗SARS-CoV-2SIgG滴度和ACE2-S相互作用抑制能力)和细胞(每百万PBMC中SARS-CoV-2S特异性T细胞斑点)反应。在第二剂量后四周(n=98)和加强剂量后八周(n=71)评估这些反应。
    结果:与非OT组相比,OT组针对B.1谱系和Omicron变体的第二次疫苗剂量后的体液反应明显减弱(q值<0.05)。加强剂量的mRNA-1273疫苗显着改善了OT组的体液反应,与非OT组相当。mRNA-1273疫苗,为最初的武汉菌株设计,与B.1谱系相比,对Omicron变体的体液反应较弱,无论肿瘤治疗或疫苗剂量。相比之下,T细胞对SARS-CoV-2的反应,包括Omicron变体,在第二次疫苗剂量后已经存在,并且没有受到肿瘤治疗的显着影响。
    结论:癌症患者,特别是那些接受免疫抑制肿瘤治疗的人,应该需要加强剂量和适应新的SARS-CoV-2变种如Omicron的COVID-19疫苗。未来的研究应该评估免疫反应的持久性和个体化治疗方案的有效性。
    BACKGROUND: Cancer patients often have weakened immune systems, resulting in a lower response to vaccines, especially those receiving immunosuppressive oncological treatment (OT). We aimed to assess the impact of OT on the humoral and T-cell response to the B.1 lineage and Omicron variant following COVID-19 vaccination in patients with solid and hematological neoplasms.
    METHODS: We conducted a prospective study on cancer patients, stratified into OT and non-OT groups, who received a two-dose series of the COVID-19 mRNA vaccine and a booster six months later. The outcomes measured were the humoral (anti-SARS-CoV-2 S IgG titers and ACE2-S interaction inhibition capacity) and cellular (SARS-CoV-2 S-specific T-cell spots per million PBMCs) responses against the B.1 lineage and Omicron variant. These responses were evaluated four weeks after the second dose (n = 98) and eight weeks after the booster dose (n = 71).
    RESULTS: The humoral response after the second vaccine dose against the B.1 lineage and Omicron variant was significantly weaker in the OT group compared to the non-OT group (q-value<0.05). A booster dose of the mRNA-1273 vaccine significantly improved the humoral response in the OT group, making it comparable to the non-OT group. The mRNA-1273 vaccine, designed for the original Wuhan strain, elicited a weaker humoral response against the Omicron variant compared to the B.1 lineage, regardless of oncological treatment or vaccine dose. In contrast, T-cell responses against SARS-CoV-2, including the Omicron variant, were already present after the second vaccine dose and were not significantly affected by oncological treatments.
    CONCLUSIONS: Cancer patients, particularly those receiving immunosuppressive oncological treatments, should require booster doses and adapted COVID-19 vaccines for new SARS-CoV-2 variants like Omicron. Future studies should evaluate the durability of the immune response and the efficacy of individualized regimens.
