Vaccines最新文献

{"title":"Human Alpha Herpesviruses Infections (HSV1, HSV2, and VZV), Alzheimer's Disease, and the Potential Benefits of Targeted Treatment or Vaccination-A Virological Perspective.","authors":"Peter A C Maple, Akram A Hosseini","doi":"10.3390/vaccines13060572","DOIUrl":"10.3390/vaccines13060572","url":null,"abstract":"<p><p>Understanding the contribution of human herpesviruses to the aetiology of neurodegenerative diseases is an emerging field of interest. The association of Epstein-Barr virus with multiple sclerosis is the most researched example; however, the definitive proof of causation is still lacking. Alzheimer's disease (AD) is the most common form of dementia and typically manifests in individuals aged over 65 years; however, it also occurs in a small number of individuals aged less than 65 years. A combination of environmental, genetic, and lifestyle factors is believed to contribute to the development of AD. There have been several reports describing potential associations of infections or reactivations of human alphaherpesviruses with AD. A particular characteristic of human alphaherpesviruses (herpes simplex viruses 1 and 2, varicella zoster virus) is that they are neurotropic and that lifelong infection (latency) is established mainly in the dorsal root and trigeminal ganglia. There have also been reports that suppression of alphaherpesvirus infections through either vaccination or the application of antiviral treatments may be protective against the development of AD. Zoster vaccines and acyclovir may prove to be effective interventions for preventing or limiting the progression of AD. This is particularly relevant as there are currently no available cheap and effective treatments for AD. In this review, the basic virology of human alphaherpesviruses is described followed by their epidemiology and associations with AD. Finally, the prevention and treatment of human alphaherpesviruses are considered in the context of potential applications for the prevention of AD.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"13 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccine Development for Human Pneumoviruses.","authors":"Elhadji Birane Mboup, Marie-Ève Hamelin, Julia Dubois, Manuel Rosa-Calatrava, Guy Boivin","doi":"10.3390/vaccines13060569","DOIUrl":"10.3390/vaccines13060569","url":null,"abstract":"<p><strong>Background: </strong>Pneumoviruses are etiologic agents of respiratory tract infections and a major cause of morbidity and mortality worldwide, particularly affecting young children, the elderly, and individuals with underlying clinical conditions. These viruses are associated with a significant burden, particularly in low- and middle-income countries, where reported deaths attributable to respiratory syncytial virus (RSV) and human metapneumovirus (HMPV) in young children are important. Recent developments have been noted in the prevention of pneumoviral infections.</p><p><strong>Method: </strong>In this review, we analyzed clinical trials of the approved RSV vaccines, as well as the recent prominent platform technologies used in RSV vaccine research. In addition, we discussed combination vaccines targeting RSV, HMPV, and Human Parainfluenza Virus Type 3 (HPIV3) that have entered clinical trials.</p><p><strong>Results: </strong>Recent advancements include the approval of three RSV vaccine candidates: AREXVY^®(GSK), ABRYSVO^®(Pfizer), and mRESVIA^®(Moderna). These vaccines are primarily intended for older adults, with ABRYSVO^® also capable of providing passive immunization to infants via maternal administration. The review highlights RSV vaccine platform technologies and combination vaccines currently being evaluated in clinical settings.</p><p><strong>Conclusions: </strong>While significant progress has been made in RSV vaccine development, especially with three approved candidates, the development of vaccines for HMPV remains an unmet medical need. Ongoing research in combination vaccines holds promise for broader protection against multiple respiratory viruses in the future.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"13 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistence of Anti-HB Antibodies in Healthcare Trainees: The Impact of Childhood Versus Adolescent Vaccination.","authors":"Luca Di Giampaolo, Luca Coppeta, Paola Borrelli, Piergiorgio Astolfi, Andrea Resta, Lucia Loffredo, Flavia Di Menno Di Bucchianico, Rocco Mangifesta, Lorenzo Ippoliti, Cristiana Ferrari","doi":"10.3390/vaccines13060562","DOIUrl":"10.3390/vaccines13060562","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B virus (HBV) infection remains a significant occupational health concern for healthcare workers (HCWs), including trainees exposed to biological risks. Although vaccination is the most effective preventive measure, the persistence of immunity over time and the need for booster doses remain subjects of debate.