免疫介导肾脏疾病患者接种 COVID-19 疫苗的前景:ERA-IWG 和 EUVAS 的共识声明。

IF 0.5 4区 农林科学 Q4 ENTOMOLOGY
Kate I Stevens, Eleni Frangou, Jae I L Shin, Hans-Joachim Anders, Annette Bruchfeld, Ulf Schönermarck, Thomas Hauser, Kerstin Westman, Gema M Fernandez-Juarez, Jürgen Floege, Dimitrios Goumenos, Kultigin Turkmen, Cees van Kooten, Stephen P McAdoo, Vladimir Tesar, Mårten Segelmark, Duvuru Geetha, David R W Jayne, Andreas Kronbichler
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引用次数: 0

摘要

免疫介导的肾脏疾病患者罹患严重冠状病毒病 2019(COVID-19)的风险增加。COVID-19 疫苗在国际上的推广提供了不同程度的保护,使人们能够了解疫苗的有效性和安全性。大多数免疫介导的肾脏疾病患者对 COVID-19 疫苗的免疫反应较低;这可能与免疫抑制或基础疾病引起的合并症和并发症有关。在接受利妥昔单抗、霉酚酸酯 (MMF)、高剂量糖皮质激素以及环磷酰胺等其他免疫抑制剂的患者中,通过抗体的存在来衡量的体液疫苗反应会受到影响或消失。使用这些药物和接种疫苗之间的时机与免疫反应水平有关:使用利妥昔单抗时,只有在 B 细胞开始恢复后才能预期疫苗反应,而一过性停用 MMF 的患者会更频繁地产生体液反应。COVID-19 新变种的出现和疫苗诱导免疫力的减弱凸显了加强剂量的价值和开发防突变疫苗的必要性。COVID-19 疫苗是安全的,发生新发或复发免疫介导肾病的风险非常低。基于人群的研究将确定这是因果关系还是巧合。此类病例可接受标准治疗,包括使用免疫抑制剂。免疫肾脏病工作组和欧洲脉管炎协会建议免疫介导的肾脏疾病患者遵循国家疫苗接种指南。可考虑根据抗体测量结果加强剂量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Perspective on COVID-19 vaccination in patients with immune-mediated kidney diseases: consensus statements from the ERA-IWG and EUVAS.

Patients with immune-mediated kidney diseases are at increased risk of severe coronavirus disease 2019 (COVID-19). The international rollout of COVID-19 vaccines has provided varying degrees of protection and enabled the understanding of vaccine efficacy and safety. The immune response to COVID-19 vaccines is lower in most patients with immune-mediated kidney diseases; either related to immunosuppression or comorbidities and complications caused by the underlying disease. Humoral vaccine response, measured by the presence of antibodies, is impaired or absent in patients receiving rituximab, mycophenolate mofetil (MMF), higher doses of glucocorticoids and likely other immunosuppressants, such as cyclophosphamide. The timing between the use of these agents and administration of vaccines is associated with the level of immune response: with rituximab, vaccine response can only be expected once B cells start to recover and patients with transient discontinuation of MMF mount a humoral response more frequently. The emergence of new COVID-19 variants and waning of vaccine-induced immunity highlight the value of a booster dose and the need to develop mutant-proof vaccines. COVID-19 vaccines are safe, exhibiting a very low risk of de novo or relapsing immune-mediated kidney disease. Population-based studies will determine whether this is causal or coincidental. Such cases respond to standard management, including the use of immunosuppression. The Immunonephrology Working Group and European Vasculitis Society recommend that patients with immune-mediated kidney diseases follow national guidance on vaccination. Booster doses based on antibody measurements could be considered.

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来源期刊
Aquatic Insects
Aquatic Insects 生物-昆虫学
CiteScore
2.00
自引率
25.00%
发文量
27
审稿时长
>12 weeks
期刊介绍: Aquatic Insects is an international journal publishing original research on the systematics, biology, and ecology of aquatic and semi-aquatic insects. The subject of the research is aquatic and semi-aquatic insects, comprising taxa of four primary orders, the Ephemeroptera, Odonata, Plecoptera, and Trichoptera but also aquatic and semi-aquatic families of Hemiptera, Coleoptera, and Diptera, as well as specific representatives of Hymenoptera , Lepidoptera, Mecoptera, Megaloptera , and Neuroptera that occur in lotic and lentic habitats during part of their life cycle. Studies on other aquatic Hexapoda (i.e., Collembola) will be only accepted if space permits. Papers on other aquatic Arthropoda (e.g., Crustacea) will not be considered, except for those closely related to aquatic and semi-aquatic insects (e.g., water mites as insect parasites). The topic of the research may include a wide range of biological fields. Taxonomic revisions and descriptions of individual species will be accepted especially if additional information is included on habitat preferences, species co-existing, behavior, phenology, collecting methods, etc., that are of general interest to an international readership. Descriptions based on single specimens are discouraged. Detailed studies on morphology, physiology, behavior, and phenology of aquatic insects in all stadia of their life cycle are welcome as well as the papers with molecular and phylogenetic analyses, especially if they discuss evolutionary processes of the biological, ecological, and faunistic formation of the group.
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