2020年12月中旬,以色列开始在全国范围内开展针对2019年冠状病毒病(COVID-19)的大规模疫苗接种运动。在最初的几周里,医务人员,老年公民,慢性病患者优先。因此,我们鼓励患有原发性和继发性免疫缺陷的患者接种疫苗.尽管基于RNA的COVID-19疫苗的功效已在普通人群中得到证实,对先天性免疫错误(IEI)患者的疗效和安全性知之甚少.
我们的目的是评估一组IEI患者对COVID-19疫苗的体液和细胞免疫反应。
共纳入26名成人患者,在第二剂Pfizer-BioNTechCOVID-19疫苗接种后2周,从中收集血浆和外周血单核细胞。通过测试抗SARS-CoV-2刺突(S)受体结合域和抗核衣壳抗体滴度并通过抑制受体结合域-血管紧张素转换酶2结合来评估中和能力来评估体液反应。通过使用ELISpot评估细胞免疫反应,评估响应于合并的SARS-CoV-2S或M肽的IL-2和IFN-γ分泌。
我们的队列包括18名主要为抗体缺乏的患者,2合并免疫缺陷,3与免疫失调,和3与其他基因定义的诊断。其中22人正在接受免疫球蛋白替代疗法。在26名患者中,18开发了特异性抗体反应,和19显示S肽特异性T细胞应答。没有患者报告显著的不良事件。
为IEI患者接种疫苗是安全的,大多数患者能够产生疫苗特异性抗体反应,S蛋白特异性细胞反应,或者两者兼而有之。
In mid-December 2020, Israel started a nationwide mass vaccination campaign against coronavirus disease 2019 (COVID-19). In the first few weeks, medical personnel, elderly citizens, and patients with chronic diseases were prioritized. As such, patients with primary and secondary immunodeficiencies were encouraged to receive the vaccine. Although the efficacy of RNA-based COVID-19 vaccines has been demonstrated in the general population, little is known about their efficacy and safety in patients with inborn errors of immunity (IEI).
Our aim was to evaluate the humoral and cellular immune response to COVID-19 vaccine in a cohort of patients with IEI.
A total of 26 adult patients were enrolled, and plasma and peripheral blood mononuclear cells were collected from them 2 weeks following the second dose of Pfizer-BioNTech COVID-19 vaccine. Humoral response was evaluated by testing anti-SARS-CoV-2 spike (S) receptor-binding domain and antinucleocapsid antibody titers and evaluating neutralizing ability by inhibition of receptor-binding domain-angiotensin-converting enzyme 2 binding. Cellular immune response was evaluated by using ELISpot, estimating IL-2 and IFN-γ secretion in response to pooled SARS-CoV-2 S- or M-peptides.
Our cohort included 18 patients with a predominantly antibody deficiency, 2 with combined immunodeficiency, 3 with immune dysregulation, and 3 with other genetically defined diagnoses. Twenty-two of them were receiving immunoglobulin replacement therapy. Of the 26 patients, 18 developed specific antibody response, and 19 showed S-peptide-specific T-cell response. None of the patients reported significant adverse events.
Vaccinating patients with IEI is safe, and most patients were able to develop vaccine-specific antibody response, S-protein-specific cellular response, or both.