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  • 文章类型: Journal Article
    分析术中自体输血对血清电解质的影响,剖宫产产妇的炎症反应和细胞免疫反应。这项研究是对2022年1月至2023年1月在我院接受剖宫产的60名妇女的回顾性研究。根据患者的输血方式将受试者分为2组。输血量的差异,输血量,血清电解质,炎症反应,细胞免疫功能,比较两组患者的凝血功能及预后。术中输血量,术后喂养时间,起床后的活动时间,观察组的身体恢复时间和住院时间均低于对照组,但观察组术中晶体输注量和胶体输注量均高于对照组(P<0.05)。观察组和对照组术前Ca2+浓度均低于同组,差异有统计学意义(P<0.05)。然而,观察组与对照组的Ca2+浓度比较差异无统计学意义(P>0.05)。术后1d,IL-1β,IL-6和粒细胞-巨噬细胞集落刺激因子(GM-CSF)均较高(P<0.05),观察组和对照组术前CD4+、CD4+/CD8+均低于同组(P<0.05)。IL-1β,与对照组比较,观察组IL-6、GM-CSF降低(P<0.05),CD3+,CD4+,观察组CD4+/CD8+较对照组升高(P<0.05)。产妇剖宫产术中自体输血和异体输血均可减轻炎性反应,对凝血无明显抑制作用,自体输血对细胞免疫反应的影响较小,在减轻炎症反应方面更有效,并显著改善预后,尽管输血后Ca2+浓度的变化需要注意。
    Analyzing the effect of intraoperative autotransfusion on serum electrolytes, inflammatory response and cellular immune response in puerperae undergoing cesarean section. This study is a retrospective study of 60 women who underwent cesarean section in our hospital from January 2022 to January 2023. The subjects were divided into 2 groups according to the blood transfusion mode of the patients. The differences in blood transfusion volume, blood transfusion volume, serum electrolyte, inflammatory response, cellular immune function, coagulation function and prognosis were compared between the 2 groups. The intraoperative blood transfusion volume, postoperative feeding time, the activity time since getting out of bed, the time of physical recovery and hospital stay in the observation group were lower compared to those of the control group, but the intraoperative crystal infusion volume and the colloid infusion volume in the observation group were higher compared to those of the control group (P < .05). Ca2+ concentrations of the observation group and the control group were lower compared with those of their same groups before surgery (P < .05), however, there were no statistically significant differences in the comparison of the Ca2+ concentrations between the observation group and the control group (P > .05). At 1d postoperatively, IL-1β, IL-6 and granulocyte-macrophage colony-stimulating factor (GM-CSF) were all higher (P < .05) and CD3+, CD4+ and CD4+/CD8+ were all lower (P < .05) in the observation group and the control group compared with those of their same groups before surgery. The IL-1 β, IL-6, and GM-CSF of the observation group were decreased compared to those of the control group (P < .05) and CD3+, CD4+, CD4+/CD8+ of the observation group were elevated compared to those of the control group (P < .05). Both autotransfusion and allogeneic blood transfusions during maternal cesarean section can attenuate the inflammatory response and have no significant inhibition of coagulation, and autotransfusion have less effect on the cellular immune response, are more effective in attenuating the inflammatory response, and significantly improve prognosis, although changes in Ca2+ concentration after transfusion require attention.
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  • 文章类型: Journal Article
    背景:巨细胞病毒特异性T细胞介导的免疫(CMV-CMI)在异基因造血细胞移植(allo-HCT)中保护免受CMV感染,但迄今为止,该人群的CMV免疫没有经过验证的测量。
    方法:在此前瞻性中,观察,试点研究,每月评估CMVT细胞反应,并在CMV血清阳性的allo-HCT受体发生移植物抗宿主病(GVHD)或CMV感染时,使用商业流式细胞术测定。CMVinSIGHTT细胞免疫面板(CMV-TCIP)。主要终点是CMV-TCIP首次阳性的时间,定义为产生干扰素-γ的CD4+或CD8+CMV特异性T细胞的百分比>0.2%。Letermovir从第+10天至≥100天开处方。
    结果:登记了28名allo-HCT接受者。CD4+的CMV-TCIP首次阳性的中位时间较早(60天[四分位距,IQR33–148])比CD8T细胞(96天[IQR33–155])更长,单倍体和错配移植受体(77和96天,分别)比匹配的捐赠者(45天和33天,分别)。CD4+和CD8+CMV-CMI恢复在10/10(100%)和10/11(91%)患者中持续,分别,没有GVHD,而CD4+和/或CD8+CMV-CMI在4/6和2/6患者中丢失,分别,GVHD需要类固醇。作为低水平CMV再激活患者临床上显着CMV感染的预测因子,CMV-TCIP的敏感性和阴性预测值分别为90%和87.5%,分别,CD4+CMV-TCIP分别为66.7%和62.5%,分别,对于CD8+CMV-TCIP。
    结论:HCT后CMV-CMI恢复的时间差异显著,单倍体和错配HCT后恢复较慢。CD4+CMV-CMI可以预防CS-CMVi,但GVHD的诊断和治疗可能会丧失免疫力。
    BACKGROUND: Cytomegalovirus-specific T-cell-mediated immunity (CMV-CMI) protects from CMV infection in allogeneic hematopoietic cell transplantation (allo-HCT), but to date, there is no validated measure of CMV immunity for this population.
