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Yaseen A, DeSantis SM, Sabharwal R, Talebi Y, Swartz MD, Zhang S, Leon Novelo L, Pinzon-Gomez CL, Messiah SE, Valerio-Shewmaker M, Kohl HW, Ross J, Lakey D, Shuford JA, Pont SJ, Boerwinkle E. Baseline characteristics of SARS-CoV-2 vaccine non-responders in a large population-based sample. PLoS One 2024; 19:e0303420. [PMID: 38739625 PMCID: PMC11090326 DOI: 10.1371/journal.pone.0303420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/25/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION Studies indicate that individuals with chronic conditions and specific baseline characteristics may not mount a robust humoral antibody response to SARS-CoV-2 vaccines. In this paper, we used data from the Texas Coronavirus Antibody REsponse Survey (Texas CARES), a longitudinal state-wide seroprevalence program that has enrolled more than 90,000 participants, to evaluate the role of chronic diseases as the potential risk factors of non-response to SARS-CoV-2 vaccines in a large epidemiologic cohort. METHODS A participant needed to complete an online survey and a blood draw to test for SARS-CoV-2 circulating plasma antibodies at four-time points spaced at least three months apart. Chronic disease predictors of vaccine non-response are evaluated using logistic regression with non-response as the outcome and each chronic disease + age as the predictors. RESULTS As of April 24, 2023, 18,240 participants met the inclusion criteria; 0.58% (N = 105) of these are non-responders. Adjusting for age, our results show that participants with self-reported immunocompromised status, kidney disease, cancer, and "other" non-specified comorbidity were 15.43, 5.11, 2.59, and 3.13 times more likely to fail to mount a complete response to a vaccine, respectively. Furthermore, having two or more chronic diseases doubled the prevalence of non-response. CONCLUSION Consistent with smaller targeted studies, a large epidemiologic cohort bears the same conclusion and demonstrates immunocompromised, cancer, kidney disease, and the number of diseases are associated with vaccine non-response. This study suggests that those individuals, with chronic diseases with the potential to affect their immune system response, may need increased doses or repeated doses of COVID-19 vaccines to develop a protective antibody level.
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Affiliation(s)
- Ashraf Yaseen
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, United States of America
| | - Stacia M. DeSantis
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, United States of America
| | - Rachit Sabharwal
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, United States of America
| | - Yashar Talebi
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, United States of America
| | - Michael D. Swartz
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, United States of America
| | - Shiming Zhang
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, United States of America
| | - Luis Leon Novelo
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, United States of America
| | - Cesar L. Pinzon-Gomez
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, United States of America
| | - Sarah E. Messiah
- The University of Texas Health Science Center at Houston, School of Public Health in Dallas, Dallas, TX, United States of America
- Center for Pediatric Population Health, UTHealth School of Public Health, Dallas, Texas, United States of America
| | - Melissa Valerio-Shewmaker
- The University of Texas Health Science Center at Houston, School of Public Health in Brownville, Brownsville, TX, United States of America
| | - Harold W. Kohl
- The University of Texas Health Science Center at Houston, School of Public Health in Austin, Austin, TX, United States of America
- University of Texas at Austin, Austin, TX, United States of America
| | - Jessica Ross
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, United States of America
| | - David Lakey
- University of Texas System, Austin, TX, United States of America
- The University of Texas Health Science Center Tyler, Tyler, TX, United States of America
| | - Jennifer A. Shuford
- Texas Department of State Health Services, Austin, TX, United States of America
| | - Stephen J. Pont
- Texas Department of State Health Services, Austin, TX, United States of America
| | - Eric Boerwinkle
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, United States of America
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2
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Song NJ, Chakravarthy KB, Jeon H, Bolyard C, Reynolds K, Weller KP, Reisinger S, Wang Y, Li A, Jiang S, Ma Q, Barouch DH, Rubinstein MP, Shields PG, Oltz EM, Chung D, Li Z. mRNA vaccines against SARS-CoV-2 induce divergent antigen-specific T-cell responses in patients with lung cancer. J Immunother Cancer 2024; 12:e007922. [PMID: 38177076 PMCID: PMC10773442 DOI: 10.1136/jitc-2023-007922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant is highly transmissible and evades pre-established immunity. Messenger RNA (mRNA) vaccination against ancestral strain spike protein can induce intact T-cell immunity against the Omicron variant, but efficacy of booster vaccination in patients with late-stage lung cancer on immune-modulating agents including anti-programmed cell death protein 1(PD-1)/programmed death-ligand 1 (PD-L1) has not yet been elucidated. METHODS We assessed T-cell responses using a modified activation-induced marker assay, coupled with high-dimension flow cytometry analyses. Peripheral blood mononuclear cells (PBMCs) were stimulated with various viral peptides and antigen-specific T-cell responses were evaluated using flow cytometry. RESULTS Booster vaccines induced CD8+ T-cell response against the ancestral SARS-CoV-2 strain and Omicron variant in both non-cancer subjects and patients with lung cancer, but only a marginal induction was detected for CD4+ T cells. Importantly, antigen-specific T cells from patients with lung cancer showed distinct subpopulation dynamics with varying degrees of differentiation compared with non-cancer subjects, with evidence of dysfunction. Notably, female-biased T-cell responses were observed. CONCLUSION We conclude that patients with lung cancer on immunotherapy show a substantial qualitative deviation from non-cancer subjects in their T-cell response to mRNA vaccines, highlighting the need for heightened protective measures for patients with cancer to minimize the risk of breakthrough infection with the Omicron and other future variants.