</p><p><strong>Objective: </strong>The present study aims to assess the prevalence of protective anti-HB antibody titers among healthcare trainees at the \"SS Annunziata\" Hospital in Chieti, comparing those vaccinated in infancy with those vaccinated during adolescence.</p><p><strong>Methods: </strong>A retrospective observational study was conducted on 2028 healthcare trainees from 2021 to 2024. Participants were divided into two groups based on vaccination timing: infancy (PED group) and adolescence (ADO group). Serological tests were performed to measure anti-HB titers, with a protective threshold set at ≥10 IU/L. Statistical analyses were conducted to evaluate differences in immunity persistence between the two groups. The results showed that the overall prevalence of protective anti-HB titers was 50.7%, with significant differences between the PED and ADO groups. Protective immunity was observed in 79.2% of individuals vaccinated during adolescence, compared to 44.6% of those vaccinated in infancy (<i>p</i> < 0.001). No significant differences in antibody persistence were found between males and females. Notably, 92.4% of participants with non-protective titers received a booster dose within two months of testing.</p><p><strong>Conclusions: </strong>The study confirms a significant decline in anti-HB titers over time among individuals vaccinated in infancy, suggesting a potential need for booster doses later in adulthood. The high adherence to vaccination recommendations among healthcare trainees is a promising finding, reinforcing the importance of continuous education and immunization programmes in healthcare settings. Further research, including longitudinal studies and additional HBV biomarkers, is necessary to optimize vaccination strategies and long-term immunity monitoring in HCWs.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"13 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rational Design and Immunological Mechanisms of Circular RNA-Based Vaccines: Emerging Frontiers in Combating Pathogen Infection.","authors":"Ying Zhang, Shumei Jin, Zan Zuo, Shujing Liu, Juan Xu, Chongyi Yang, Ping Wan, Linting Xun, Mei Luo, Fan Yang, Wenjie Chen, Zhengji Song, Jialong Qi","doi":"10.3390/vaccines13060563","DOIUrl":"10.3390/vaccines13060563","url":null,"abstract":"<p><p>Vaccines remain one of the most effective tools in combating infectious diseases, though traditional platforms are constrained by limitations including suboptimal immunogenicity, safety concerns, and manufacturing complexity. Circular RNA (circRNA) vaccines have recently emerged as a novel vaccine modality, demonstrating unique advantages including high stability, low innate immunogenicity, and sustained antigen expression. Although early research has predominantly focused on viral targets, accumulating evidence now supports the application potential of circRNA vaccines against diverse pathogens, particularly antibiotic-resistant bacteria. Through encoding critical antigens or virulence factors, these circRNA vaccines demonstrate capability to induce protective immune responses, presenting a viable alternative to conventional antimicrobial strategies. This review highlights recent advances in circRNA vaccine development, spanning synthetic circularization techniques, delivery approaches, and immunological mechanisms. We emphasize their potential against viral, bacterial, fungal, and parasitic infections, while addressing current challenges and future research directions of this emerging platform. Collectively, these insights underscore circRNA's multifaceted versatility and its expanding relevance in next-generation vaccine innovation.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"13 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rates of SARS-CoV-2 Breakthrough Infection or Severe COVID-19 and Associated Risk Factors After Primary and Booster Vaccination Against COVID-19 in the Netherlands.","authors":"Jesse M van den Berg, Marieke T Blom, Jetty A Overbeek, Sharon Remmelzwaal, Ron M C Herings, Petra J M Elders","doi":"10.3390/vaccines13060564","DOIUrl":"10.3390/vaccines13060564","url":null,"abstract":"<p><p><b>Background:</b> The effectiveness of COVID-19 vaccines appears to decline rapidly over time due to waning immunity and immune evasion by emerging variants of concern, and may be reduced in high-risk populations. We aimed to evaluate the rates of