    METHODS: In this prospective, observational, pilot study, CMV T-cell responses were evaluated monthly and at onset of graft-versus-host disease (GVHD) or CMV infection in CMV-seropositive allo-HCT recipients using a commercial flow cytometry assay, the CMV inSIGHT T-Cell Immunity Panel (CMV-TCIP). The primary endpoint was the time to first positive CMV-TCIP, defined as percentage of interferon-γ-producing CD4+ or CD8+ CMV-specific T cells >0.2%. Letermovir was prescribed from day +10 to ≥100.
    RESULTS: Twenty-eight allo-HCT recipients were enrolled. The median time to first positive CMV-TCIP result was earlier for CD4+ (60 days [interquartile range, IQR 33‒148]) than for CD8+ T cells (96 days [IQR 33‒155]) and longer for haploidentical and mismatched transplant recipients (77 and 96 days, respectively) than for matched donors (45 and 33 days, respectively). CD4+ and CD8+ CMV-CMI recovery was sustained in 10/10 (100%) and 10/11 (91%) patients, respectively, without GVHD, whereas CD4+ and/or CD8+ CMV-CMI was lost in 4/6 and 2/6 patients, respectively, with GVHD requiring steroids. As a predictor of clinically significant CMV infection in patients with low-level CMV reactivation, the sensitivity and negative predictive value of CMV-TCIP were 90% and 87.5%, respectively, for CD4+ CMV-TCIP and 66.7% and 62.5%, respectively, for CD8+ CMV-TCIP.
    CONCLUSIONS: There was significant variability in time to CMV-CMI recovery post-HCT, with slower recovery after haploidentical and mismatched HCT. CD4+ CMV-CMI may protect against CS-CMVi, but immunity may be lost with GVHD diagnosis and treatment.
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  • 文章类型: Journal Article
    背景:单剂量的Ad26。COV2.S耐受性良好,可有效预防COVID-19导致的中度至重度疾病结局。我们评估了剂量水平的影响,剂量的数量,和免疫原性的剂量间隔,反应原性,Ad26的安全性COV2.S在成人还探索了记忆障碍的反应。
    方法:这是随机的,双盲,安慰剂对照,2a期研究在18-55岁和≥65岁的成年人中进行(NCT04535453)。四种剂量水平(1.25×1010,2.5×1010,5×1010和1×1011病毒颗粒[vp],单剂量和2剂量时间表,和56天和84天的剂量间隔,被评估。初次疫苗接种后4或6个月,Ad26.COV2.S1.25×1010vp用于评估记忆反应。测量体液和细胞介导的免疫应答。对所有参与者进行反应性和安全性评估。
    结果:全部Ad26。COV2.S时间表诱导体液反应,并有剂量反应关系的证据。单剂量的Ad26。COV2.S(5×1010vp)诱导的抗体和细胞免疫反应持续至少6个月。在2剂量方案中,在相当的剂量水平下,抗体反应高于1剂量方案,当剂量间隔增加时(84天对56天),免疫反应的幅度增加。快速,疫苗抗原暴露后,所有组均观察到明显的免疫反应,表明免疫记忆。在抗原暴露后至少6个月,在所有组中观察到持久的免疫应答。观察到中和抗体与结合抗体之间的强烈且一致的相关性,在所有方案之后,CD4+和CD8+T细胞应答是相似的。疫苗接种后7天内的反应原性倾向于剂量相关。
    结论:该研究支持主要的,单剂量方案与Ad26。COV2.5×1010vp的S和6个月间隔后的同源加强疫苗接种。对疫苗抗原暴露的快速和显著的反应表明通过1-和2-剂量初次疫苗接种诱导免疫记忆。
    BACKGROUND: A single dose of Ad26.COV2.S is well-tolerated and effective in preventing moderate-to-severe disease outcomes due to COVID-19. We evaluated the impact of dose level, number of doses, and dose interval on immunogenicity, reactogenicity, and safety of Ad26.COV2.S in adults. Anamnestic responses were also explored.