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Affiliation(s)
- No-Joon Song
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA
| | - Karthik B Chakravarthy
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA
| | - Hyeongseon Jeon
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA
- Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Chelsea Bolyard
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA
| | - Kelsi Reynolds
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA
| | - Kevin P Weller
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA
| | - Sarah Reisinger
- The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Yi Wang
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA
| | - Anqi Li
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA
| | - Sizun Jiang
- Department of Pathology, Stanford University, Stanford, California, USA
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Qin Ma
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA
- Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Dan H Barouch
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Mark P Rubinstein
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Peter G Shields
- The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Eugene M Oltz
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, Ohio, USA
| | - Dongjun Chung
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA
- Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Zihai Li
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
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Dukes CW, Potez M, Lancet J, Kuter BJ, Whiting J, Mo Q, Leav B, Wang H, Vanas JS, Cubitt CL, Isaacs-Soriano K, Kennedy K, Rathwell J, Diaz Cobo J, O’Nan W, Sirak B, Dong N, Tan E, Hwu P, Giuliano AR, Pilon-Thomas S. Neutralizing Antibody Response following a Third Dose of the mRNA-1273 Vaccine among Cancer Patients. Vaccines (Basel) 2023; 12:13. [PMID: 38250826 PMCID: PMC10818923 DOI: 10.3390/vaccines12010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/06/2023] [Accepted: 12/19/2023] [Indexed: 01/23/2024] Open
Abstract
Cancer patients are at an increased risk of morbidity and mortality from SARS-CoV-2 infection and have a decreased immune response to vaccination. We conducted a study measuring both the neutralizing and total antibodies in cancer patients following a third dose of the mRNA-1273 COVID-19 vaccine. Immune responses were measured with an enzyme-linked immunosorbent assay (ELISA) and neutralization assays. Kruskal-Wallis tests were used to evaluate the association between patient characteristics and neutralization geometric mean titers (GMTs), and paired t-tests were used to compare the GMTs between different timepoints. Spearman correlation coefficients were calculated to determine the correlation between total antibody and neutralization GMTs. Among 238 adults diagnosed with cancer, a third dose of mRNA-1273 resulted in a 37-fold increase in neutralization GMT 28 days post-vaccination and maintained a 14.6-fold increase at 6 months. Patients with solid tumors or lymphoid cancer had the highest and lowest neutralization GMTs, respectively, at both 28 days and 6 months post-dose 3. While total antibody GMTs in lymphoid patients continued to increase, other cancer types showed decreases in titers between 28 days and 6 months post-dose 3. A strong correlation (p < 0.001) was found between total antibody and neutralization GMTs. The third dose of mRNA-1273 was able to elicit a robust neutralizing antibody response in cancer patients, which remained for 6 months after administration. Lymphoid cancer patients can benefit most from this third dose, as it was shown to continue to increase total antibody GMTs 6 months after vaccination.
