CD19+IgD+CD27-幼稚 B 细胞作为免疫功能低下患者对 COVID-19 mRNA 疫苗接种的体液反应的预测因子,medRxiv - Hematology

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CD19+IgD+CD27-幼稚 B 细胞作为免疫功能低下患者对 COVID-19 mRNA 疫苗接种的体液反应的预测因子
medRxiv - Hematology Pub Date : 2021-09-29 , DOI: 10.1101/2021.08.11.21261898
Eduard Schulz , Isabel Hodl , Patrick Forstner , Stefan Hatzl , Nazanin Sareban , Martina Moritz , Johannes Fessler , Barbara Dreo , Barbara Uhl , Claudia Url , Andrea Grisold , Michael Khalil , Barbara Kleinhappl , Christian Enzinger , Martin Helmut Stradner , Hildegard Greinix , Peter Schlenke , Ivo Steinmetz

免疫功能低下的患者被认为是高危患者，优先接种 COVID-19 疫苗。我们旨在分析这些患者的 B 细胞亚群，以确定体液疫苗接种反应的潜在预测因子。患有血液系统恶性肿瘤或其他免疫缺陷原因的患者 (n=120) 和健康对照 (n=79) 接受了 mRNA 疫苗的完整疫苗接种系列。在接种疫苗之前分析了 B 细胞亚群。在第二次接种疫苗三到四个星期后，进行了两次针对受体结合域 (RBD) 或三聚体 S 蛋白 (TSP) 的独立抗 SARS-CoV-2 免疫测定。100% 的健康对照发生血清转化，而免疫功能低下的患者为 67% (RBD) 和 82% (TSP)，而只有 32% (RBD) 和 22% (TSP) 达到与健康对照相当的抗体水平。⁺ IgD ⁺ CD27 ^-初始 B 细胞与抗体水平密切相关（ρ=0.761，P<0.001），并且是实现与健康对照相当的抗体水平的唯一独立预测因子（OR 1.07 每增加 10 µl，95%CI 1.02– 1.12，P=0.009）。接受者操作特征分析确定了每微升 ≥ 61 个初始 B 细胞的临界值，以区分具有和不具有最佳抗体反应的患者。因此，测量免疫功能低下的血液病患者的幼稚 B 细胞可能有助于预测他们的体液疫苗接种反应。

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CD19+IgD+CD27- naïve B Cells as predictors of humoral response to COVID-19 mRNA vaccination in immunocompromised patients

Immunocompromised patients are considered high-risk and prioritized for vaccination against COVID-19. We aimed to analyze B-cell subsets in these patients to identify potential predictors of humoral vaccination response. Patients (n=120) suffering from hematologic malignancies or other causes of immunodeficiency and healthy controls (n=79) received a full vaccination series with an mRNA vaccine. B-cell subsets were analyzed prior to vaccination. Two independent anti-SARS-CoV-2 immunoassays targeting the receptor-binding domain (RBD) or trimeric S protein (TSP) were performed three to four weeks after the second vaccination. Seroconversion occurred in 100% of healthy controls, in contrast to 67% (RBD) and 82% (TSP) of immunocompromised patients, while only 32% (RBD) and 22% (TSP) achieved antibody levels comparable to those of healthy controls. The number of circulating CD19⁺IgD⁺CD27^- naïve B cells was strongly associated with antibody levels (ρ=0.761, P<0.001) and the only independent predictor for achieving antibody levels comparable to healthy controls (OR 1.07 per 10-µl increase, 95%CI 1.02–1.12, P=0.009). Receiver operating characteristic analysis identified a cut-off at ≥61 naïve B cells per µl to discriminate between patients with and without an optimal antibody response. Consequently, measuring naïve B cells in immunocompromised hematologic patients could be useful in predicting their humoral vaccination response.

更新日期：2021-10-01

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