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肾移植受者接种新型冠状病毒疫苗的最新进展

刘琪星, 李月红. 肾移植受者接种新型冠状病毒疫苗的最新进展[J]. 器官移植, 2023, 14(1): 135-141. doi: 10.3969/j.issn.1674-7445.2023.01.018
引用本文: 刘琪星, 李月红. 肾移植受者接种新型冠状病毒疫苗的最新进展[J]. 器官移植, 2023, 14(1): 135-141. doi: 10.3969/j.issn.1674-7445.2023.01.018
Liu Qixing, Li Yuehong. The latest progress on novel coronavirus vaccination in kidney transplant recipients[J]. ORGAN TRANSPLANTATION, 2023, 14(1): 135-141. doi: 10.3969/j.issn.1674-7445.2023.01.018
Citation: Liu Qixing, Li Yuehong. The latest progress on novel coronavirus vaccination in kidney transplant recipients[J]. ORGAN TRANSPLANTATION, 2023, 14(1): 135-141. doi: 10.3969/j.issn.1674-7445.2023.01.018

肾移植受者接种新型冠状病毒疫苗的最新进展

doi: 10.3969/j.issn.1674-7445.2023.01.018
基金项目: 

北京市科技计划“首都临床诊疗技术研究及示范应用” Z191100006619001

清华大学研究生教育教学改革项目 202104J057

详细信息
    作者简介:
    通讯作者:

    李月红,主任医师,研究方向为肾移植,Email:lyha01051@btch.edu.cn

  • 中图分类号: R617, R392

The latest progress on novel coronavirus vaccination in kidney transplant recipients

More Information
  • 摘要: 肾移植受者由于长期服用免疫抑制药,免疫功能低下,感染新型冠状病毒后有更高的重症风险,对该高风险人群进行预防性接种疫苗至关重要。但有证据表明,肾移植受者对新型冠状病毒疫苗的免疫反应显著弱于健康人群,美国的标准接种方案如接种2针信使核糖核酸(mRNA)疫苗并不足以为肾移植受者提供足够的保护作用。已有多项研究证明增加肾移植受者疫苗接种的次数能够提高疫苗的效力,而调整免疫抑制治疗对提高疫苗效力的证据仍十分有限。本文就肾移植受者接种新型冠状病毒疫苗的重要性、有效性、特殊性以及免疫抑制治疗对新型冠状病毒疫苗效力影响进行综述,以期为肾移植受者的疫苗接种提供参考。

     

  • 表  1  未感染新型冠状病毒的器官移植受者接种2针或3针mRNA疫苗后血清学转换率

    Table  1.   Seroconversion of organ transplant recipients without previous novel coronavirus history after vaccinated with the 2nd or 3rd doses of mRNA vaccine