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Affiliation(s)
- Christopher W. Dukes
- Department of Immunology, Moffitt Cancer Center, Tampa, FL 33612, USA
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL 33612, USA (A.R.G.)
| | - Marine Potez
- Department of Immunology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Jeffrey Lancet
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Barbara J. Kuter
- Department of Infectious Diseases, Moderna, Inc., Cambridge, MA 02139, USA
| | - Junmin Whiting
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Qianxing Mo
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Brett Leav
- Department of Infectious Diseases, Moderna, Inc., Cambridge, MA 02139, USA
| | - Haixing Wang
- Department of Infectious Diseases, Moderna, Inc., Cambridge, MA 02139, USA
| | - Julie S. Vanas
- Department of Infectious Diseases, Moderna, Inc., Cambridge, MA 02139, USA
| | | | - Kimberly Isaacs-Soriano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL 33612, USA (A.R.G.)
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Kayoko Kennedy
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL 33612, USA (A.R.G.)
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Julie Rathwell
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL 33612, USA (A.R.G.)
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Julian Diaz Cobo
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Wesley O’Nan
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Bradley Sirak
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Ning Dong
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Elaine Tan
- James A. Haley Veterans Hospital, Tampa, FL 33612, USA
| | - Patrick Hwu
- Department of Immunology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Anna R. Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL 33612, USA (A.R.G.)
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Shari Pilon-Thomas
- Department of Immunology, Moffitt Cancer Center, Tampa, FL 33612, USA
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL 33612, USA (A.R.G.)
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Schiaroli E, Gidari A, Brachelente G, Bicchieraro G, Spaccapelo R, Bastianelli S, Pierucci S, Busti C, Pallotto C, Malincarne L, Camilloni B, Falcinelli F, De Socio GV, Villa A, Mencacci A, Francisci D. Impaired neutralizing antibody efficacy of tixagevimab-cilgavimab 150+150 mg as pre-exposure prophylaxis against Omicron BA.5. A real-world experience in booster vaccinated immunocompromised patients. J Clin Virol 2023; 168:105584. [PMID: 37778220 DOI: 10.1016/j.jcv.2023.105584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Tixagevimab-cilgavimab has been approved as primary pre-exposure prophylaxis in immunocompromised patients as support or replacement for vaccination, even though the Omicron variant of concern (VOC) was spreading at the time. OBJECTIVES The aim of our study was to evaluate the post-injection neutralising activity (NT90-Abs titre) against the Omicron BA.5 variant in fully vaccinated immunocompromised patients. STUDY DESIGN NT90-Abs titres against BA.5 and 20A.EU1 as well as anti-spike and anti-receptor-binding domain IgG were evaluated 0, 14, and 30 d after tixagevimab-cilgavimab administration. The primary end point was NT90-Abs titres ≥ 80 against BA.5 in ≥ 25% of patients, and the secondary end point was NT90-Abs titres ≥ 1280 against 20A.EU1 in >50% of patients on day 14. RESULTS At baseline, 35.2%, 37.02%, and 32.5% of booster vaccinated patients exhibited undetectable levels of anti-S and anti-RBD IgG antibodies such as NT90-Abs titres against A20.EU1. Moreover, 35 patients (61.5%) had undetectable NT90-Abs titres against BA.5. On day 14, IgG anti-S and anti-RBD levels were 3880 BAU/mL and 776.6 AU/mL, respectively. Only 12.5% of patients met a NT90-Abs titres ≥ 80 against BA.5, whereas the median NT90-Abs titre against 20A.EU1 was 1280. NT90-Abs titres against BA.5 were 64-fold lower than those against A20.EU1. Four patients (7.5%) had a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the 3 months after treatment, all with a time gap between the booster vaccination and injection. CONCLUSIONS To date, tixagevimab-cilgavimab cannot be considered a substitute for vaccination but may be a useful supporting therapy if the recommended dose for pre-exposure prophylaxis is doubled.