    METHODS: This randomised, double-blind, placebo-controlled, Phase 2a study was conducted in adults aged 18-55 years and ≥ 65 years (NCT04535453). Four dose levels (1.25 × 1010, 2.5 × 1010, 5 × 1010, and 1 × 1011 viral particles [vp], single and 2-dose schedules, and dose intervals of 56 and 84 days, were assessed. Four or 6 months post-primary vaccination, Ad26.COV2.S 1.25 × 1010 vp was given to evaluate anamnestic responses. Humoral and cell-mediated immune responses were measured. Reactogenicity and safety were assessed in all participants.
    RESULTS: All Ad26.COV2.S schedules induced humoral responses with evidence of a dose response relationship. A single dose of Ad26.COV2.S (5 × 1010 vp) induced antibody and cellular immune responses that persisted for up to at least 6 months. In the 2-dose regimens, antibody responses were higher than 1-dose regimens at comparable dose levels, and the magnitude of the immune response increased when the interval between doses was increased (84 days vs 56 days). Rapid, marked immune responses were observed in all groups after vaccine antigen exposure indicating immune memory. Durable immune responses were observed in all groups for up to at least 6 months post-antigen exposure. Strong and consistent correlations between neutralising and binding antibodies were observed CD4 + and CD8 + T cell responses were similar after all regimens. Reactogenicity within 7 days post-vaccination tended to be dose-related.
    CONCLUSIONS: The study supports the primary, single dose schedule with Ad26.COV2.S at 5 × 1010 vp and homologous booster vaccination after a 6 month interval. Rapid and marked responses to vaccine antigen exposure indicate induction of immune memory by 1- and 2-dose primary vaccination.
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  • 文章类型: Journal Article
    疫苗接种仍然是全球防御COVID-19的基石。本研究旨在评估创新疫苗LYB001的安全性和免疫原性。
    这是一个随机的,双盲,平行对照试验,在100名健康的中国成年人(21至72岁)中。三剂30或60µg基于SARS-CoV-2RBD的VLP疫苗(LYB001),或基于SARS-CoV-2RBD的蛋白质亚单位疫苗(ZF2001,对照组)以28天的间隔给药。测量了不同组之间不良事件(AE)的发生率以及体液和细胞免疫指标的差异。
    未确认与疫苗相关的严重不良事件,LYB001组和对照组或年龄亚组之间的不良事件发生率差异无统计学意义(p>0.05)。LYB001组血清转换率显著高于或相当水平,中和抗体,S蛋白结合抗体,全疫苗接种后的细胞免疫高于对照组。
    我们的研究结果支持在VLP平台上开发的LYB001是安全的,具有良好的免疫原性,可用于健康成年人的基础疫苗接种。因此,有必要开展更大规模的临床研究.
    本试验已在ClinicalTrials.gov(NCT05552573)注册。
    UNASSIGNED: Vaccination remains the cornerstone of defense against COVID-19 globally. This study aims to assess the safety and immunogenicity profile of innovative vaccines LYB001.
    UNASSIGNED: This was a randomized, double-blind, parallel-controlled trial, in 100 healthy Chinese adults (21 to 72 years old). Three doses of 30 or 60 µg of SARS-CoV-2 RBD-based VLP vaccine (LYB001), or the SARS-CoV-2 RBD-based protein subunit vaccine (ZF2001, control group) were administered with a 28-day interval. Differences in the incidence of adverse events (AEs) and indicators of humoral and cellular immunity among the different groups were measured.
    UNASSIGNED: No severe adverse events were confirmed to be vaccine-related, and there was no significant difference in the rate of adverse events between the LYB001 and control group or the age subgroups (p > 0.05). The LYB001 groups had significantly higher or comparable levels of seroconversion rates, neutralization antibody, S protein-binding antibody, and cellular immunity after whole vaccination than the control group.
    UNASSIGNED: Our findings support that LYB001 developed on the VLP platform is safe and well tolerated with favorable immunogenicity for fundamental vaccination in healthy adults. Therefore, further larger-scale clinical studies are warranted.
