humoral response

体液反应
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  • 文章类型: Journal Article
    COVID-19大流行造成了严重的人命损失和世界范围内的生活质量下降。尽管我们对这一流行病的理解从一开始就有了显著的改善,COVID-19的自然史及其对代表性不足人群的影响,比如来自美国的土著人,基本上是未知的。我们对两名巴西土著居民(n=624)进行了回顾性血清学调查,Tupiniquim和Guarani-Mbyá。样本收集时间为2020年9月至2021年7月:这段时间包括SARS-CoV-2变种的传播和在巴西开始接种COVID-19疫苗。使用三种不同的市售ELISA试剂盒评估针对S和N抗原的血清转化。样本还用于评估相同人群中的结核病(TB)患病率(n=529)。如果三种ELISA试剂盒中的至少一种检测到特异性抗体的水平高于制造商指定的阈值,则认为针对SARS-CoV-2抗原的血清转化为阳性。在这个意义上,我们报告了56.0%(n=349/623)的血清转换个体。在2021年2月推出Coronavac疫苗后,相对血清转化率达到峰值。疫苗接种使抗SIgG的产量从3.9%增加到48.6%。我们的结果还表明,所有个体中有11.0%(n=46/417)的结核病阳性。结核病测试结果阳性的个体与测试结果阴性的个体之间血清转化为SARS-CoV-2相似。大多数接种疫苗的个体血清转化为SARS-CoV-2,表明Coronavac在这些土著群体中的保护作用与在巴西普通人群中观察到的一样。无论疫苗覆盖不完全,COVID-19的严重程度都是最低的,这表明疫苗接种可能不是保护个体免受严重COVID-19感染的唯一因素。结核病非常普遍,与SARS-CoV-2的血清转化增加无关。
    The COVID-19 pandemic caused a significant loss of human lives and a worldwide decline in quality of life. Although our understanding of the pandemic has improved significantly since the beginning, the natural history of COVID-19 and its impacts on under-represented populations, such as Indigenous people from America, remain largely unknown. We performed a retrospective serological survey with two Brazilian Indigenous populations (n=624), Tupiniquim and Guarani-Mbyá. Samples were collected between September 2020 and July 2021: a period comprising the dissemination of SARS-CoV-2 variants and the beginning of COVID-19 vaccination in Brazil. Seroconversions against S and N antigens were assessed using three different commercially available ELISA kits. Samples were also used to assess the prevalence of tuberculosis (TB) in the same population (n=529). Seroconversion against SARS-CoV-2 antigens was considered positive if at least one of the three ELISA kits detected levels of specific antibodies above the threshold specified by the manufacturer. In this sense, we report 56.0% (n=349/623) of seroconverted individuals. Relative seroconversion peaked after introduction of the Coronavac vaccine in February 2021. Vaccination increased the production of anti-S IgG from 3.9% to 48.6%. Our results also indicated that 11.0% (n=46/417) of all individuals were positive for TB. Seroconversion to SARS-CoV-2 was similar between individuals with positive tuberculosis test results to those with negative test results. Most vaccinated individuals seroconverted to SARS-CoV-2, indicating that Coronavac may be as protective in individuals from these indigenous groups as observed in the general Brazilian population. COVID-19 severity was minimal regardless of incomplete vaccine coverage, suggesting that vaccination may not be the only factor protecting individuals from severe COVID-19. Tuberculosis is highly prevalent and not associated with increased seroconversion to SARS-CoV-2.
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  • 文章类型: Journal Article
    HIV-1具有编码ASP蛋白的反义基因重叠env。ASP功能仍然未知,但它与感染细胞的病毒包膜和膜中的gp120有关,使其成为免疫反应的潜在目标。尽管如此,针对ASP的免疫反应模式描述不充分,并且可能受到env基因的高遗传变异性的影响。为了探索这个,我们分析了100kHIV-1ASP序列从LosAlamosHIV序列数据库使用系统发育,香农熵(Hs),和徽标工具,以研究来自巴西最普遍的HIV-1亚型的全球和巴西序列中的ASP变异性(B,C,和F1)。在计算机上获得的数据通过在纤维素膜上的点合成指导了15聚体重叠肽的设计和合成。筛选肽阵列以评估来自HIV控制者和患有急性或近期HIV感染的个体的汇集血浆样品中的IgG和IgM应答。排除对准精度低的区域,在数据集中确定了几个变异性较高的位点(Hs>1.5)(全球序列为25个,巴西序列为20)。在Hs<1.5的位点中,序列标识允许鉴定具有亚型特异性签名的23个其他位点。总之,在鉴定的48个可变位点中频率>20%的氨基酸变异包括在92个肽中,分为15套,表示接近全长的ASP。在免疫筛查过程中,在三组中观察到最强的反应,一个在蛋白质的中间,一个在蛋白质的C末端。虽然一些集合呈现与IgG和IgM靶标之间的表位置换潜在相关的变异,并且亚型特异性特征似乎影响一些肽的应答水平。尽管存在B/C/F1特征,但仍观察到某些组的交叉反应性信号。我们的数据提供了IgG和IgM应答优先靶向的ASP区域的图谱。尽管ASP中的B/C/F1子类型签名,IgM和IgG优先靶向的某些区域的氨基酸变异并未对针对免疫原性较高区域的应答产生负面影响.
    HIV-1 has an antisense gene overlapping env that encodes the ASP protein. ASP functions are still unknown, but it has been associated with gp120 in the viral envelope and membrane of infected cells, making it a potential target for immune response. Despite this, immune response patterns against ASP are poorly described and can be influenced by the high genetic variability of the env gene. To explore this, we analyzed 100k HIV-1 ASP sequences from the Los Alamos HIV sequence database using phylogenetic, Shannon entropy (Hs), and logo tools to study ASP variability in worldwide and Brazilian sequences from the most prevalent HIV-1 subtypes in Brazil (B, C, and F1). Data obtained in silico guided the design and synthesis of 15-mer overlapping peptides through spot synthesis on cellulose membranes. Peptide arrays were screened to assess IgG and IgM responses in pooled plasma samples from HIV controllers and individuals with acute or recent HIV infection. Excluding regions with low alignment accuracy, several sites with higher variability (Hs > 1.5) were identified among the datasets (25 for worldwide sequences, 20 for Brazilian sequences). Among sites with Hs < 1.5, sequence logos allowed the identification of 23 other sites with subtype-specific signatures. Altogether, amino acid variations with frequencies > 20% in the 48 variable sites identified were included in 92 peptides, divided into 15 sets, representing near full-length ASP. During the immune screening, the strongest responses were observed in three sets, one in the middle and one at the C-terminus of the protein. While some sets presented variations potentially associated with epitope displacement between IgG and IgM targets and subtype-specific signatures appeared to impact the level of response for some peptides, signals of cross-reactivity were observed for some sets despite the presence of B/C/F1 signatures. Our data provides a map of ASP regions preferentially targeted by IgG and IgM responses. Despite B/C/F1 subtype signatures in ASP, the amino acid variation in some areas preferentially targeted by IgM and IgG did not negatively impact the response against regions with higher immunogenicity.
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  • 文章类型: Journal Article
    我们最近表明,具有野生型和BA4/BA.5Omicron亚型表位的适应性SARS-CoV-2疫苗在血液透析患者中诱导了广泛的短期免疫反应。在第五次疫苗剂量后3周的随访期后,具有保护能力的抗体得到了显着增强。然而,目前尚缺乏关于二价疫苗接种后体液应答寿命的数据,但迫切需要为该患者组进一步加强疫苗接种提供建议.这项研究是我们先前发表的数据的扩展,其中包括40名接受血液透析的患者,在经过调整的加强疫苗剂量后随访12个月。我们对体液免疫反应进行了详细的表征,并评估了突破性感染。此外,使用已建立的分级系统评估突破性感染的严重程度.抗SlIgG和替代中和抗体在12个月期间显著降低(分别为p<0.01和p<0.001)。针对野生型和BA.5亚型的活病毒中和抗体也随时间显著降低(分别为p<0.01和p<0.01)。然而,甚至在施用适应疫苗剂量后12个月,所有40/40(100%)的血液透析患者均表现出可检测的SARS-CoV-2野生型中和活性,35/40(88%)也表现出可检测的BA.5亚型中和活性。随访期间,13/40(33%)患者感染了SARS-CoV-2突破性感染,其中12例分为无症状或轻度,而只有1例被归类为中度疾病活动。因此,二价加强疫苗接种似乎可在血液透析患者中诱导持续的免疫反应,这些患者的突破性感染频繁发生,但主要表现为无症状或轻度.
    We recently showed that an adapted SARS-CoV-2 vaccine with wildtype and BA.4/BA.5 Omicron subtype epitopes induced a broad short-term immune response in hemodialysis patients. Antibodies with protective capacity were boosted significantly after a follow-up period of 3 weeks following a fifth vaccine dose. However, data on the longevity of the humoral response after bivalent vaccination are lacking but urgently needed to make recommendations for further booster vaccinations in this patient group. This study is an extension of our previously published data including 40 patients on hemodialysis with a follow-up period of 12 months after an adapted booster vaccine dose. We performed a detailed characterization of humoral immune responses and assessed breakthrough infections. In addition, the severity of breakthrough infections was assessed using an established grading system. Anti-S1 IgG and surrogate neutralizing antibodies significantly decreased during the period of 12 months (p < 0.01 and p < 0.001, respectively). Live-virus neutralizing antibodies against the wildtype and the BA.5 subtype also significantly decreased over time (p < 0.01 and p < 0.01, respectively). However, even 12 months after administration of the adapted vaccine dose, all 40/40 (100%) of hemodialysis patients showed detectable SARS-CoV-2 wildtype neutralization activity, with 35/40 (88%) also exhibiting detectable BA.5 subtype neutralization activity. During follow-up, 13/40 (33%) patients contracted a SARS-CoV-2 breakthrough infection, among which 12 cases were categorized as asymptomatic or mild, while only 1 case was classified as moderate disease activity. Thus, bivalent booster vaccination seems to induce a sustained immune response in hemodialysis patients over a period of 12 months with breakthrough infections occurring frequently but predominantly manifesting as asymptomatic or mild.
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  • 文章类型: Journal Article
    猪繁殖与呼吸综合征病毒(PRRSV)导致生殖衰竭和呼吸道症状,给养猪业造成了巨大的经济损失。尽管市场上有几种针对PRRSV的疫苗,但它们显示出总体疗效低,一些国家需要覆盖当地的疫苗,循环变体。该项目旨在开发一种新的针对PRRSV特异性表位的嵌合抗原,并评估两种测试佐剂以配制疫苗候选物。测试抗原称为LTB-PRRSV,其在大肠杆菌中重组产生并且由来自大肠杆菌(LTB)的热不稳定肠毒素B亚基和来自PRRSV的四个表位组成。LTB-PRRSV被拯救为包涵体及其溶解方法,基于IMAC的纯化,重新折叠是标准化的,导致每升培养物平均产量为18毫克纯蛋白质。鉴于其生物相容性,层状双氢氧化物(LDH)已被用作疫苗佐剂,低成本,和正表面电荷,可以有效吸附带负电荷的生物分子。因此,选择LDH作为LTB-PRRSV的递送载体。通过在不同的LDH:LTB-PRRSV质量比(1:0.25、1:0.5、1:1和1:2)和pH9.5下孵育,将纯LTB-PRRSV吸附到LDH上。最佳吸附发生在1:2的质量比,和蔗糖-吐温溶液。获得的缀合物具有0.26的多分散指数,192nm的流体动力学直径,抗原终浓度为64.2μg/mL。通过向小鼠注射LDH:LTB-PRRSV,明矾/LTB-PRRSV,或LTB-PRRSV在包括以两周间隔和两个剂量水平(1和5μg)的三次免疫的方案中。LTB-PRRSV能够诱导强烈的体液反应,当LDH用作递送媒介物/佐剂时,其持续较长时间。讨论了LDH作为兽医疫苗有吸引力的载体的潜力。
    The Porcine Reproductive and Respiratory Syndrome Virus (PRRSV) causes reproductive failure and respiratory symptoms, leading to huge economic losses for the pig farming industry. Although several vaccines against PRRSV are available in the market; they show an overall low efficacy, and several countries have the need for vaccines covering the local, circulating variants. This project aims at developing a new chimeric antigen targeting specific epitopes from PRRSV and evaluating two test adjuvants to formulate a vaccine candidate. The test antigen was called LTB-PRRSV, which was produced recombinantly in Escherichia coli and consisted of the heat labile enterotoxin B subunit from E. coli (LTB) and four epitopes from PRRSV. LTB-PRRSV was rescued as inclusion bodies and methods for its solubilization, IMAC-based purification, and refolding were standardized, leading to mean yields of 18 mg of pure protein per liter culture. Layered double hydroxides (LDH) have been used as vaccine adjuvants given their biocompatibility, low cost, and positive surface charge that allows an efficient adsorption of negatively charged biomolecules. Therefore, LDH were selected as delivery vehicles of LTB-PRRSV. Pure LTB-PRRSV was adsorbed onto LDH by incubation at different LDH:LTB-PRRSV mass ratios (1:0.25, 1:0.5, 1:1, and 1:2) and at pH 9.5. The best adsorption occurred with a 1:2 mass ratio, and in a sucrose-tween solution. The conjugates obtained had a polydispersity index of 0.26, a hydrodynamic diameter of 192 nm, and a final antigen concentration of 64.2 μg/mL. An immunogenicity assessment was performed by injecting mice with LDH:LTB-PRRSV, Alum/LTB-PRRSV, or LTB-PRRSV in a scheme comprising three immunizations at two-week intervals and two dose levels (1 and 5 μg). LTB-PRRSV was capable of inducing strong humoral responses, which lasted for a longer period when LDH was used as the delivery vehicle/adjuvant. The potential of LDH to serve as an attractive carrier for veterinary vaccines is discussed.
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  • 文章类型: Journal Article
    这项研究评估了从2021年3月开始在我们机构接受三剂疫苗的原位肝移植(OLT)和肺移植(LUT)接受者对BNT162b2疫苗的体液和T细胞介导的免疫反应。在第二次和第三次给药后60天收集血清样品以定量针对SARS-CoV-2的刺突区域的抗体,同时收集全血样品以使用IFN-γELISpot测定法分析SARS-CoV-2特异性T细胞应答。我们注册了244个OLT和120个LUT收件人。第三剂量增加了OLT接受者的抗体滴度(从第二剂量后的中位数131到5523IU/mL,p<0.001)和LUT接受者(从14.8到1729IU/mL,p<0.001)。OLT受者的T细胞反应也增加(每250,000个PBMC从8.5到23个IFN-γSFU,p<0.001)和LUT接受者(每250,000个PBMC从8到15个IFN-γSFU,p<0.001)。共观察到128例突破性感染:2例(0.8%)OLT受者因COVID-19住院,1例死亡(0.4%);在LUT受者中,7人住院(5.8%),2人死亡(1.7%).总之,BNT162b2疫苗的三剂量方案在实体器官移植受者中引起体液和T细胞介导的反应。在这一人群中,疫苗接种后严重COVID-19的风险很低。
    This study assessed humoral and T cell-mediated immune responses to the BNT162b2 vaccine in orthotopic liver transplant (OLT) and lung transplant (LUT) recipients who received three doses of the vaccine from March 2021 at our institution. Serum samples were collected 60 days post-second and third dose to quantify antibodies against the spike region of SARS-CoV-2 while whole blood samples were collected to analyze the SARS-CoV-2-specific T-cell response using an IFN-γ ELISpot assay. We enrolled 244 OLT and 120 LUT recipients. The third dose increased antibody titres in OLT recipients (from a median value of 131 after the second dose to 5523 IU/mL, p < 0.001) and LUT recipients (from 14.8 to 1729 IU/mL, p < 0.001). T-cell response also increased in OLT recipients (from 8.5 to 23 IFN-γ SFU per 250,000 PBMC, p < 0.001) and LUT recipients (from 8 to 15 IFN-γ SFU per 250,000 PBMC, p < 0.001). A total of 128 breakthrough infections were observed: two (0.8%) OLT recipients were hospitalized due to COVID-19 and one died (0.4%); among LUT recipients, seven were hospitalized (5.8%) and two patients died (1.7%). In conclusion, the three-dose schedule of the BNT162b2 vaccine elicited both humoral and T cell-mediated responses in solid organ transplant recipients. The risk of severe COVID-19 post-vaccination was low in this population.
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  • 文章类型: Journal Article
    慢性淋巴细胞白血病(CLL)的特征是疾病和治疗相关的免疫抑制。CLL患者包括2019年冠状病毒病(COVID-19)的脆弱人群,而COVID-19疫苗的保护作用仍不确定。我们进行了一项系统评价,以评估已发表的报告CLL患者对COVID-19疫苗接种反应的数据。主要结果是完全初次疫苗接种后的血清阳性率,而次要结局是中和抗体阳性率,细胞反应,和不良事件。还评估了加强剂量的疫苗接种后的反应。23项完全初级疫苗接种研究(12项CLL特异性,1747例患者,11例混合性血液病,包括1044例CLL),共2791例,分析中纳入了8项关于389例患者的加强剂量的研究.研究之间的血清学反应有所不同,中位数为55%。据报道,中位中和抗体应答率为61.2%,细胞应答率为44.2%.在使用抗CD20单克隆抗体积极治疗的患者中,血清学反应较差。BCL2和BTK抑制剂。本综述强调了CLL患者对COVID-19疫苗接种的体液和细胞反应严重受损,而接受积极治疗的患者是最脆弱的。
    Chronic lymphocytic leukemia (CLL) is characterized by disease- and treatment-related immunosuppression. Patients with CLL comprise a vulnerable population to coronavirus disease 2019 (COVID-19), while the protective effect of COVID-19 vaccination remains uncertain.We conducted a systematic review to evaluate published data reporting response to COVID-19 vaccination in patients with CLL. The primary outcome was the rate of seropositivity after full primary vaccination, while secondary outcomes were rates of positive neutralizing antibodies, cellular responses, and adverse events. Response after booster doses of vaccination was also evaluated.Twenty-three studies of full primary vaccination (12 CLL-specific with 1747 patients, 11 with mixed hematologic diseases including 1044 patients with CLL) with a total of 2791 patients, and eight studies on booster doses with 389 patients were included in the analysis. The serologic response varied between studies with a median of 55%. Where reported, the median neutralizing antibody response rate was 61.2% and the cellular response rate was 44.2%. Poor serologic response was noted in patients under active treatment with anti-CD20 monoclonal antibodies, BCL2, and BTK inhibitors.The present review highlights the substantially impaired humoral and cellular response to COVID-19 vaccination in patients with CLL with patients under active treatment being the most vulnerable.
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  • 文章类型: Journal Article
    鱼类养殖的发展和生长受到病毒和细菌传染病的阻碍,这需要有效的疾病控制措施。糠疹,主要由沙门氏菌气单胞菌引起,作为一种影响鲑鱼养殖场的重大细菌性疾病,尤其是虹鳟鱼.疫苗接种已成为抗击这种疾病的重要工具。本实验的目的是评估和比较不同的疫苗方案在控制饲养条件下对大型鳟鱼的furunlosis的功效和持续时间。通过腹膜内单次和加强给药,口服,和沉浸路线。在测试的各种疫苗接种方案中,只有那些涉及腹膜内注射的,至少管理一次,事实证明,它确实有效地预防了糠疹的临床症状的表达并降低了死亡率。单次腹膜内给药可提供长达2352度-天的保护,相当于在16°C的水中约5个月。然而,腹膜内接种疫苗可导致由于所产生的腹膜内粘连导致的鱼生长减少。此外,无论初次疫苗接种的施用途径如何,通过腹膜内注射并入加强剂量的方案都显示出功效。然而,在疗效方面,通过腹膜内途径使用加强疫苗接种与单次腹膜内注射相比没有任何显著优势.
    The development and growth of fish farming are hindered by viral and bacterial infectious diseases, which necessitate effective disease control measures. Furunculosis, primarily caused by Aeromonas salmonicida, stands out as a significant bacterial disease affecting salmonid fish farms, particularly rainbow trout. Vaccination has emerged as a crucial tool in combating this disease. The objective of this experiment was to assess and compare the efficacy and duration of different vaccine protocols against furunculosis in large trout under controlled rearing conditions, utilizing single and booster administrations via intraperitoneal, oral, and immersion routes. Among the various vaccination protocols tested, only those involving intraperitoneal injection, administered at least once, proved truly effective in preventing the expression of clinical signs of furunculosis and reducing mortality rates. A single intraperitoneal administration provided protection for up to 2352°-days, equivalent to approximately 5 months in water at 16 °C. However, intraperitoneal vaccination may lead to reduced growth in the fish due to resultant intraperitoneal adhesions. Additionally, protocols incorporating booster doses via intraperitoneal injection demonstrated efficacy regardless of the administration route of the primary vaccination. Nevertheless, the use of booster vaccinations via the intraperitoneal route did not confer any significant advantage over a single intraperitoneal injection in terms of efficacy.
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  • 文章类型: Journal Article
    针对SARS-CoV-2的特异性T细胞反应提供了大流行期间获得性免疫的概述。抗SARS-CoV-2免疫决定了急性疾病的严重程度,但也可能与症状的可能持续有关(长COVID)。我们回顾性分析了26例确诊为严重疾病的COVID-19患者的离体纵向CD8+T细胞反应,最初(1个月)和长期(10个月),在32名接种疫苗的医护人员中,以前没有SARS-CoV-2感染。我们使用了肽-人白细胞抗原(pHLA)葡聚糖,可识别病毒和其他非结构蛋白的26种SARS-CoV-2衍生表位。大多数患者对研究的至少一种肽有反应,主要来源于非结构ORF1ab蛋白。经过10个月的随访,CD8+T细胞应答长期维持,针对某些表位的反应(A*01:01-ORF1ab1637)仍然被检测到,显示记忆样表型(CD127+PD-1+)。在这些患者中,SARS-CoV-2特异性CD8+T细胞的总数与长期COVID的保护作用显着相关。与疫苗接种相比,感染患者对HLA限制的刺突蛋白衍生肽的免疫反应效果较差。所以,A*01:01-S865和A*24:02-S1208葡聚糖仅在接种疫苗的个体中被识别。我们得出的结论是,最初的SARS-CoV-2特异性CD8T细胞反应可用作标志物,以了解SARS-CoV-2感染后严重疾病和急性后遗症的演变。
    Specific T cell responses against SARS-CoV-2 provided an overview of acquired immunity during the pandemic. Anti-SARS-CoV-2 immunity determines the severity of acute illness, but also might be related to the possible persistence of symptoms (long COVID). We retrospectively analyzed ex vivo longitudinal CD8+ T cell responses in 26 COVID-19 patients diagnosed with severe disease, initially (1 month) and long-term (10 months), and in a cohort of 32 vaccinated healthcare workers without previous SARS-CoV-2 infection. We used peptide-human leukocyte antigen (pHLA) dextramers recognizing 26 SARS-CoV-2-derived epitopes of viral and other non-structural proteins. Most patients responded to at least one of the peptides studied, mainly derived from non-structural ORF1ab proteins. After 10 months follow-up, CD8+ T cell responses were maintained at long term and reaction against certain epitopes (A*01:01-ORF1ab1637) was still detected and functional, showing a memory-like phenotype (CD127+ PD-1+). The total number of SARS-CoV-2-specific CD8+ T cells was significantly associated with protection against long COVID in these patients. Compared with vaccination, infected patients showed a less effective immune response to spike protein-derived peptides restricted by HLA. So, the A*01:01-S865 and A*24:02-S1208 dextramers were only recognized in vaccinated individuals. We conclude that initial SARS-CoV-2-specific CD8+ T cell response could be used as a marker to understand the evolution of severe disease and post-acute sequelae after SARS-CoV-2 infection.
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  • 文章类型: Journal Article
    COVID-19疫苗的新机制引起了人们对其在接受免疫调节治疗的类风湿性关节炎(RA)患者中潜在免疫原性的关注。我们设计了一项回顾性单中心研究,以调查其在该人群中的有效性和安全性。分析第一次疫苗接种计划(2020年12月至2021年10月)的数据。纳入标准是疫苗接种后血清学的可用性和至少6个月的后续随访。结合抗体单位(BAU/mL)≥7.1定义了足够的血清学反应。疫苗后COVID-19的发病率及其自疫苗接种以来的时间,不良事件(AE),并记录RA耀斑。进行了调整的逻辑和线性多变量回归分析,以确定与疫苗反应相关的因素。我们纳入了118名患者(87.2%为女性,年龄65.4±11.6岁,进化12.0±9.6年),其中95.8%有完整的疫苗接种计划。88.1%的患者获得了足够的体液免疫原性,并且与以前的COVID-19和mRNA疫苗相关,而吸烟,aCCP,年龄,和DMARDs产生了负面影响。疫苗后COVID-19发生在18.6%的患者中,疫苗接种后的中位数为6.5个月。疫苗AE(19.5%)和RA耀斑(1.7%)大多是轻度的,与年龄成反比。我们的结果表明,COVID-19疫苗诱导足够的体液免疫原性,在RA患者中具有可接受的安全性。
    Novel mechanisms of COVID-19 vaccines raised concern about their potential immunogenicity in patients with rheumatoid arthritis (RA) undergoing immunomodulatory treatments. We designed a retrospective single-center study to investigate their effectiveness and safety in this population, analyzing data from the first vaccination program (December 2020-October 2021). Inclusion criteria were availability of post-vaccination serology and a minimum subsequent follow-up of 6 months. Binding antibody units (BAU/mL) ≥ 7.1 defined an adequate serological response. Post-vaccine COVID-19 incidence and its timing since vaccination, adverse events (AEs), and RA flares were recorded. Adjusted logistic and linear multivariate regression analyses were carried out to identify factors associated with vaccine response. We included 118 patients (87.2% women, age 65.4 ± 11.6 years, evolution 12.0 ± 9.6 years), of whom 95.8% had a complete vaccination schedule. Adequate humoral immunogenicity was achieved in 88.1% of patients and was associated with previous COVID-19 and mRNA vaccines, whereas smoking, aCCP, age, and DMARDs exerted a negative impact. Post-vaccine COVID-19 occurred in 18.6% of patients, a median of 6.5 months after vaccination. Vaccine AE (19.5%) and RA flares (1.7%) were mostly mild and inversely associated with age. Our results suggest that COVID-19 vaccines induce adequate humoral immunogenicity, with an acceptable safety profile in RA patients.
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