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Affiliation(s)
- Elisabetta Schiaroli
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
| | - Anna Gidari
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giovanni Brachelente
- Clinical Pathology and Ematology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Giulia Bicchieraro
- Genomics and Genetics Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Roberta Spaccapelo
- Functional Genomic Center (C.U.R.Ge.F), Department of Medicine and Surgery, Genomics and Genetics section Department of Medicine and Surgery, University of Perugia, Italy
| | - Sabrina Bastianelli
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Sara Pierucci
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Chiara Busti
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Carlo Pallotto
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Lisa Malincarne
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Barbara Camilloni
- Microbiology and Clinical Microbiology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Flavio Falcinelli
- Hematolgy Clinic, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giuseppe Vittorio De Socio
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Alfredo Villa
- Clinical Pathology and Ematology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Antonella Mencacci
- Microbiology and Clinical Microbiology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Daniela Francisci
- Clinic of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Martin-Onraët A, Barrientos-Flores C, Vilar-Compte D, Pérez-Jimenez C, Alatorre-Fernandez P. Use of remdesivir for COVID-19 in patients with hematologic cancer. Clin Exp Med 2023; 23:2231-2238. [PMID: 36508048 PMCID: PMC9744041 DOI: 10.1007/s10238-022-00964-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022]
Abstract
PURPOSES Patients with hematologic malignancies (HM) are among the individuals with highest risk of COVID-19 complications. We report the impact of remdesivir in patients with hematologic malignancies (HM) during Omicron in Mexico City. METHODS All patients with HM and COVID-19 during December 2021-March 2022 were included. Socio-demographic and clinical data were collected. The primary outcome was COVID-19 progression. Variables associated with progression were analyzed. RESULTS 115 patients were included. Median age was 50 years (IQR 35-63); 36% (N = 41) had at least one comorbidity. Fifty-two percent had non-Hodgkin lymphoma. Fifty patients (44%) had at least two doses of SARS-CoV-2 vaccine. COVID-19 was classified as mild (52.6%), moderate (9.7%), and severe/critical (28%). Twenty-eight patients (24%) received remdesivir. Nine patients received remdesivir at the ambulatory clinic (33%), the rest during hospital admission. Overall, 22(19%) patients progressed to severe/critical COVID-19; nine died due to COVID-19(8%). Hospital admission for non-COVID-19 causes was associated with higher odds of progression. Remdesivir did not reduce the risk of progression in hospitalized patients; none of the patients who received remdesivir in the ambulatory clinic progressed to severe COVID-19 or died. CONCLUSIONS Patients with HM and COVID-19 continue to present with high risk of complications. More prospective studies are needed to define the impact of antivirals in this high-risk group, including the best duration of treatment. Also, better vaccine coverage and access to treatment are mandatory.
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Affiliation(s)
- Alexandra Martin-Onraët
- Infectious Diseases Department, Instituto Nacional de Cancerología, Avenida San Fernando 22, Col Sección 16 Belisario Dominguez, 14080 Tlalpan CDMX, Mexico
| | - Corazón Barrientos-Flores
- Infectious Diseases Department, Instituto Nacional de Cancerología, Avenida San Fernando 22, Col Sección 16 Belisario Dominguez, 14080 Tlalpan CDMX, Mexico
| | - Diana Vilar-Compte
- Infectious Diseases Department, Instituto Nacional de Cancerología, Avenida San Fernando 22, Col Sección 16 Belisario Dominguez, 14080 Tlalpan CDMX, Mexico
| | - Carolina Pérez-Jimenez
- Infectious Diseases Department, Instituto Nacional de Cancerología, Avenida San Fernando 22, Col Sección 16 Belisario Dominguez, 14080 Tlalpan CDMX, Mexico
| | - Pamela Alatorre-Fernandez
- Infectious Diseases Department, Instituto Nacional de Cancerología, Avenida San Fernando 22, Col Sección 16 Belisario Dominguez, 14080 Tlalpan CDMX, Mexico
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Baratè C, Caruso T, Mavilia F, Sammuri P, Pratesi F, Motta G, Guerri V, Galimberti S, Migliorini P. Induction of neutralizing antibodies in CLL patients after SARS-CoV-2 mRNA vaccination: a monocentric experience. Clin Exp Med 2023; 23:1197-1203. [PMID: 36074205 PMCID: PMC9453722 DOI: 10.1007/s10238-022-00877-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/14/2022] [Indexed: 11/03/2022]
Abstract
Vaccination represents the best strategy to fight COVID-19 pandemics, especially in immune compromised subjects. In chronic lymphatic leukemia patients, a marked impairment of the immune response to mRNA SARS-CoV-2 vaccine was observed. In this report, we analyzed anti-RBD and neutralizing antibodies in CLL patients after two doses of mRNA SARS CoV 2 vaccine and evaluated the impact of Bruton kinase inhibitory agents. Twenty-seven CLL patients vaccinated with mRNA vaccines against SARS CoV-2 were recruited. Serum IgG, IgM and IgA anti-RBD antibodies and neutralizing antibodies were detected, and antibody avidity was measured. Peripheral blood leukocytes subsets were evaluated by flow cytometry. After two vaccine doses anti-RBD IgG were produced in 11/27 (40.5%) of patients and levels of IgG and IgA anti RBD in CLL patients were sensibly lower than in controls. Neutralizing antibodies were detectable in 12/27 (44.5%) of the patients and their level was lower than that observed in controls. Disease burden and treatment with Bruton kinases inhibitors markedly impaired vaccine induced antibody response. However, in responder patients, antibody avidity was comparable to normal subjects, indicating that the process of clonal selection and affinity maturation takes place as expected. Taken together, these data confirm the impact of disease burden and therapy on production of anti-RBD and neutralizing antibodies and support the current policy of vaccinating CLL patients.