    UNASSIGNED: This trial was registered with ClinicalTrials.gov (NCT05552573).
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  • 文章类型: Journal Article
    随着高度传播性变体的出现,严重急性呼吸道综合征冠状病毒2(SARS-CoV-2)仍然构成2019年冠状病毒病(COVID-19)死灰复燃的全球威胁。对新变体的细胞反应比体液反应更稳定。因此,细胞反应在评估人群中针对严重疾病的免疫保护方面很有意义.我们的目的是在人群水平上评估细胞对SARS-CoV-2的反应。IFNγ(干扰素γ)对野生型SARS-CoV-2的反应使用ELISpot测定法在未接种疫苗的个体中进行分析,这些个体具有不同的体液反应:Ig(IgM和/或IgG)血清阴性(n=90)和血清阳性(n=181),对刺突受体结合域(抗S-RBD)具有低(<300U/mL)或高(≥300U/mL)的体液反应。在血清反应阳性的参与者中,71.3%(129/181)的IFNγELISpot阳性,血清阴性参与者的比例为15.6%(14/90)。常见的COVID-19症状,如发热和迟钝,与血清阳性参与者的IFNγELISpot阳性相关,而血清阴性参与者中没有参与者特征与IFNγELISpot阳性相关。发热和/或呼吸困难和抗S-RBD水平与较高的IFNγ反应相关。更严重的疾病和更高的抗S-RBD应答的症状与更高的IFNγ应答相关。显着比例(15.6%)的血清阴性参与者的IFNγELISpot阳性。细胞反应的评估可以改善一般人群中对SARS-CoV-2的免疫反应的估计。
    目的:关于适应性细胞免疫的数据对于定义人群中针对严重急性呼吸综合征冠状病毒2的免疫保护非常重要,这对加强疫苗接种策略的决策很重要。这项研究提供了有关参与者特征与具有不同体液反应的未接种疫苗个体的细胞免疫反应之间关联的数据。
    With the emergence of highly transmissible variants of concern, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) still poses a global threat of coronavirus disease 2019 (COVID-19) resurgence. Cellular responses to novel variants are more robustly maintained than humoral responses, and therefore, cellular responses are of interest in assessing immune protection against severe disease in the population. We aimed to assess cellular responses to SARS-CoV-2 at the population level. IFNγ (interferon γ) responses to wild-type SARS-CoV-2 were analyzed using an ELISpot assay in vaccine-naive individuals with different humoral responses: Ig (IgM and/or IgG) seronegative (n = 90) and seropositive (n = 181) with low (<300 U/mL) or high (≥300 U/mL) humoral responses to the spike receptor binding domain (anti-S-RBD). Among the seropositive participants, 71.3% (129/181) were IFNγ ELISpot positive, compared to 15.6% (14/90) among the seronegative participants. Common COVID-19 symptoms such as fever and ageusia were associated with IFNγ ELISpot positivity in seropositive participants, whereas no participant characteristics were associated with IFNγ ELISpot positivity in seronegative participants. Fever and/or dyspnea and anti-S-RBD levels were associated with higher IFNγ responses. Symptoms of more severe disease and higher anti-S-RBD responses were associated with higher IFNγ responses. A significant proportion (15.6%) of seronegative participants had a positive IFNγ ELISpot. Assessment of cellular responses may improve estimates of the immune response to SARS-CoV-2 in the general population.
    OBJECTIVE: Data on adaptive cellular immunity are of interest to define immune protection against severe acute respiratory syndrome coronavirus 2 in a population, which is important for decision-making on booster-vaccination strategies. This study provides data on associations between participant characteristics and cellular immune responses in vaccine-naive individuals with different humoral responses.