    研究者 受者类型 例数(n) 疫苗接种次数 评估距最后一次接种的时间 血清学转换率(%) 备注
    Sattler A, et al[10] 肾移植 39 2针BNT162b2 8 d 2.5 S蛋白特异辅助T细胞反应较对照和透析人群显著降低,S蛋白特异CD8+T细胞反应几乎检测不到
    Benning L, et al[12] 肾移植 135 2针BNT162b2或mRNA-1273或ChAdOx1 nCoV-19 21 d 30 健康对照者的血清学转换率为100%
    Kamar N, et al[14] 实体器官移植肾移植 10178 3针BNT162b2 30 d 68 在59例第2针疫苗接种仍血清学阴性的受者中有26例(44%)在第3针疫苗接种后出现血清学转换
    Benotmane I, et al[15] 肾移植 159 3针mRNA-1273 51 d 49 第2针疫苗接种后有微弱免疫反应的受者对第3针有反应的可能性高于第2针疫苗接种后无反应的受者(81.3%比27.4%)
    Hall VG, et al[16] 实体器官移植 120 3针mRNA-1273 30 d 55 随机对照试验,接种加强针组与安慰剂组的血清学转换率为55%比18%
    Massa F, et al[18] 肾移植 61 3针BNT162b2 28 d 62.3 接种第2针和第3针疫苗后的S蛋白特异的干扰素-γ释放细胞平均有19.9和64.0个/100万个外周血细胞
    Rozen-Zvi B, et al[27] 肾移植 308 2针BNT162b2 2~4周 38.4 低剂量抗代谢药物、低血CNI浓度、不使用mTOR抑制剂与血清学转换相关
    Chavarot N, et al[30] 肾移植 35 2针BNT162b2 28 d 5.7 均使用了贝拉西普
    Benotmane I, et al[32] 肾移植 204 2针mRNA-1273 28 d 48 第1针疫苗接种后血清学阳性的受者接种第2针后有更高的抗体滴度
    Grupper A, et al[33] 肾移植 136 2针BNT162b2 10~20 d 37.5 接种后症状与血清学转换无相关性
    Marion O, et al[34] 实体器官移植肾移植 367271 2针BNT162b2 28 d 33 肝移植受者较其他器官受者有更好的体液免疫反应
    Cucchiari D, et al[35] 肾移植 117 2针mRNA-1273 2周 29.9 65%的患者存在体液免疫反应或细胞免疫反应
    Midtvedt K, et al[36] 肾移植 141 2针BNT162b2 25~89 d 18 受者年龄较大,中位数为75岁
    Werbel WA, et al[37] 实体器官移植肾移植 3023 3针mRNA-1273或BNT162b2或ad26.COV2.S 14 d 46.6 15例受者第3针接种了ad26.COV2.S
    Stumpf J, et al[38] 肾移植 48 3针BNT162b2 30 d 40 26%的受者在接种3针疫苗后有细胞免疫反应
    注:①血清学转换指接种疫苗后在血清中检测到抗S蛋白IgG。
    ②ChAdOx1 nCoV-19是由牛津大学和阿斯利康合作研发的一种腺病毒载体疫苗。
    ③ad26.COV2.S是强生公司研发的一种腺病毒载体疫苗。
    下载: 导出CSV
  • [1] CAILLARD S, ANGLICHEAU D, MATIGNON M, et al. An initial report from the French SOT COVID Registry suggests high mortality due to COVID-19 in recipients of kidney transplants[J]. Kidney Int, 2020, 98(6): 1549-1558. DOI: 10.1016/j.kint.2020.08.005.
    [2] CRAVEDI P, MOTHI SS, AZZI Y, et al. COVID-19 and kidney transplantation: results from the TANGO International Transplant Consortium[J]. Am J Transplant, 2020, 20(11): 3140-3148. DOI: 10.1111/ajt.16185.
    [3] GANDOLFINI I, CRESPO M, HELLEMANS R, et al. Issues regarding COVID-19 in kidney transplantation in the ERA of the Omicron variant: a commentary by the ERA Descartes Working Group[J]. Nephrol Dial Transplant, 2022, 37(10): 1824-1829. DOI: 10.1093/ndt/gfac203.
    [4] COCHRAN W, SHAH P, BARKER L, et al. COVID-19 clinical outcomes in solid organ transplant recipients during the Omicron surge[J]. Transplantation, 2022, 106(7): e346-e347. DOI: 10.1097/TP.0000000000004162.
    [5] BERTRAND D, LAURENT C, LEMÉE V, et al. Efficacy of anti-SARS-CoV-2 monoclonal antibody prophylaxis and vaccination on the Omicron variant of COVID-19 in kidney transplant recipients[J]. Kidney Int, 2022, 102(2): 440-442. DOI: 10.1016/j.kint.2022.05.007.
    [6] SAHIN U, MUIK A, VOGLER I, et al. BNT162b2 vaccine induces neutralizing antibodies and poly-specific T cells in humans[J]. Nature, 2021, 595(7868): 572-577. DOI: 10.1038/s41586-021-03653-6.
    [7] KHOURY DS, CROMER D, REYNALDI A, et al. Neutralizing antibody levels are highly predictive of immune protection from symptomatic SARS-CoV-2 infection[J]. Nat Med, 2021, 27(7): 1205-1211. DOI: 10.1038/s41591-021-01377-8.
    [8] FIOLET T, KHERABI Y, MACDONALD CJ, et al. Comparing COVID-19 vaccines for their characteristics, efficacy and effectiveness against SARS-CoV-2 and variants of concern: a narrative review[J]. Clin Microbiol Infect, 2022, 28(2): 202-221. DOI: 10.1016/j.cmi.2021.10.005.
    [9] CAILLARD S, THAUNAT O. COVID-19 vaccination in kidney transplant recipients[J]. Nat Rev Nephrol, 2021, 17(12): 785-787. DOI: 10.1038/s41581-021-00491-7.