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Affiliation(s)
- Claudia Baratè
- Division of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Teresita Caruso
- Clinical Immunology and Allergy Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56126, Pisa, Italy
| | - Fabrizio Mavilia
- Division of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Paola Sammuri
- Division of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Federico Pratesi
- Clinical Immunology and Allergy Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56126, Pisa, Italy
- General Pathology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giuseppe Motta
- Clinical Immunology and Allergy Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56126, Pisa, Italy
| | - Valentina Guerri
- Division of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara Galimberti
- Division of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Paola Migliorini
- Clinical Immunology and Allergy Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56126, Pisa, Italy.
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7
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Mariniello DF, Aronne L, Vitale M, Schiattarella A, Pagliaro R, Komici K. Current challenges and perspectives in lung cancer care during COVID-19 waves. Curr Opin Pulm Med 2023; 29:239-247. [PMID: 37132294 PMCID: PMC10241323 DOI: 10.1097/mcp.0000000000000967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
PURPOSE OF REVIEW In the era of the SARS-Cov2 pandemic, the multidisciplinary care of patients with lung cancer is the main challenge for clinicians. The depiction of complex networking between SARS-CoV2 and cancer cells is crucial to understanding the downstream signalling pathways leading to more severe clinical behaviour of COVID-19 among lung cancer patients. RECENT FINDINGS The immunosuppressive status caused by both blunted immune response and active anticancer treatments (e.g. radiotherapy, chemotherapy) affects also the response to vaccines. Furthermore, the COVID-19 pandemic has significantly influenced early detection, therapeutic management, and clinical research for patients with lung cancer. SUMMARY SARS-CoV-2 infection does undoubtedly represent a challenge for care of patients with lung cancer. Since symptoms of infection may overlap with underlying condition, diagnosis must be reached and treatment should start as soon as possible. Although any cancer treatment should be procrastinated as long as infection is not cured, every choice must be pondered on individual basis, according to clinical conditions. Underdiagnosis should be avoided, and both surgical and medical treatment must be tailored to each patient. Therapeutic scenario standardization represents a major challenge for clinicians and researchers.
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Affiliation(s)
| | - Luigi Aronne
- Department of Translational Medical Science, University of Campania Luigi Vanvitelli
| | - Maria Vitale
- CEINGE, Biotecnologie Avanzate
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples
| | - Angela Schiattarella
- Department of Translational Medical Science, University of Campania Luigi Vanvitelli
| | - Raffaella Pagliaro
- Department of Translational Medical Science, University of Campania Luigi Vanvitelli
| | - Klara Komici
- Department of Medicine and Health Sciences University of Molise, Campobasso, Italy
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8
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Chen C, Dai L, Zheng C, Li H, Li X, Yang M, Gao R, Yao J, Zhang Z, Shi Y, Han X. Antibody response to SARS-CoV-2 WT and Omicron BA.4/5 of inactivated COVID-19 vaccine in patients with lung cancer after second and booster immunization. J Hematol Oncol 2023; 16:47. [PMID: 37138279 PMCID: PMC10155141 DOI: 10.1186/s13045-023-01443-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/20/2023] [Indexed: 05/05/2023] Open
Abstract
COVID-19 inactivated vaccine-induced humoral responses in patients with lung cancer (LCs) to SARS-CoV-2 wild-type (WT) strain and variants BA.4/5 after the primary 2-dose and booster vaccination remained unknown. We conducted a cross-sectional study in 260 LCs, 140 healthy controls (HC) and additional 40 LCs with serial samples by detecting total antibodies, IgG anti-RBD and neutralizing antibodies (NAb) toward WT and BA.4/5. SARS-CoV-2-specific antibody responses were augmented by the booster dose of inactivated vaccines in LCs, whereas they were lower than that in HCs. Enhanced humoral responses waned over time after triple injection, notably in NAb against WT and BA.4/5. The NAb against BA.4/5 was much lower than WT. Age ≥ 65 was risk factor for immunization of NAb to WT. Undergoing treatment resulted in a lower antibody response than those without and radiotherapy was a also risk factor for seroconversion of NAb to WT. Lower lymphocyte counts contributed to a lower titer of IgG anti-RBD and NAb against BA.4/5 in LCs than HCs. Specifically, total B cells, CD4+T cells and CD8+T counts were correlated with the humoral response. These results should be taken into consideration for the elderly patients under treatment.
