BA.1/BA.5 Immunogenicity, Reactogenicity, and Disease Activity after COVID-19 Vaccination in Patients with ANCA-Associated Vasculitis: A Prospective Observational Cohort Study

被引：1

作者：

Speer, Claudius ^{[1
,2
]}

Toellner, Maximilian ^{[1
]}

Benning, Louise ^{[1
]}

Bartenschlager, Marie ^{[3
]}

Kim, Heeyoung ^{[3
]}

Nusshag, Christian ^{[1
]}

Kaelble, Florian ^{[1
]}

Reineke, Marvin ^{[1
]}

Reichel, Paula ^{[1
]}

Schnitzler, Paul ^{[4
]}

Zeier, Martin ^{[1
]}

Morath, Christian ^{[1
]}

Schmitt, Wilhelm ^{[5
]}

Bergner, Raoul ^{[6
]}

Bartenschlager, Ralf ^{[3
,7
,8
]}

Lorenz, Hanns-Martin ^{[9
]}

Schaier, Matthias ^{[1
]}

机构：

[1] Univ Hosp Heidelberg, Dept Nephrol, D-69120 Heidelberg, Germany

[2] EMBL, Mol Med Partnership Unit Heidelberg, D-69120 Heidelberg, Germany

[3] Heidelberg Univ, Med Fac Heidelberg, Ctr Integrat Infect Dis Res, Dept Infect Dis,Mol Virol, D-68167 Heidelberg, Germany

[4] Univ Hosp Heidelberg, Dept Infect Dis, Virol, D-69120 Heidelberg, Germany

[5] Ctr Renal Dis, D-69469 Weinheim, Germany

[6] Clin Ctr Ludwigshafen, Dept Internal Med A, D-67071 Ludwigshafen, Germany

[7] German Ctr Infect Res DZIF, Heidelberg Partner Site, D-69120 Heidelberg, Germany

[8] German Canc Res Ctr, Div Virus Associated Carcinogenesis, D-69120 Heidelberg, Germany

[9] Heidelberg Univ, Dept Med 5, Div Rheumatol, D-69120 Heidelberg, Germany

来源：

VIRUSES-BASEL | 2023年 / 15卷 / 08期

关键词：

ANCA-associated vasculitis; COVID-19; vaccination; omicron subtypes; neutralizing antibodies; ANTIBODY-RESPONSE; SARS-COV-2; VACCINES;

D O I：

10.3390/v15081778

中图分类号：

Q93 [微生物学];

学科分类号：

071005 ; 100705 ;

摘要：

Emerging omicron subtypes with immune escape lead to inadequate vaccine response with breakthrough infections in immunocompromised individuals such as Anti-neutrophil Cytoplasmic Antibody (ANCA)-associated vasculitis (AAV) patients. As AAV is considered an orphan disease, there are still limited data on SARS-CoV-2 vaccination and prospective studies that have focused exclusively on AAV patients are lacking. In addition, there are safety concerns regarding the use of highly immunogenic mRNA vaccines in autoimmune diseases, and further studies investigating reactogenicity are urgently needed. In this prospective observational cohort study, we performed a detailed characterization of neutralizing antibody responses against omicron subtypes and provided a longitudinal assessment of vaccine reactogenicity and AAV disease activity. Different vaccine doses were generally well tolerated and no AAV relapses occurred during follow-up. AAV patients had significantly lower anti-S1 IgG and surrogate-neutralizing antibodies after first, second, and third vaccine doses as compared to healthy controls, respectively. Live-virus neutralization assays against omicron subtypes BA.1 and BA.5 revealed that previous SARS-CoV-2 vaccines result in an inadequate neutralizing immune response in immunocompromised AAV patients. These data demonstrate that new vaccination strategies including adapted mRNA vaccines against epitopes of emerging variants are needed to help protect highly vulnerable individuals such as AAV patients.

引用

页数：17

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