第三次疫苗强化剂和抗 S-IgG 水平:肝细胞癌中同源反应和异源反应以及不良免疫原性的比较。

The Kaohsiung journal of medical sciences Pub Date : 2024-05-01 Epub Date: 2024-02-16 DOI:10.1002/kjm2.12812
Chih-Wen Wang, Chung-Feng Huang, Tyng-Yuan Jang, Ming-Lun Yeh, Po-Cheng Liang, Yu-Ju Wei, Po-Yao Hsu, Ching-I Huang, Ming-Yen Hsieh, Yi-Hung Lin, Jee-Fu Huang, Chia-Yen Dai, Wan-Long Chuang, Ming-Lung Yu
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引用次数: 0

摘要

慢性肝病患者在接种第二剂2019年冠状病毒病(COVID-19)疫苗后免疫反应往往较低,但第三剂疫苗对其免疫反应的影响目前尚不清楚。我们从三家医院招募了722名既往未感染严重急性呼吸系统综合征冠状病毒2(SARS-CoV-2)的患者。患者接受了同源(MMM)和异源(AZAZBNT、AZAZM)强化免疫,其中AZ、BNT和M分别表示AZD1222、BNT162b2和mRNA-1273疫苗。血清 IgG 尖峰抗体水平分别在第三次疫苗强化免疫后平均 1.5 ± 0.7(第 1 次就诊)和 5.0 ± 0.5(第 2 次就诊)个月时进行测量。4160 AU/mL的阈值被认为具有显著的抗体活性。在两次检查中,接受 MMM 加强剂的患者的抗 S-IgG 水平均高于接受 AZAZBNT 和 AZAZM 加强剂的患者。活动性肝细胞癌(HCC)患者在第一次就诊时的抗-S-IgG水平低于对照组(761.6 对 1498.2 BAU/mL;p = 0.019)。第 2 次就诊时,抗 S-IgG 水平明显下降。抗体活性明显的患者中,肝硬化失代偿率(0.7% 失代偿 vs. 8.0% 非失代偿和 91.3% 非肝硬化,p = 0.015)和活动性 HCC(1.5% 活动性 HCC vs. 3.7% 非活动性 HCC 和 94.7% 非 HCC,p = 0.015)较低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Third vaccine boosters and anti-S-IgG levels: A comparison of homologous and heterologous responses and poor immunogenicity in hepatocellular carcinoma.

The immune response of patients with chronic liver disease tends to be lower after receiving their second coronavirus disease 2019 (COVID-19) vaccine dose, but the effect of a third vaccine dose on their immune response is currently unknown. We recruited 722 patients without previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection from three hospitals. The patients received homologous (MMM) and heterologous (AZAZBNT, AZAZM) boosters, where AZ, BNT, and M denoted the AZD1222, BNT162b2, and mRNA-1273 vaccines, respectively. Serum IgG spike antibody levels were measured at a mean 1.5 ± 0.7 (visit 1) and 5.0 ± 0.5 (visit 2) months after the third vaccine booster. A threshold of 4160 AU/mL was considered significant antibody activity. In both visits, the patients who received the MMM booster had higher anti-S-IgG levels than those who received the AZAZBNT and AZAZM boosters. Patients with active hepatocellular carcinoma (HCC) had lower anti-S-IgG levels than the control group (761.6 vs. 1498.2 BAU/mL; p = 0.019) at visit 1. The anti-S-IgG levels decreased significantly at visit 2. The patients with significant antibody activity had a lower rate of liver cirrhosis with decompensation (0.7% decompensation vs. 8.0% non-decompensation and 91.3% non-liver cirrhosis, p = 0.015), and active HCC (1.5% active HCC vs. 3.7% non-active HCC and 94.7% non-HCC, p < 0.001). Receiving the MMM booster regimen (OR = 10.67, 95% CI 5.20-21.91, p < 0.001) increased the odds of having significant antibody activity compared with the AZAZBNT booster regimen. Patients with active HCC had a reduced immune response to the third COVID-19 vaccine booster. These findings underscore the importance of booster vaccinations, especially in immunocompromised patients, with superior efficacy observed with the homologous mRNA-1273 regimen.

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