新冠灭活疫苗加强针通过B细胞和CD4^(+)T细胞增强对感染者的保护作用  

Study on the effect of booster injection of COVID-19 inactivated vaccine on immune function of patients with Omicron variant

作　　者：郑会强 崔晓利 雷静 邬霞 武航 王海东 康磊 张欣 ZHENG Huiqiang;CUI Xiaoli;LEI Jing;WU Xia;WU Hang;WANG Haidong;KANG Lei;ZHANG Xin(Department of Laboratory Medicine,Xi'an Chest Hospital,Xi'an 710100,China;Department of Blood Transfusion,Xi'an Chest Hospital,Xi'an 710100,China)

机构地区：[1]西安市胸科医院检验科,西安710100 [2]西安市胸科医院输血科,西安710100

出　　处：《国际免疫学杂志》2024年第6期601-606,共6页International Journal of Immunology

基　　金：西安市科学技术局医学研究项目(22YXYJ0085)。

摘　　要：目的探讨新型冠状病毒灭活疫苗(新冠疫苗)加强针接种对新冠奥密克戎变异株感染者免疫功能的影响。方法本研究为病例对照研究。采用非随机抽样的方法,纳入2022年9月至2022年11月在西安市胸科医院治疗的783例SARS-CoV-2奥密克戎感染患者。根据新冠疫苗接种情况将所有病例分为已加强针组(457例)和未加强针组(326例),比较两组感染者的临床分型、淋巴细胞计数、新冠特异性免疫球蛋白(immunoglobulin,Ig)G和IgM抗体、以及B淋巴细胞、CD4^(+)T淋巴细胞和CD8^(+)T淋巴细胞的比例、活化和细胞因子分泌情况。结果加强针组普通型患者比例低于未加强针组(0.66%比7.67%,χ^(2)=27.13,P<0.05),而加强针无症状患者比例高于未加强针组(79.87%比72.70%,χ^(2)=5.50,P<0.05);加强针组患者新冠特异性IgG和IgM抗体均高于未加强针组,差异均有统计学意义[截断值(cutoff index,COI):3.91比1.83,0.13比0.11,Z值分别为-10.20和-2.93,P值均<0.05],加强针组患者淋巴细胞计数低于未加强针组(1.54×10^(9)/L比1.73×10^(9)/L,Z=-2.73,P<0.05);加强针组患者的B淋巴细胞和CD27^(+)B淋巴细胞比例高于未加强针组,差异均有统计学意义(10.99%比7.17%,26.67%比17.85%,t值分别为2.95和3.35,P值均<0.05);加强针组患者的CD4^(+)、CD38^(+)CD4^(+)和CD45RO^(+)CD4^(+)T淋巴细胞以及CD4^(+)T淋巴细胞分泌的干扰素(interferon,IFN)-γ比例高于未加强针组,差异均有统计学意义(45.78%比37.9%,35.64%比27.62%,20.95%比14.28%,8.85%比4.68%,t值分别为3.14、3.54、2.50和3.46,P值均<0.05)。结论新冠疫苗加强针接种能够增加感染者B淋巴细胞比例,促进其的活化,进而增加新冠特异性抗体的产生,并且新冠疫苗加强针接种能够增加感染者CD4^(+)T淋巴细胞比例,促进其的活化,分泌更多细胞因子IFN-γ,进而减轻感染者的临床症状。Objective To explore the effect of booster injection of inactivated COVID-2019 vaccine(Corona Vac)on immune function of patients with Omicron variant.Methods This study is a case-control study.A total of 783 patients with SARS-CoV-2 Omicron infection treated in Xi'an Chest Hospital from September to November 2022 were included by non-random sampling method.According to the status of COVID-19 vaccination,all cases were divided into the booster group(457 cases)and the non-booster group(326 cases).The clinical classification,lymphocyte count,COVID-19 specific immunoglobulin(Ig)G and IgM antibodies,as well as the proportion of B lymphocytes,CD4^(+)T lymphocytes and CD8^(+)T lymphocytes,activation and cytokine secretion of the infected persons in the two groups were compared.Results In terms of clinical classification,the proportion of common type patients in the booster acupuncture group was significantly lower than that in the non-booster acupuncture group(0.66%vs 7.67%,χ^(2)=27.13,P<0.05),while the proportion of asymptomatic patients in the booster acupuncture group was significantly higher than that in the non-booster acupuncture group(79.87%vs 72.70%,χ^(2)=5.50,P<0.05).The novel coronavirus specific IgG and IgM antibodies in the enhanced acupuncture group were higher than those in the non-enhanced acupuncture group(cut off index:3.91 vs 1.83,0.13 vs 0.11,Z values were-10.20 and-2.93,all P values<0.05),and the lymphocyte count in the enhanced acupuncture group was lower than that in the non-enhanced acupuncture group,the differences were statistically significant(1.54×10^(9)vs 1.73×10^(9),Z=-2.73,P<0.05).The proportion of B lymphocytes and CD27+B lymphocytes in the booster acupuncture group was higher than that in the non-booster acupuncture group,the differences were statistically significant(10.99%vs 7.17%,26.67%vs 17.85%,t values were 2.95 and 3.35,all P values<0.05).The proportions of CD4^(+),CD38^(+)CD4^(+),CD45RO^(+)CD4^(+)T lymphocytes and interferon(IFN)-γsecreted by CD4^(+)T lymphocytes in the booste

关 键 词：新型冠状病毒 疫苗 特异性抗体 B淋巴细胞 T淋巴细胞 

分 类 号：R511[医药卫生—内科学] R186[医药卫生—临床医学]