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  • 文章类型: Journal Article
    重组腺相关病毒(rAAV)载体出现,比以往任何时候都多,成为体内基因转移的有效病毒载体,如欧洲和美国7种药物的批准所示。然而,在人类中预先存在的对AAV衣壳的免疫仍然是成功的临床翻译的主要限制之一。而预先存在的对AAV衣壳的体液反应是有据可查的,预先存在的衣壳特异性T细胞反应的患病率仍需要研究和表征.这里,我们使用标准的IFNγELISpot测定法调查了大量健康供体中针对AAV2,4,5,8,9和rh10的AAV特异性循环T细胞的患病率。我们观察到对AAV9血清型的预先存在的细胞免疫的最高患病率,其次是AAV8,AAV4,AAV2,AAVrh10和AAV5,与供体血清学状态无关。对两种最普遍的血清型8和9的T细胞应答的深入分析显示,对于两种血清型,IFNγ分泌主要由CD8T细胞介导。多功能分析揭示了AAV8和AAV9之间不同的细胞因子谱。令人惊讶的是,抗AAV9免疫细胞不介导IL-2分泌,提示这些细胞可能比细胞毒性T细胞耗尽或终末分化。总之,这些结果表明,针对AAV的预先存在的免疫可能因血清型而异,并支持使用多参数监测方法来更好地表征抗衣壳细胞免疫的必要性,并预测其在rAAV介导的临床试验中的影响.
    Recombinant adeno-associated virus (rAAV) vectors appear, more than ever, to be efficient viral vectors for in vivo gene transfer as illustrated by the approvals of 7 drugs across Europe and the United States. Nevertheless, preexisting immunity to AAV capsid in humans remains one of the major limits for a successful clinical translation. Whereas a preexisting humoral response to AAV capsid is well documented, the prevalence of preexisting capsid-specific T cell responses still needs to be studied and characterized. In this study, we investigated the prevalence of AAV-specific circulating T cells toward AAV2, 4, 5, 8, 9, and rh10 in a large cohort of healthy donors using the standard IFNγ ELISpot assay. We observed the highest prevalence of preexisting cellular immunity to AAV9 serotype followed by AAV8, AAV4, AAV2, AAVrh10, and AAV5 independently of the donors\' serological status. An in-depth analysis of T cell responses toward the 2 most prevalent serotypes 8 and 9 shows that IFNγ secretion is mainly mediated by CD8 T cells for both serotypes. A polyfunctional analysis reveals different cytokine profiles between AAV8 and AAV9. Surprisingly, no IL-2 secretion was mediated by anti-AAV9 immune cells suggesting that these cells may rather be exhausted or terminally differentiated than cytotoxic T cells. Altogether, these results suggest that preexisting immunity to AAV may vary depending on the serotype and support the necessity of using multiparametric monitoring methods to better characterize anticapsid cellular immunity and foresee its impact in rAAV-mediated clinical trials.
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  • 文章类型: Journal Article
    背景:青少年/年轻成人(AYA)癌症患者中SARS-CoV-2疫苗反应性的数据很少。本研究评估了该人群疫苗接种后的体液和细胞免疫反应。
    方法:在这项前瞻性研究中,我们招募了接受癌症治疗的年龄为12~30岁的患者(“接受治疗”)和幸存者(“未接受治疗”).在基线测量抗-受体结合域(RBD)蛋白IgG水平,第一次疫苗剂量(T1)后四周,第二次给药后6周(T2)。在患者亚组中使用活化诱导的标志物和细胞内细胞因子染色来评估细胞免疫。主要结果是与基线相比,在T2时量化两个队列中的体液反应。鉴定T2时对数抗体滴度的临床预测因子。
    结果:在2022年4月至12月之间,招募了118名中位年龄15.4岁的患者。其中,77人(65.2%)在“治疗”组中,77人(65.2%)接受了BBV152疫苗.在基线,108例(91.5%)患者抗RBD抗体血清阳性。在整个队列中,抗RBD滴度的对数从基线上升到T2(p值=0.001);从基线T1(p值<0.001)开始,这种上升是显着的,但不是从T1到T2(p值=0.842)。在“治疗”队列中也看到了类似的模式。BECOV-2疫苗与高于BBV152的对数抗RBD滴度独立相关(回归系数:0.41;95%CI:0.10-0.73;p=0.011)。在三个时间点,“开”和“关”组的细胞免疫反应相似。
    结论:在AYA癌症患者中,单一的非mRNA疫苗剂量赋予强大的混合体液免疫,而第二剂的获益有限.