SARS-CoV-2 breakthrough infection or severe COVID-19, both in individuals who had completed their primary COVID-19 vaccination, and in those who had received their first booster vaccination. Specifically, we aimed to evaluate whether persons with certain risk factors, such as age, gender, socioeconomic status (SES), and specified comorbidities have an increased risk of either breakthrough infection or severe COVID-19, compared to those without the respective risk factors. <b>Methods:</b> Data on COVID-19 vaccinations, infections, hospitalizations, and deaths were collected from the PHARMO Data Network, consisting of health records from Dutch residents. Two cohorts were established: (1) all persons who have completed their primary COVID-19 vaccination regimen, and (2) those who have received their first booster vaccination. The outcomes were SARS-CoV-2 breakthrough infection, and severe COVID-19, defined as either hospitalization or death following SARS-CoV-2 infection. Incidence rates of these outcomes were calculated in both cohorts. The adjusted incidence rate ratios of these outcomes in persons with certain risk factors were calculated, using generalized linear models with a Poisson distribution. <b>Results:</b> In 2021, a total of 1,090,567 individuals received either two doses of BNT162b2, AZD1222, or mRNA-1273, or one dose of Ad26.COV2.S and were included in the primary vaccination cohort, of which 344,153 (31.6%) received a booster vaccination. Overall incidence rates of SARS-CoV-2 breakthrough infection and severe COVID-19 after primary vaccination were 29.9 and 3.1 per 1000 person-years, respectively, and after booster vaccination were 256.4 and 2.3, respectively. Male gender, older age, lower SES, history of COVID-19, and recent hospitalization were factors associated with a lower risk of breakthrough infection after primary vaccination, and a higher risk of severe COVID-19. The risk of severe COVID-19 after primary vaccination was increased in persons with several comorbidities, compared to those without, and remained elevated after booster vaccination in persons with diabetes or lung disease. <b>Conclusions:</b> Our study emphasizes the crucial role of boosters in reducing breakthrough infections, particularly in high-risk populations. The varied impact on severe outcomes in individuals with comorbidities underscores the need for ongoing surveillance and tailored vaccination strategies.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"13 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nanoparticle-Based mRNA Vaccine Induces Protective Neutralizing Antibodies Against Infectious Bronchitis Virus in In-Vivo Infection.","authors":"Aseno Sakhrie, Ankarao Kalluri, Zeinab H Helal, Challa V Kumar, Mazhar I Khan","doi":"10.3390/vaccines13060568","DOIUrl":"10.3390/vaccines13060568","url":null,"abstract":"<p><p><b>Background:</b> Live attenuated and inactivated virus vaccines are commonly used against infectious bronchitis virus (IBV) in chickens, but they have limitations such as mutation risks and short efficacy. This study explores cationic bovine serum albumin (BSA) polyamine nanoparticles (NPs) for delivering IBV spike protein mRNA, aiming to develop a safer and more effective vaccine. <b>Methods</b>: A BSA-based nanoparticle system was designed with positive surface charges and characterized using dynamic light scattering (DLS), Zetasizer, and transmission electron microscopy (TEM). Its cytotoxicity, cellular uptake, and ability to deliver IBV spike protein mRNA were evaluated in macrophage-like chicken cell lines (HD11), followed by immunogenicity studies in SPF chickens to assess immune responses. <b>Results</b>: The study demonstrated successful binding and transfection efficiency of the in vitro transcription (IVT)-mRNA complexed with the NPs, which was enhanced with chloroquine. Immunogenicity studies in SPF chickens showed a significant increase in antibody titers in chickens vaccinated with the mRNA vaccine compared to the PBS control, indicating an effective immune response against the IBV S protein. Furthermore, the neutralization index doubled after a higher-dose mRNA booster with chloroquine, and PBMCs from immunized chickens exhibited a threefold higher stimulation index than the PBS control. <b>Conclusions</b>: BSA-based NPs effectively deliver IBV spike protein mRNA, enhancing immune responses and offering a promising strategy for a safer, more effective IBV vaccine.