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Affiliation(s)
- Chen Chen
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases, NMPA Key Laboratory for Clinical Research and Evaluation of Drug, Beijing Key Laboratory of Clinical PK and PD Investigation for Innovative Drugs, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, 100730, China
| | - Liyuan Dai
- Department of Clinical Laboratory, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Cuiling Zheng
- Department of Clinical Laboratory, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Haolong Li
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Xiaomeng Li
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
- Department of Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Mengwei Yang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Ruyun Gao
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Jiarui Yao
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Zhishang Zhang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Yuankai Shi
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Xiaohong Han
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases, NMPA Key Laboratory for Clinical Research and Evaluation of Drug, Beijing Key Laboratory of Clinical PK and PD Investigation for Innovative Drugs, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, 100730, China.
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9
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Liatsou E, Ntanasis-Stathopoulos I, Lykos S, Ntanasis-Stathopoulos A, Gavriatopoulou M, Psaltopoulou T, Sergentanis TN, Terpos E. Adult Patients with Cancer Have Impaired Humoral Responses to Complete and Booster COVID-19 Vaccination, Especially Those with Hematologic Cancer on Active Treatment: A Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:cancers15082266. [PMID: 37190194 DOI: 10.3390/cancers15082266] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 05/17/2023] Open
Abstract
The exclusion of patients with cancer in clinical trials evaluating COVID-19 vaccine efficacy and safety, in combination with the high rate of severe infections, highlights the need for optimizing vaccination strategies. The aim of this study was to perform a systematic review and meta-analysis of the published available data from prospective and retrospective cohort studies that included patients with either solid or hematological malignancies according to the PRISMA Guidelines. A literature search was performed in the following databases: Medline (Pubmed), Scopus, Clinicaltrials.gov, EMBASE, CENTRAL and Google Scholar. Overall, 70 studies were included for the first and second vaccine dose and 60 studies for the third dose. The Effect Size (ES) of the seroconversion rate after the first dose was 0.41 (95%CI: 0.33-0.50) for hematological malignancies and 0.56 (95%CI: 0.47-0.64) for solid tumors. The seroconversion rates after the second dose were 0.62 (95%CI: 0.57-0.67) for hematological malignancies and 0.88 (95%CI: 0.82-0.93) for solid tumors. After the third dose, the ES for seroconversion was estimated at 0.63 (95%CI: 0.54-0.72) for hematological cancer and 0.88 (95%CI: 0.75-0.97) for solid tumors. A subgroup analysis was performed to evaluate potential factors affecting immune response. Production of anti-SARS-CoV-2 antibodies was found to be more affected in patients with hematological malignancies, which was attributed to the type of malignancy and treatment with monoclonal antibodies according to the subgroup analyses. Overall, this study highlights that patients with cancer present suboptimal humoral responses after COVID-19 vaccination. Several factors including timing of vaccination in relevance with active therapy, type of therapy, and type of cancer should be considered throughout the immunization process.
