心脏移植受者对SARS-CoV-2疫苗的免疫反应:一项系统综述

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2022-01-01 DOI:10.1177/11795484221105327

Saeed Shoar, Adriana C. Carolina Prada-Ruiz, Gabriel Patarroyo-Aponte, A. Chaudhary, Mohammad Sadegh Asadi

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引用次数: 3

摘要

背景心脏移植(HTX)受者在感染SARS-CoV-2时，由于慢性免疫抑制和其他慢性疾病的共存，不良临床结果的风险明显更高。虽然针对SARS-CoV-2的疫苗接种是目前在实体器官移植受者中预防2019年严重冠状病毒病(COVID-19)最有希望的措施，但HTX患者的免疫反应程度及其保护效果尚未得到充分研究。方法通过查询PubMed/Medline对文献进行系统回顾，以确定在至少接受过一剂SARS-CoV-2疫苗的HTX接受者中进行的原始研究。从所有符合条件的研究中收集体液或细胞免疫反应的测量数据。在这些研究中进一步调查了与免疫反应不良相关的因素。结果共纳入12项研究，563名HTX受者。研究参与者的平均年龄为60.8岁。64%的研究对象为男性。90%的患者接受了mRNA疫苗(Pfizer/ BNT162b2或Moderna/mRNA-1273)。0%至100%的患者报告了对SARS-CoV-2疫苗的阳性免疫反应。年龄(> 65岁)、疫苗剂量(第一次、第二次或第三次)、从HTX到第一次接种疫苗的时间、最近一次接种疫苗与免疫反应测量之间的时间间隔以及免疫抑制方案的类型都被认为是对SARS-CoV-2疫苗接种产生强大免疫反应的潜在决定因素。结论与普通人群相比，HTX受者对SARS-CoV-2疫苗的免疫反应较弱。年龄较大，抗代谢物药物如霉酚酸酯，以及HTX后第一年接种疫苗已被认为是不良免疫反应的潜在决定因素。

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Immune Response to SARS-CoV-2 Vaccine among Heart Transplant Recipients: A Systematic Review

Background Heart transplant (HTX) recipients are at a significantly higher risk of adverse clinical outcomes, due to chronic immunosuppression and co-existence of other chronic conditions, when contracting the SARS-CoV-2 infection. Although vaccination against SARS-CoV-2 is currently the most promising measure for the prevention of severe Coronavirus Disease 2019 (COVID-19) among solid organ transplant recipients, the extent of immune response and its protective efficacy among patients receiving HTX has not been sufficiently studied. Methods We performed a systematic review of the literature by inquiring PubMed/Medline to identify original studies among HTX recipients, who had received at least one dose of the SARS-CoV-2 vaccine. Data on the measured humoral or cellular immune response was collected from all the eligible studies. Factors associated with a poor immune response were further investigated within these studies. Results A total of 12 studies comprising 563 HTX recipients were included. The average age of the study participants was 60.8 years. Sixty four percent of the study population were male. Ninety percent of the patients had received an mRNA vaccine (Pfizer/ BNT162b2 or Moderna/mRNA-1273). A positive immune response to SARS-CoV-2 vaccine was variably reported in 0% to 100% of the patients. Older age (> 65 years), vaccine dose (first, second, or third), time since HTX to the first dose of the vaccine, the time interval between the latest dose of the vaccine and measurement of the immune response, and the type of immunosuppressive regimen were all indicated as potential determinants of a robust immune response to the SARS-CoV-2 vaccination. Conclusion HTX recipients demonstrate a weaker immune response to the vaccination against SARS-CoV-2 compared to the general population. Older age, anti-metabolite agents such as mycophenolate mofetil, and vaccination during the first year following the HTX have been indicated as potential determinants of a poor immune response.

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.