Cellular and humoral immunity following two AZD1222 and two booster vaccinations in hemodialysis patients.

IF 3.7 2区医学 Q2 IMMUNOLOGY

Journal of Microbiology Immunology and Infection Pub Date : 2025-08-27 DOI:10.1016/j.jmii.2025.08.014

Tsai-Chieh Ling, Po-Lin Chen, Jen-Ren Wang, Wen-Chien Ko, Chiao-Hsuan Chao, Chi-Chang Shieh, Jia-Ling Wu, Chien-Yao Sun, Wei-Ren Lin, Chieh-Hsin Huang, Yu-Tzu Chang

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Abstract

Background: Dialysis patients are vulnerable to SARS-CoV-2 infection and subsequent complications. However, the vaccine-induced immunity, especially against new variants, following two AZD1222 and two booster doses in hemodialysis patients remain largely unknown.

Methods: In this observational cohort study, we monitored immune responses in 127 hemodialysis patients receiving the 3^rd and 4th vaccinations until three months after the 4th immunization. Humoral and cellular immunity were assessed by anti-SARS-CoV-2 receptor-binding domain(RBD) antibody, neutralizing antibodies against the ancestral virus, delta, omicron BA.1 and BA.2 and SARS-CoV-2 specific IFN-γ releasing assay (Covi-FERON).

Results: The primary series and the fourth dose predominantly consisted of two-dose AZD1222 and mRNA-1273, respectively. The most common vaccines chosen for the third dose was mRNA-1273(n = 84), following by BNT 162b2(n = 38). Anti-RBD antibody increased to 13803.8 and 18197U/ml after the 3^rd and 4th vaccination, respectively, but dropped to 8709.6U/ml three months after the fourth vaccination. One month after the fourth vaccination, 99 %,98 %,51.5 % and 93.9 % participants had neutralizing antibodies against the ancestral virus, delta, omicron BA.1 and BA.2, respectively. 87.9 % and 81.8 % patients reacted to the ancestral or alpha and beta or gamma spike antigens in Covi-FERON, respectively, after four vaccinations. Higher Covi-FERON reactions were associated with increased IL-2 and IL-4 secretion. In linear mixed effect models, mRNA-1273 as the third vaccination was associated higher anti-RBD antibody titers and higher neutralization against the ancestral virus and delta compared with BNT162b2 but with higher mild adverse events following vaccination.

Conclusions: Two AZD1222 and two mRNA booster doses confer substantial humoral and cellular immunity against variants including omicron in hemodialysis patients.

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血液透析患者两次AZD1222和两次加强疫苗接种后的细胞和体液免疫。

背景：透析患者易发生SARS-CoV-2感染及其并发症。然而，在血液透析患者中接种两次AZD1222和两次加强剂后，疫苗诱导的免疫力，特别是针对新变异的免疫力在很大程度上仍然未知。方法：在这项观察性队列研究中，我们监测127例接受第三次和第四次免疫接种的血液透析患者的免疫反应，直到第四次免疫接种后3个月。采用抗SARS-CoV-2受体结合域（RBD）抗体、抗祖先病毒的中和抗体、δ、组粒BA.1和BA.2和SARS-CoV-2特异性IFN-γ释放试验（Covi-FERON）评估体液和细胞免疫。结果：第一系列和第四剂量主要由两剂AZD1222和mRNA-1273组成。第三剂最常用的疫苗是mRNA-1273(n = 84)，其次是BNT 162b2（n = 38）。抗rbd抗体在第三次和第四次接种后分别上升至13803.8和18197U/ml，但在第四次接种后3个月降至8709.6U/ml。在第四次疫苗接种一个月后，99%、98%、51.5%和93.9%的参与者分别具有针对祖先病毒δ、组粒BA.1和BA.2的中和抗体。四次疫苗接种后，分别有87.9%和81.8%的患者对Covi-FERON的祖先或α和β或γ刺突抗原有反应。较高的Covi-FERON反应与IL-2和IL-4分泌增加有关。在线性混合效应模型中，与BNT162b2相比，mRNA-1273作为第三种疫苗与更高的抗rbd抗体滴度和对祖先病毒和三角洲病毒的更高中和有关，但接种后的轻度不良事件更高。结论：两剂AZD1222和两剂mRNA增强剂可使血液透析患者对包括组粒在内的变异产生实质性的体液和细胞免疫。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Microbiology Immunology and Infection IMMUNOLOGY-INFECTIOUS DISEASES

CiteScore

15.90

自引率

5.40%

发文量

159

审稿时长

67 days

期刊介绍： Journal of Microbiology Immunology and Infection is an open access journal, committed to disseminating information on the latest trends and advances in microbiology, immunology, infectious diseases and parasitology. Article types considered include perspectives, review articles, original articles, brief reports and correspondence. With the aim of promoting effective and accurate scientific information, an expert panel of referees constitutes the backbone of the peer-review process in evaluating the quality and content of manuscripts submitted for publication.