Abstract
Knowledge of the immunogenicity of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in liver transplant recipients (LTRs) is mainly limited to messenger RNA (mRNA)-based types. We aimed to evaluate the humoral response in LTRs and to address the use of different doses of mycophenolate (MMF) on the probability of developing anti-spike immunoglobulin G (IgG). In this prospective cohort study, SARS-CoV-2 anti-spike IgG, neutralizing antibodies (NAs), and nucleocapsid protein (N) were evaluated in LTRs and healthy volunteers 21-90 days after receiving the second vaccine dose of either ChAdOx1 (AstraZeneca), rAd26-rAd5 (Sputnik V), inactivated BBIBP-CorV (Sinopharm), or the heterologous combination rAd26/mRNA-1273 (Sputnik V/Moderna). We collected information regarding clinical data and vaccine side effects. After excluding three LTRs due to a positive N test, 120 LTRs and 27 controls were analyzed. No significant differences were found among groups. Overall, 24 (89%) controls and 74 (62%) LTRs were positive for anti-spike IgG (p = 0.007). Among LTRs, those immunized with rAd26/mRNA-1273 presented significantly higher positive serology and NAs when compared with the homologous regimens (91% vs. 55%, p = 0.001; and 1182 IU/ml vs. 446 IU/ml, p = 0.002; respectively). In the multivariate analysis, humoral response was significantly reduced in LTRs who received higher doses of MMF (odds ratio [OR], 0.1; 95% confidence interval [CI], 0.03-0.3; p < 0.001) and with increased BMI (OR, 0.4; 95% CI, 0.2-0.7; p = 0.005); and it was significantly higher in those immunized with rAd26/mRNA-1273 (OR, 13.1; 95% CI, 2.3-72.9; p = 0.003). In LTRs anti-spike IgG concentrations showed a very good correlation with NA titers (R 2 = 0.949; 95% CI, 0.919-0.967; p < 0.001). No serious adverse events were reported in either group. Conclusion: In LTRs, rAd26/mRNA-1273 was independently associated with higher antibody response. Future studies are necessary to evaluate whether combining different vaccine platforms and MMF reduction may lead to a better booster response.
【초록키워드】 neutralizing antibody, SARS-CoV-2, IgG, Vaccine, coronavirus, Antibody Response, prospective cohort study, nucleocapsid protein, vaccine dose, Probability, Immunoglobulin, anti-Spike IgG, Control, vaccine platform, BMI, Side effects, correlation, information, homologous, liver, ChAdOx1, AstraZeneca, Heterologous, Anti-spike, inactivated, BBIBP-CorV, Sinopharm, Combination, Concentration, Analysis, dose, Odds ratio, humoral, regimen, reduction, Messenger RNA, Serious Adverse Event, acute respiratory syndrome, significant difference, 95% CI, 95% confidence interval, Clinical data, positive, recipient, LTRs, positive serology, Future, immunized, SARS-CoV-2 anti-spike IgG, analyzed, collected, evaluate, significantly, reported, evaluated, receiving, reduced, significantly higher, groups, R 2, booster response, different dose, healthy volunteer, LTR, MMF, 【제목키워드】 coronavirus, RNA, liver, humoral, regimen, acute respiratory syndrome, recipient,