    BACKGROUND: Data on SARS-CoV-2 vaccine responsiveness in adolescent/young adult (AYA) cancer patients are sparse. The present study assessed humoral and cellular immune responses post-vaccination in this population.
    METHODS: In this prospective study, patients aged 12-30 years undergoing cancer therapy (\"on therapy\") and survivors (\"off therapy\") were recruited. Anti-receptor binding domain (RBD) protein IgG levels were measured at baseline, four weeks post-first vaccine dose (T1), and six weeks post-second dose (T2). Cellular immunity was assessed using activation-induced markers and intracellular cytokine staining in a patient subset. The primary outcome was to quantify humoral responses in both cohorts at T2 compared to baseline. Clinical predictors of log antibody titres at T2 were identified.
    RESULTS: Between April-December 2022, 118 patients were recruited of median age 15.4 years. Among them, 77 (65.2 %) were in the \"on therapy\" group, and 77 (65.2 %) had received the BBV152 vaccine. At baseline, 108 (91.5 %) patients were seropositive for anti-RBD antibody. The log anti-RBD titre rose from baseline to T2 (p-value = 0.001) in the whole cohort; this rise was significant from baseline-T1 (p-value < 0.001), but not from T1 to T2 (p-value = 0.842). A similar pattern was seen in the \"on therapy\" cohort. BECOV-2 vaccine was independently associated with higher log anti-RBD titres than BBV152 (regression coefficient: 0.41; 95 % CI: 0.10-0.73; p = 0.011). Cellular immune responses were similar in the \"on-\" and \"off therapy\" groups at the three time points.
    CONCLUSIONS: Among AYA cancer patients, a single non-mRNA vaccine dose confers robust hybrid humoral immunity with limited benefit from a second dose.
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  • 文章类型: Letter
    严重的免疫失调和对SARS-CoV-2疫苗的反应受损,使慢性淋巴细胞白血病(CLL)患者面临严重COVID-19的风险。我们比较了加强剂量疫苗接种或突破感染后的体液记忆和T细胞反应。(绿色)抗-刺突特异性抗体的定量测定。加强剂量增加了所有患者类别的血清转换率和抗体滴度,最终产生类似于感染后队列中观察到的体液反应。详细来说,在观察和等待中,>80%的患者出现体液反应,中位抗体滴度超标,缓解期的非治疗,或正在使用维奈托克单药治疗。抗CD20抗体和BTK抑制剂(BTKi)的积极治疗代表了体液反应的限制因素,在加强剂量或感染后,约40%的病例仍有记忆。(蓝色)SARS-CoV-2特异性T细胞应答的评价。每个患者中记录的T细胞功能活化标志物的数量。绝大多数患者,包括那些血清阴性,发育的T细胞反应,治疗组之间或单独接种疫苗和感染病例之间的质量相似。这些数据突出了加强剂量在引发T细胞免疫方面的功效,而与治疗状态无关,并支持使用其他疫苗接种加强剂来刺激积极的CLL指导治疗患者的体液免疫。
    Profound immune dysregulation and impaired response to the SARS-CoV-2 vaccine put patients with chronic lymphocytic leukemia (CLL) at risk of severe COVID-19. We compared humoral memory and T-cell responses after booster dose vaccination or breakthrough infection. (Green) Quantitative determination of anti-Spike specific antibodies. Booster doses increased seroconversion rate and antibody titers in all patient categories, ultimately generating humoral responses similar to those observed in the postinfection cohort. In detail, humoral response with overscale median antibody titers arose in >80% of patients in watch and wait, off-therapy in remission, or under treatment with venetoclax single-agent. Anti-CD20 antibodies and active treatment with BTK inhibitors (BTKi) represent limiting factors of humoral response, still memory mounted in ~40% of cases following booster doses or infection. (Blue) Evaluation of SARS-CoV-2-specific T-cell responses. Number of T-cell functional activation markers documented in each patient. The vast majority of patients, including those seronegative, developed T-cell responses, qualitatively similar between treatment groups or between vaccination alone and infection cases. These data highlight the efficacy of booster doses in eliciting T-cell immunity independently of treatment status and support the use of additional vaccination boosters to stimulate humoral immunity in patients on active CLL-directed treatments.
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  • 文章类型: Journal Article
    一项基于现实世界人口的纵向研究,旨在确定不同类型的COVID-19疫苗诱导的免疫的程度和持续时间,始于2021年,在首次接种疫苗时招募了2,497名个体。该研究队列包括年龄≤65岁的健康成年人和年龄>65岁的有两种或两种以上合并症的老年受试者。这里,抗SARS-CoV-2体液和细胞介导的特异性免疫反应的模式,评估了1,182个剩余科目,在第一次疫苗接种后6(T6)和12个月(T12),被描述。在T12时,与T6相比,中位抗刺突IgG抗体水平增加。抗刺性IgG增加的决定因素是在T6和T12之间接受第三次疫苗剂量,并且在T12(最近感染的标志)时对抗核皂甙IgG呈阳性,而年龄没有显著影响。在接种疫苗的受试者亚组中评估T12血清体外中和祖先B菌株和OmicronBA.5变体的能力。鉴定了抗SIgG水平与血清中和能力之间的相关性,并且与虚弱的老年受试者相比,在健康成年人中以及在T12时抗核皂甙IgG呈阳性的那些人中,中和能力更高。值得注意的是,来自抗核皂甙IgG阴性的老年个体的T12血清的三分之一无法中和BA.5变异株。最后,对T细胞介导的免疫的评估表明,大多数分析的受试者,独立于年龄和合并症,显示具有高度多功能性的Spike特异性响应,特别是在CD8室。总之,接种疫苗的受试者在初次接种疫苗后12个月有高水平的抗SARS-CoV-2尖峰蛋白的循环抗体,与T6相比增加。增强效果可归因于第三疫苗剂量的施用,但也归因于突破性感染的发生。老年人,尤其是那些抗核皂甙IgG阴性的人,表现出中和BA.5变异株的能力受损。刺激特异性T细胞反应,能够维持免疫力并保持抵抗感染的能力,在T12时测定的大多数老年和年轻受试者中都存在。
    A real-world population-based longitudinal study, aimed at determining the magnitude and duration of immunity induced by different types of vaccines against COVID-19, started in 2021 by enrolling a cohort of 2,497 individuals at time of their first vaccination. The study cohort included both healthy adults aged ≤65 years and elderly subjects aged >65 years with two or more co-morbidities. Here, patterns of anti-SARS-CoV-2 humoral and cell-mediated specific immune response, assessed on 1,182 remaining subjects, at 6 (T6) and 12 months (T12) after the first vaccine dose, are described. At T12 median anti-Spike IgG antibody levels were increased compared to T6. The determinants of increased anti-Spike IgG were the receipt of a third vaccine dose between T6 and T12 and being positive for anti-Nucleocapside IgG at T12, a marker of recent infection, while age had no significant effect. The capacity of T12 sera to neutralize in vitro the ancestral B strain and the Omicron BA.5 variant was assessed in a subgroup of vaccinated subjects. A correlation between anti-S IgG levels and sera neutralizing capacity was identified and higher neutralizing capacity was evident in healthy adults compared to frail elderly subjects and in those who were positive for anti-Nucleocapside IgG at T12. Remarkably, one third of T12 sera from anti-Nucleocapside IgG negative older individuals were unable to neutralize the BA.5 variant strain. Finally, the evaluation of T-cell mediated immunity showed that most analysed subjects, independently from age and comorbidity, displayed Spike-specific responses with a high degree of polyfunctionality, especially in the CD8 compartment. In conclusion, vaccinated subjects had high levels of circulating antibodies against SARS-CoV-2 Spike protein 12 months after the primary vaccination, which increased as compared to T6. The enhancing effect could be attributable to the administration of a third vaccine dose but also to the occurrence of breakthrough infection. Older individuals, especially those who were anti-Nucleocapside IgG negative, displayed an impaired capacity to neutralize the BA.5 variant strain. Spike specific T-cell responses, able to sustain immunity and maintain the ability to fight the infection, were present in most of older and younger subjects assayed at T12.
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