    [10] SATTLER A, SCHREZENMEIER E, WEBER UA, et al. Impaired humoral and cellular immunity after SARS-CoV-2 BNT162b2 (Tozinameran) prime-boost vaccination in kidney transplant recipients[J]. J Clin Invest, 2021, 131(14): e150175. DOI: 10.1172/JCI150175.
    [11] CAILLARD S, CHAVAROT N, BERTRAND D, et al. Occurrence of severe COVID-19 in vaccinated transplant patients[J]. Kidney Int, 2021, 100(2): 477-479. DOI: 10.1016/j.kint.2021.05.011.
    [12] BENNING L, MORATH C, BARTENSCHLAGER M, et al. Neutralization of SARS-CoV-2 variants of concern in kidney transplant recipients after standard COVID-19 vaccination[J]. Clin J Am Soc Nephrol, 2022, 17(1): 98-106. DOI: 10.2215/CJN.11820921.
    [13] AL JURDI A, GASSEN RB, BORGES TJ, et al. Suboptimal antibody response against SARS-CoV-2 Omicron variant after third dose of mRNA vaccine in kidney transplant recipients[J]. Kidney Int, 2022, 101(6): 1282-1286. DOI: 10.1016/j.kint.2022.04.009.
    [14] KAMAR N, ABRAVANEL F, MARION O, et al. Three doses of an mRNA COVID-19 vaccine in solid-organ transplant recipients[J]. N Engl J Med, 2021, 385(7): 661-662. DOI: 10.1056/NEJMc2108861.
    [15] BENOTMANE I, GAUTIER G, PERRIN P, et al. Antibody response after a third dose of the mRNA-1273 SARS-CoV-2 vaccine in kidney transplant recipients with minimal serologic response to 2 doses[J]. JAMA, 2021, 326(11): 1063-1065. DOI: 10.1001/jama.2021.12339.
    [16] HALL VG, FERREIRA VH, KU T, et al. Randomized trial of a third dose of mRNA-1273 vaccine in transplant recipients[J]. N Engl J Med, 2021, 385(13): 1244-1246. DOI: 10.1056/NEJMc2111462.
    [17] MASSET C, KERLEAU C, GARANDEAU C, et al. A third injection of the BNT162b2 mRNA COVID-19 vaccine in kidney transplant recipients improves the humoral immune response[J]. Kidney Int, 2021, 100(5): 1132-1135. DOI: 10.1016/j.kint.2021.08.017.
    [18] MASSA F, CREMONI M, GÉRARD A, et al Safety and cross-variant immunogenicity of a three-dose COVID-19 mRNA vaccine regimen in kidney transplant recipients[J]. EBioMedicine, 2021, 73: 103679. DOI: 10.1016/j.ebiom.2021.103679.
    [19] KUMAR D, HU Q, SAMSON R, et al. Neutralization against Omicron variant in transplant recipients after three doses of mRNA vaccine[J]. Am J Transplant, 2022, 22(8): 2089-2093. DOI: 10.1111/ajt.17020.
    [20] CAILLARD S, THAUNAT O, BENOTMANE I, et al. Antibody response to a fourth messenger RNA COVID-19 vaccine dose in kidney transplant recipients: a case series[J]. Ann Intern Med, 2022, 175(3): 455-456. DOI: 10.7326/L21-0598.
    [21] OSMANODJA B, RONICKE S, BUDDE K, et al. Serological response to three, four and five doses of SARS-CoV-2 vaccine in kidney transplant recipients[J]. J Clin Med, 2022, 11(9): 2565. DOI: 10.3390/jcm11092565.
    [22] BENOTMANE I, BRUEL T, PLANAS D, et al. A fourth dose of the mRNA-1273 SARS-CoV-2 vaccine improves serum neutralization against the Delta variant in kidney transplant recipients[J]. Kidney Int, 2022, 101(5): 1073-1076. DOI: 10.1016/j.kint.2022.02.011.
    [23] CHARMETANT X, ESPI M, BENOTMANE I, et al. Infection or a third dose of mRNA vaccine elicits neutralizing antibody responses against SARS-CoV-2 in kidney transplant recipients[J]. Sci Transl Med, 2022, 14(636): eabl6141. DOI: 10.1126/scitranslmed.abl6141.
    [24] BENOTMANE I, GAUTIER-VARGAS G, GALLAIS F, et al. Strong antibody response after a first dose of a SARS-CoV-2 mRNA-based vaccine in kidney transplant recipients with a previous history of COVID-19[J]. Am J Transplant, 2021, 21(11): 3808-3810. DOI: 10.1111/ajt.16764.
