妊娠期SARS-CoV-2突破感染优先引起IgG4应答和胎盘转移增强

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-07-09 DOI:10.1016/j.vaccine.2025.127476

Sheridan B. Wagner , Monica Rincon , Katelyn E. Keen , Gregory S. Hawk , Nicole E. Marshall , Ilhem Messaoudi

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引用次数: 0

摘要

SARS-CoV-2变体的出现和体液免疫的减弱导致突破性感染的发生率增加。孕妇和新生儿特别容易受到与COVID-19相关的不良后果的影响。目的评价突破感染、未接种疫苗者感染和妊娠期未接种疫苗者接种疫苗后母体抗sars - cov -2 IgG反应和抗体向胎儿的胎盘转移情况。方法在俄勒冈健康中心(Oregon Health &；并根据感染和疫苗接种状况分配到三个队列。采用ELISA纵向测定孕妇血液和母乳、分娩时孕妇血液、脐带血液和新生儿血液中受体结合域（RBD）和核衣壳蛋白（NP）特异性IgG终点滴度（EPT）和光密度（OD）值。结果与母体血浆和母乳中单独感染或接种疫苗相比，接种疫苗的参与者的突破性感染诱导了更高的母体rbd特异性IgG反应。据报道，通过反复接种疫苗，突破感染使rbd特异性IgG反应向IgG4反应倾斜。突破感染和未接种/感染组中，IgG1和IgG3是主要的np特异性亚类。突破感染组新生儿与产妇的rbd特异性IgG比值最高，产妇与新生儿滴度之间有很强的相关性。结论妊娠期突破感染可延长已存在的体液免疫，促进抗体经胎盘向新生儿的转移，这反映了预先接种疫苗而非单独感染引起的抗体启动效应。这些结果证明在怀孕期间继续接种最新的SARS-CoV-2疫苗，以降低疾病严重程度并为新生儿提供更好的保护。

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SARS-CoV-2 breakthrough infection during pregnancy preferentially elicits IgG4 response and enhanced placental-transfer

Background

Emerging SARS-CoV-2 variants and waning humoral immunity have led to increased occurrences of breakthrough infection. Pregnant individuals and neonates are particularly vulnerable to adverse outcomes associated with COVID-19.

Objective

We aimed to evaluate the maternal anti-SARS-CoV-2 IgG response and the placental transfer of antibodies to the fetus following breakthrough infection, infection in unvaccinated participants, and vaccination in the absence of infection during pregnancy.

Methods

Pregnant patients (n = 165) were enrolled at Oregon Health & Science University and assigned to three cohorts based on infection and vaccination status. Receptor-binding domain (RBD) and nucleocapsid protein (NP) specific IgG endpoint titers (EPT) and optical density (OD) values were determined via ELISA longitudinally in maternal blood and breastmilk, and at delivery in paired maternal, umbilical cord, and newborn blood.

Results

Breakthrough infection in vaccinated participants induced a higher maternal RBD-specific IgG response compared to infection or vaccination alone in maternal plasma and breastmilk. As reported with repeated vaccination, breakthrough infection skewed RBD-specific IgG responses toward an IgG4 response. IgG1 and IgG3 were the dominant NP-specific subclasses for both breakthrough infection and unvaccinated/infection groups. The breakthrough infection cohort had the highest newborn-to-maternal ratio of RBD-specific IgG with a strong correlation between maternal and newborn delivery titers.

Conclusion

Breakthrough infection during pregnancy prolongs pre-existing humoral immunity and facilitates the transplacental transfer of antibodies to the neonate, reflecting an antibody priming effect induced by prior vaccination rather than infection alone. These results warrant continued administration of updated SARS-CoV-2 vaccination during pregnancy to reduce disease severity and provide greater protection to newborns.

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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