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Affiliation(s)
- Efstathia Liatsou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | | | - Stavros Lykos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | | | - Maria Gavriatopoulou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Theodora Psaltopoulou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Theodoros N Sergentanis
- Department of Public Health Policy, School of Public Health, University of West Attica, 12243 Aigaleo, Greece
| | - Evangelos Terpos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, 11528 Athens, Greece
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10
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Acar A. Pan-Cancer Analysis of the COVID-19 Causal Gene SLC6A20. ACS OMEGA 2023; 8:13153-13161. [PMID: 37041751 PMCID: PMC10081573 DOI: 10.1021/acsomega.3c00407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
Genome-wide association studies demonstrated that the chromosome 3p31.21 locus was linked to the severity of COVID-19 disease. The SLC6A20 gene was reported to be one of the critical causal genes regulated by this locus. Various studies focused on demonstrating the severity of COVID-19 in cancer patients and reported that elevated SARS-CoV-2-associated gene expression might contribute to increased susceptibility for COVID-19 in cancer patients. Given that pan-cancer association for the COVID-19 causal gene SLC6A20 is lacking, we aimed to perform systematic profiling of SLC6A20 in different malignancies. Human Protein Atlas, UALCAN, and Hepatocellular Carcinoma (HCCDB) databases were used to assess SLC6A20 gene expression changes in The Cancer Genome Atlas samples with respect to their normal counterparts. GEPIA and TIMER2.0 databases were used to determine the correlation between SLC6A20 and COVID-19-associated genes. Different databases were used for identification of the correlation of SCL6A20 with infiltrating immune cells. The canSAR database was utilized to determine the association of SCL6A20 with immune profiling in different malignancies. The STRING database was utilized to determine the protein network interacting with SLC6A20. Here, we showed SLC6A20 mRNA expression in pan-cancer samples and their normal counterparts. Increased SCL6A20 expression was associated with tumor grade, and there was a positive correlation with SARS-CoV-2-associated genes. Furthermore, SLC6A20 expression was positively correlated with infiltrating neutrophils and immune-related signatures. Lastly, SLC6A20 expression was found to be associated with the angiotensin converting enzyme 2 homologue, TMEM27, suggesting a potential link between SLC6A20 and COVID-19. Taken together, these results suggest that elevated SLC6A20 levels might be partly responsible for increased susceptibility of cancer patients to COVID-19 disease. Therapeutic intervention strategies against SLC6A20 in cancer patients, alongside other treatment modalities, might offer a benefit in delaying COVID-19 disease.
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11
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Azar JH, Evans JP, Sikorski MH, Chakravarthy KB, McKenney S, Carmody I, Zeng C, Teodorescu R, Song NJ, Hamon JL, Bucci D, Velegraki M, Bolyard C, Weller KP, Reisinger SA, Bhat SA, Maddocks KJ, Denlinger N, Epperla N, Gumina RJ, Vlasova AN, Oltz EM, Saif LJ, Chung D, Woyach JA, Shields PG, Liu SL, Li Z, Rubinstein MP. Selective suppression of de novo SARS-CoV-2 vaccine antibody responses in patients with cancer on B cell-targeted therapy. JCI Insight 2023; 8:e163434. [PMID: 36749632 PMCID: PMC10070099 DOI: 10.1172/jci.insight.163434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 02/01/2023] [Indexed: 02/08/2023] Open
Abstract
We assessed vaccine-induced antibody responses to the SARS-CoV-2 ancestral virus and Omicron variant before and after booster immunization in 57 patients with B cell malignancies. Over one-third of vaccinated patients at the pre-booster time point were seronegative, and these patients were predominantly on active cancer therapies such as anti-CD20 monoclonal antibody. While booster immunization was able to induce detectable antibodies in a small fraction of seronegative patients, the overall booster benefit was disproportionately evident in patients already seropositive and not receiving active therapy. While ancestral virus- and Omicron variant-reactive antibody levels among individual patients were largely concordant, neutralizing antibodies against Omicron tended to be reduced. Interestingly, in all patients, including those unable to generate detectable antibodies against SARS-CoV-2 spike, we observed comparable levels of EBV- and influenza-reactive antibodies, demonstrating that B cell-targeting therapies primarily impair de novo but not preexisting antibody levels. These findings support rationale for vaccination before cancer treatment.
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Affiliation(s)
- Joseph H. Azar
- Division of Medical Oncology, Department of Internal Medicine
- The Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – James
| | - John P. Evans
- Center for Retrovirus Research
- Department of Veterinary Biosciences
- Molecular, Cellular and Developmental Biology Program
| | - Madison H. Sikorski
- Division of Medical Oncology, Department of Internal Medicine
- The Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – James
| | - Karthik B. Chakravarthy
- Division of Medical Oncology, Department of Internal Medicine
- The Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – James
| | - Selah McKenney
- Division of Medical Oncology, Department of Internal Medicine
- The Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – James
| | - Ian Carmody
- Division of Medical Oncology, Department of Internal Medicine
- The Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – James
| | - Cong Zeng
- Center for Retrovirus Research
- Department of Veterinary Biosciences
| | - Rachael Teodorescu
- Division of Medical Oncology, Department of Internal Medicine
- The Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – James
| | - No-Joon Song
- Division of Medical Oncology, Department of Internal Medicine
- The Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – James
| | - Jamie L. Hamon
- The Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – James
| | - Donna Bucci
- Division of Medical Oncology, Department of Internal Medicine
- The Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – James
| | - Maria Velegraki
- Division of Medical Oncology, Department of Internal Medicine
- The Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – James
| | - Chelsea Bolyard
- The Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – James
| | - Kevin P. Weller
- The Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – James
| | - Sarah A. Reisinger
- The Ohio State University Comprehensive Cancer Center – James, The James Cancer Hospital
| | - Seema A. Bhat
- Division of Hematology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center – James
| | - Kami J. Maddocks
- Division of Hematology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center – James
| | - Nathan Denlinger
- Division of Hematology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center – James
| | - Narendranath Epperla
- Division of Hematology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center – James
| | - Richard J. Gumina
- Department of Internal Medicine, Division of Cardiovascular Medicine; and
| | - Anastasia N. Vlasova
- Center for Food Animal Health, Animal Sciences Department, Ohio Agricultural Research and Development Center, College of Food, Agricultural and Environmental Sciences, The Ohio State University, Columbus, Ohio, USA
- Veterinary Preventive Medicine Department, College of Veterinary Medicine, The Ohio State University, Wooster, Ohio, USA
- Viruses and Emerging Pathogens Program, Infectious Diseases Institute
| | - Eugene M. Oltz
- The Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – James
- Department of Microbial Infection and Immunity; and
| | - Linda J. Saif
- Center for Food Animal Health, Animal Sciences Department, Ohio Agricultural Research and Development Center, College of Food, Agricultural and Environmental Sciences, The Ohio State University, Columbus, Ohio, USA
- Veterinary Preventive Medicine Department, College of Veterinary Medicine, The Ohio State University, Wooster, Ohio, USA
- Viruses and Emerging Pathogens Program, Infectious Diseases Institute
| | - Dongjun Chung
- The Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – James
- Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio, USA
| | - Jennifer A. Woyach
- Division of Hematology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center – James
| | - Peter G. Shields
- Division of Medical Oncology, Department of Internal Medicine
- The Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – James
| | - Shan-Lu Liu
- Center for Retrovirus Research
- Department of Veterinary Biosciences
- Viruses and Emerging Pathogens Program, Infectious Diseases Institute
- Department of Microbial Infection and Immunity; and
| | - Zihai Li
- Division of Medical Oncology, Department of Internal Medicine
- The Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – James
| | - Mark P. Rubinstein
- Division of Medical Oncology, Department of Internal Medicine
- The Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – James
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12
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Helfgott DC, Racine-Brzostek S, Short KJ, Zhao Z, Christos P, Nino I, Niu T, Contreras J, Ritchie EK, Desai P, Samuel M, Roboz GJ. Immunogenicity of COVID-19 mRNA vaccines in patients with acute myeloid leukemia and myelodysplastic syndrome. Leuk Lymphoma 2023; 64:662-670. [PMID: 36282213 DOI: 10.1080/10428194.2022.2131414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Immunocompromised patients are susceptible to complications from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The mRNA vaccines BNT162b2 and mRNA-1273 are effective in immunocompetent adults, but have diminished activity in immunocompromised patients. We measured anti-spike SARS-CoV-2 antibody (anti-S) response, avidity, and surrogate neutralizing antibody activity in COVID-19 vaccinated patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). Anti-S was induced in 89% of AML and 88% of MDS patients, but median levels were significantly lower than in healthy controls. SARS-CoV-2 antibody avidity and neutralizing activity from AML patients were significantly lower than controls. Antibody avidity was significantly greater in patients after mRNA-1273 versus BNT162b2; there were trends toward higher anti-S levels and greater neutralizing antibody activity after mRNA-1273 vaccination. Patients with AML and MDS are likely to respond to COVID-19 mRNA vaccination, but differences in anti-S levels, avidity, and neutralizing antibody activity may affect clinical outcomes and require further study.
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Affiliation(s)
- David C Helfgott
- Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Sabrina Racine-Brzostek
- Department of Pathology and Laboratory Medicine, Translational Research Program, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Kelsey J Short
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Zhen Zhao
- Department of Pathology and Laboratory Medicine, Translational Research Program, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Paul Christos
- Department of Biostatistics, Weill Cornell Medicine, New York, NY, USA
| | - Itzel Nino
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Tina Niu
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Jorge Contreras
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Ellen K Ritchie
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Pinkal Desai
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Michael Samuel
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Gail J Roboz
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
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13
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Caruso T, Salani F, Catanese S, Pratesi F, Mercinelli C, Motta G, Genovesi V, Bonato A, Sara G, Masi G, