{"title":"阻塞性睡眠呼吸暂停严重程度和治疗对COVID-19疫苗诱导的免疫反应的影响","authors":"Lan Chen, Sun Zhang, Zhao Chen, Jinling Cheng, Canjie Chen, Tian Tang, Jingxian Zhao, Jincun Zhao, Nanshan Zhong, Nuofu Zhang, Airu Zhu","doi":"10.21037/jtd-2025-391","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is a common disorder linked to immune dysregulation and increased risk of severe coronavirus disease 2019 (COVID-19) outcomes. While vaccination is essential for preventing infection and severe disease, the impact of OSA on vaccine efficacy remains underexplored. This study examines the effects of OSA on immune responses following the third dose of the inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine (CoronaVac or BBIBP-CorV).</p><p><strong>Methods: </strong>A total of 97 severe OSA participants with apnea-hypopnea index (AHI) >30 events/hour, and 88 healthy donors (HDs) were enrolled. Among the OSA participants, 43 individuals without symptomatic treatment before and during follow-up were designated as the untreated OSA group, while 41 participants receiving positive airway pressure (PAP) prior to the third COVID-19 vaccine dose were categorized as the treated OSA group. Full-night polysomnography (PSG) was performed to assess OSA severity. Neutralizing antibody (nAb) levels and cellular immune responses were analyzed at multiple time points following booster vaccination.</p><p><strong>Results: </strong>Immune responses in untreated OSA participants were inversely associated with disease severity. Specifically, untreated OSA participants with AHI >50 events/hour exhibited significantly reduced nAb titers, antibody-secreting cell (ASC) frequencies, and circulating T follicular helper (cTfh) cells, indicating impaired immune recall responses. In contrast, PAP-treated OSA participants demonstrated improved humoral responses, notably at peak immune response stages.</p><p><strong>Conclusions: </strong>These findings highlight a severity-dependent impairment of vaccine-induced immune responses in untreated OSA participants, with evidence that PAP treatment may enhance vaccine efficacy. This study emphasizes the need to consider OSA severity and treatment when optimizing vaccination strategies for this population.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 8","pages":"5610-5625"},"PeriodicalIF":1.9000,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433113/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of obstructive sleep apnea severity and treatment on COVID-19 vaccine-induced immune responses.\",\"authors\":\"Lan Chen, Sun Zhang, Zhao Chen, Jinling Cheng, Canjie Chen, Tian Tang, Jingxian Zhao, Jincun Zhao, Nanshan Zhong, Nuofu Zhang, Airu Zhu\",\"doi\":\"10.21037/jtd-2025-391\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is a common disorder linked to immune dysregulation and increased risk of severe coronavirus disease 2019 (COVID-19) outcomes. While vaccination is essential for preventing infection and severe disease, the impact of OSA on vaccine efficacy remains underexplored. This study examines the effects of OSA on immune responses following the third dose of the inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine (CoronaVac or BBIBP-CorV).</p><p><strong>Methods: </strong>A total of 97 severe OSA participants with apnea-hypopnea index (AHI) >30 events/hour, and 88 healthy donors (HDs) were enrolled. Among the OSA participants, 43 individuals without symptomatic treatment before and during follow-up were designated as the untreated OSA group, while 41 participants receiving positive airway pressure (PAP) prior to the third COVID-19 vaccine dose were categorized as the treated OSA group. Full-night polysomnography (PSG) was performed to assess OSA severity. Neutralizing antibody (nAb) levels and cellular immune responses were analyzed at multiple time points following booster vaccination.</p><p><strong>Results: </strong>Immune responses in untreated OSA participants were inversely associated with disease severity. Specifically, untreated OSA participants with AHI >50 events/hour exhibited significantly reduced nAb titers, antibody-secreting cell (ASC) frequencies, and circulating T follicular helper (cTfh) cells, indicating impaired immune recall responses. In contrast, PAP-treated OSA participants demonstrated improved humoral responses, notably at peak immune response stages.</p><p><strong>Conclusions: </strong>These findings highlight a severity-dependent impairment of vaccine-induced immune responses in untreated OSA participants, with evidence that PAP treatment may enhance vaccine efficacy. This study emphasizes the need to consider OSA severity and treatment when optimizing vaccination strategies for this population.</p>\",\"PeriodicalId\":17542,\"journal\":{\"name\":\"Journal of thoracic disease\",\"volume\":\"17 8\",\"pages\":\"5610-5625\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-08-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433113/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of thoracic disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21037/jtd-2025-391\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of thoracic disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/jtd-2025-391","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/28 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Impact of obstructive sleep apnea severity and treatment on COVID-19 vaccine-induced immune responses.
Background: Obstructive sleep apnea (OSA) is a common disorder linked to immune dysregulation and increased risk of severe coronavirus disease 2019 (COVID-19) outcomes. While vaccination is essential for preventing infection and severe disease, the impact of OSA on vaccine efficacy remains underexplored. This study examines the effects of OSA on immune responses following the third dose of the inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine (CoronaVac or BBIBP-CorV).
Methods: A total of 97 severe OSA participants with apnea-hypopnea index (AHI) >30 events/hour, and 88 healthy donors (HDs) were enrolled. Among the OSA participants, 43 individuals without symptomatic treatment before and during follow-up were designated as the untreated OSA group, while 41 participants receiving positive airway pressure (PAP) prior to the third COVID-19 vaccine dose were categorized as the treated OSA group. Full-night polysomnography (PSG) was performed to assess OSA severity. Neutralizing antibody (nAb) levels and cellular immune responses were analyzed at multiple time points following booster vaccination.
Results: Immune responses in untreated OSA participants were inversely associated with disease severity. Specifically, untreated OSA participants with AHI >50 events/hour exhibited significantly reduced nAb titers, antibody-secreting cell (ASC) frequencies, and circulating T follicular helper (cTfh) cells, indicating impaired immune recall responses. In contrast, PAP-treated OSA participants demonstrated improved humoral responses, notably at peak immune response stages.
Conclusions: These findings highlight a severity-dependent impairment of vaccine-induced immune responses in untreated OSA participants, with evidence that PAP treatment may enhance vaccine efficacy. This study emphasizes the need to consider OSA severity and treatment when optimizing vaccination strategies for this population.
期刊介绍：
The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.
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