浆细胞增生症患者接种第二或第三剂重症急性呼吸综合症冠状病毒2型mRNA疫苗后的体液和细胞免疫反应。
Humoral and cellular immune response to second and third severe acute respiratory syndrome coronavirus 2 mRNA vaccine in patients with plasma cell dyscrasia.
发表日期：2023 Apr 26
作者：
Tomotaka Suzuki, Shigeru Kusumoto, Yoshiko Kamezaki, Hiroya Hashimoto, Nozomi Nishitarumizu, Yoko Nakanishi, Yukiyasu Kato, Akimi Kawai, Naohiro Matsunaga, Toru Ebina, Tomoyuki Nakamura, Yoshiaki Marumo, Kana Oiwa, Shiori Kinoshita, Tomoko Narita, Asahi Ito, Atsushi Inagaki, Masaki Ri, Hirokazu Komatsu, Takashi Aritsu, Shinsuke Iida
来源：
Cellular & Molecular Immunology
摘要：
重点开发的新型冠状病毒肺炎病毒2 (SARS-CoV-2) mRNA 疫苗使用历史较短，尚需进一步的研究以了解其在免疫功能受损情况下的有效性，例如浆细胞增生性疾病(PCD)。我们对109名患有PCD的患者进行了回顾性研究，在第二和第三次mRNA疫苗接种后（分别为第二和第三剂），测量了血清中针对刺突蛋白的SARS-CoV-2抗体(S-IgG)。我们评估了具有充分体液反应(即S-IgG滴度≥300抗体单位/毫升)的患者比例。虽然在疫苗接种前进行的活动性抗骨髓瘤治疗对充分体液反应具有显著负面影响，但包括免疫调节药物、蛋白酶体抑制剂和单克隆抗体在内的特定药物亚类并没有出现负面关联，除了B细胞成熟抗原靶向治疗。第3剂(加强剂疫苗)导致S-IgG滴度显著升高，并有更多的患者获得了充分的体液反应。此外，使用T-spot发现SARS-CoV-2检测套件评估疫苗诱导的细胞免疫反应后，研究发现第3剂剂量导致了增强的细胞免疫反应。本研究突出了在免疫功能受损的PCD患者中加强SARS-CoV-2 mRNA疫苗接种对体液和细胞免疫的重要性。此外，本研究突出了某些药物亚类对疫苗诱导的体液免疫反应可能产生的影响。©2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
The recently developed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine has a short history of use and further information is needed regarding its efficacy, especially in immunocompromised conditions, such as plasma cell dyscrasia (PCD).We retrospectively measured serum SARS-CoV-2 antibodies against the spike protein (S-IgG) after the second and third mRNA vaccine doses (doses 2 and 3, respectively) in 109 patients with PCD. We evaluated the proportion of patients with an adequate humoral response (defined as S-IgG titers ≥300 antibody units/mL).Although active anti-myeloma treatments prior to vaccination had a significantly negative impact on adequate humoral response, specific drug subclasses including immunomodulatory drugs, proteasome inhibitors, and monoclonal antibodies were not negatively associated, except for B-cell maturation antigen-targeted therapy. Dose 3 (booster vaccination) led to significantly higher S-IgG titers and more patients acquired an adequate humoral response. Furthermore, evaluation of vaccine-induced cellular immune response in patients using T-spot Discovery SARS-CoV-2 kit, revealed an enhanced cellular immune response after Dose 3.This study highlighted the significance of booster SARS-CoV-2 mRNA vaccination in patients with PCD with respect to humoral and cellular immunity. Moreover, this study highlighted the potential impact of certain drug subclasses on vaccine-induced humoral immune response.© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.