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"13 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Effectiveness of Boosting Against Omicron Hospitalization in Older Adults, Stratified by Frailty.","authors":"Liang En Wee, Enoch Xue Heng Loy, Jue Tao Lim, Wei Hao Kwok, Calvin Chiew, Christopher Lien, Barbara Helen Rosario, Ian Yi Onn Leong, Reshma Aziz Merchant, David Chien Boon Lye, Kelvin Bryan Tan","doi":"10.3390/vaccines13060565","DOIUrl":"10.3390/vaccines13060565","url":null,"abstract":"<p><strong>Background/objectives: </strong>Older adults with frailty are at-risk of worse outcomes following respiratory-viral-infections such as COVID-19. Data on effectiveness of vaccination/boosting in frail older adults during Omicron is lacking.</p><p><strong>Methods: </strong>National healthcare-claims data and COVID-19 registries were utilized to enroll a cohort of older Singaporeans (≥60 years) as of 1 January 2022, divided into low/intermediate/high-risk for frailty; matching weights were utilized to adjust for sociodemographic differences/vaccination uptake at enrolment across frailty categories. Competing-risk-regression (Fine-Gray) taking death as a competing risk, with matching weights applied, was utilized to compare risks of COVID-19-related hospitalizations and severe COVID-19 across frailty levels (low/intermediate/high-risk), with estimates stratified by booster status. Individuals were followed up until study end-date (20 December 2023).</p><p><strong>Results: </strong>874,160 older adults were included during Omicron-predominant transmission; ~10% had intermediate/high-frailty-risk. Risk of hospitalization/severe COVID-19 was elevated in those with intermediate/high-frailty-risk up to XBB/JN.1 transmission. Boosting was associated with decreased risk of COVID-19-related hospitalization across all frailty categories in infection-naïve individuals. However, in infection-naïve older adults with high-frailty-risk, while receipt of first boosters was associated with lower risk of COVID-19-hospitalization/severe COVID-19, additional booster doses did not reduce risk. In reinfected older adults, first boosters were still associated with lower hospitalization risk (adjusted-hazards-ratio, aHR = 0.55, 95% CI = 0.33-0.92) among the non-frail, but not in the intermediate/high-frailty-risk minority.</p><p><strong>Conclusions: </strong>First boosters were associated with reduced adverse COVID-19 outcomes across all frailty categories in infection-naïve older adults during Omicron. However, in the high-frailty minority, boosting did not additionally reduce risk in reinfected individuals with hybrid immunity, and beyond the first booster for infection-naïve individuals.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"13 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FcRn-Driven Nanoengineered Mucosal Vaccine with Multi-Epitope Fusion Induces Robust Dual Immunity and Long-Term Protection Against <i>Brucella</i>.","authors":"Tingting Tian, Yuejie Zhu, Kaiyu Shang, Huidong Shi, Ruixue Xu, Mingzhe Li, Fuling Pu, Junyu Kuang, Jianbing Ding, Fengbo Zhang","doi":"10.3390/vaccines13060567","DOIUrl":"10.3390/vaccines13060567","url":null,"abstract":"<p><strong>Background: </strong>Brucellosis poses a significant public health challenge, necessitating effective vaccine development. Current vaccines have limitations such as safety concerns and inadequate mucosal immunity. This study aims to develop an FcRn-targeted mucosal <i>Brucella</i> vaccine by fusing the human Fc domain with <i>Brucella</i>'s multi-epitope protein (MEV), proposing a novel approach for human brucellosis prevention.</p><p><strong>Methods: </strong>The study developed a recombinant antigen (h-tFc-MEV) through computational analyses to validate antigenicity, structural stability, solubility, and allergenic potential. Molecular simulations confirmed FcRn binding. The vaccine was delivered orally via chitosan nanoparticles in murine models. Immunization was compared to MEV-only immunization. Post-challenge assessments were conducted to evaluate protection against <i>Brucella</i> colonization. Mechanistic studies investigated dendritic cell activation and antigen presentation.</p><p><strong>Results: </strong>Computational analyses showed that the antigen had favorable properties without allergenic potential. Molecular simulations demonstrated robust FcRn binding. In murine models, oral delivery elicited enhanced systemic immunity with elevated serum IgG titers and amplified CD4+/CD8+ T-cell ratios compared to MEV-only immunization. Mucosal immunity was evidenced by significant IgA upregulation across multiple tracts. Long-term immune memory persisted for six months. Post-challenge assessments revealed markedly reduced <i>Brucella</i> colonization in visceral organs. Mechanistic studies identified FcRn-mediated dendritic cell activation through enhanced MHC-II expression and antigen presentation efficiency.