    [25] BENNING L, MORATH C, BARTENSCHLAGER M, et al. Natural SARS-CoV-2 infection results in higher neutralization response against variants of concern compared with 2-dose BNT162b2 vaccination in kidney transplant recipients[J]. Kidney Int, 2022, 101(3): 639-642. DOI: 10.1016/j.kint.2021.12.009.
    [26] ZONG K, PENG D, YANG H, et al. Risk factors for weak antibody response of SARS-CoV-2 Vaccine in adult solid organ transplant recipients: a systemic review and meta-analysis[J]. Front Immunol, 2022, 13: 888385. DOI: 10.3389/fimmu.2022.888385.
    [27] ROZEN-ZVI B, YAHAV D, AGUR T, et al. Antibody response to SARS-CoV-2 mRNA vaccine among kidney transplant recipients: a prospective cohort study[J]. Clin Microbiol Infect, 2021, 27(8): 1173. e1-1173. e4. DOI: 10.1016/j.cmi.2021.04.028.
    [28] KANTAUSKAITE M, MÜLLER L, KOLB T, et al. Intensity of mycophenolate mofetil treatment is associated with an impaired immune response to SARS-CoV-2 vaccination in kidney transplant recipients[J]. Am J Transplant, 2022, 22(2): 634-639. DOI: 10.1111/ajt.16851.
    [29] NETTI GS, INFANTE B, TROISE D, et al. mTOR inhibitors improve both humoral and cellular response to SARS-CoV-2 messenger RNA BNT16b2 vaccine in kidney transplant recipients[J]. Am J Transplant, 2022, 22(5): 1475-1482. DOI: 10.1111/ajt.16958.
    [30] CHAVAROT N, OUEDRANI A, MARION O, et al. Poor anti-SARS-CoV-2 humoral and T-cell responses after 2 injections of mRNA vaccine in kidney transplant recipients treated with belatacept[J]. Transplantation, 2021, 105(9): e94-e95. DOI: 10.1097/TP.0000000000003784.
    [31] REGELE F, HEINZEL A, HU K, et al. Stopping of mycophenolic acid in kidney transplant recipients for 2 weeks peri-vaccination does not increase response to SARS-CoV-2 vaccination-a non-randomized, controlled pilot study[J]. Front Med (Lausanne), 2022, 9: 914424. DOI: 10.3389/fmed.2022.914424.
    [32] BENOTMANE I, GAUTIER-VARGAS G, COGNARD N, et al. Low immunization rates among kidney transplant recipients who received 2 doses of the mRNA-1273 SARS-CoV-2 vaccine[J]. Kidney Int, 2021, 99(6): 1498-1500. DOI: 10.1016/j.kint.2021.04.005.
    [33] GRUPPER A, RABINOWICH L, SCHWARTZ D, et al. Reduced humoral response to mRNA SARS-CoV-2 BNT162b2 vaccine in kidney transplant recipients without prior exposure to the virus[J]. Am J Transplant, 2021, 21(8): 2719-2726. DOI: 10.1111/ajt.16615.
    [34] MARION O, DEL BELLO A, ABRAVANEL F, et al. Safety and immunogenicity of anti-SARS-CoV-2 messenger RNA vaccines in recipients of solid organ transplants[J]. Ann Intern Med, 2021, 174(9): 1336-1338. DOI: 10.7326/M21-1341.
    [35] CUCCHIARI D, EGRI N, BODRO M, et al. Cellular and humoral response after mRNA-1273 SARS-CoV-2 vaccine in kidney transplant recipients[J]. Am J Transplant, 2021, 21(8): 2727-2739. DOI: 10.1111/ajt.16701.
    [36] MIDTVEDT K, TRAN T, PARKER K, et al. Low immunization rate in kidney transplant recipients also after dose 2 of the BNT162b2 vaccine: continue to keep your guard up![J]. Transplantation, 2021, 105(8): e80-e81. DOI: 10.1097/TP.0000000000003856.
    [37] WERBEL WA, BOYARSKY BJ, OU MT, et al. Safety and immunogenicity of a third dose of SARS-CoV-2 vaccine in solid organ transplant recipients: a case series[J]. Ann Intern Med, 2021, 174(9): 1330-1332. DOI: 10.7326/L21-0282.
    [38] STUMPF J, TONNUS W, PALIEGE A, et al. Cellular and humoral immune responses after 3 doses of BNT162b2 mRNA SARS-CoV-2 vaccine in kidney transplant[J]. Transplantation, 2021, 105(11): e267-e269. DOI: 10.1097/TP.0000000000003903.
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  • 收稿日期:  2022-08-19
  • 网络出版日期:  2023-01-17
  • 刊出日期:  2023-01-15

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