</p><p><strong>Conclusions: </strong>The FcRn-targeted strategy establishes concurrent mucosal and systemic protective immunity against <i>Brucella</i> infection. This novel vaccine candidate shows potential for effective human brucellosis prevention, offering a promising approach to address the limitations of current vaccines.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"13 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two Outbreaks of Invasive Pneumococcal Disease in Nursing Homes in Gipuzkoa, Northern Spain.","authors":"José María Marimón, Ayla Manzanal, Olatz Mokoroa, Lorea Alvarez, Maite Rekalde, Diego Vicente","doi":"10.3390/vaccines13060570","DOIUrl":"10.3390/vaccines13060570","url":null,"abstract":"<p><p><b>Background</b>: The aging of the population has increased the number of frail people living in long-term care facilities, underscoring the need for continuous updates in infectious diseases prevention strategies. The aim of this study was to analyze two pneumococcal disease outbreaks in elderly residences in Gipuzkoa, northern Spain, their impact on residents, and the containment measures implemented. <b>Material and methods</b>: The outbreaks took place in 2023 and in 2024 in two residences of 111 and of 155 residents, respectively. Diagnosis was based on clinical criteria, radiological findings, and microbiological techniques. Pneumococcal isolates were characterized by whole-genome sequencing. <b>Results</b>: The outbreaks involved five and six residents, respectively. Most residents in both facilities had been vaccinated with the pneumococcal polysaccharide 23-valent vaccine (PPV23) more than five years prior. The median attack rates were 4.5% and 3.9%, lower than those reported in similar outbreaks. The adopted infection transmission prevention measures successfully limited the spread of the outbreaks. <b>Conclusions</b>: PPV23 vaccination did not prevent invasive pneumococcal infection in the affected residents. The vaccination of elderly people living in long-term care facilities with 20-valent and 21-valent pneumococcal conjugated vaccines should be evaluated as a new preventive measure.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"13 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Immuno-Response and Risk of Breakthrough Infection After SARS-CoV-2 Vaccination in Kidney Transplantation.","authors":"Vincenzo Bellizzi, Mario Fordellone, Carmine Secondulfo, Paolo Chiodini, Giancarlo Bilancio","doi":"10.3390/vaccines13060566","DOIUrl":"10.3390/vaccines13060566","url":null,"abstract":"<p><p><b>Background</b>: Kidney transplant (KTx) recipients exhibit impaired responses to SARS-CoV-2 vaccination. Correlates of vaccine-induced immunity and risk factors for breakthrough infection are not fully defined. This study evaluated the humoral response trajectories and determinants of breakthrough infection in KTx recipients. <b>Methods</b>: KTx recipients received two doses of the BNT162b2 mRNA vaccine three weeks apart and a booster after six months. Patients were categorized based on pre-vaccination status: previous COVID-19 disease (DIS), asymptomatic SARS-CoV-2 infection (INF), or infection-naïve (NEG). Serum anti-spike antibody titers were assessed at baseline, before the second dose, and at 1, 3, 6, 9, and 12 months. Linear mixed models and survival analyses were performed. <b>Results</b>: Of 326 enrolled patients, 189 with complete time-point data were included in the longitudinal analysis. Antibodies were detectable in 89% of DIS/INF at baseline and 91% before the second dose, but were negligible in NEG. In NEG, the seropositivity increased after vaccination and booster, reaching 78% at 12 months. Age (-5% per year, <i>p</i> < 0.001) and BMI (+10% per unit, <i>p</i> = 0.004) influenced titers; antimetabolites and steroids had strong negative effects (-70%, <i>p</i> = 0.005; -84%, <i>p</i> = 0.001). Breakthrough infections occurred in 104 (31.9%); 40% were asymptomatic, and 2 patients died. An mTOR inhibitor was associated with a reduced infection risk (OR 0.27 [CI: 0.09-0.70], <i>p</i> = 0.009). Higher antibody titers correlated with delayed infection (<i>p</i> = 0.063). <b>Conclusions</b>: In KTx patients, humoral response to SARS-CoV-2 vaccination is limited in infection-naïve patients but improved by booster dosing; the hybrid immunity is more effective. Immunosuppressive regimens influence the immune response, and mTOR inhibitors may protect against breakthrough infection.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"13 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}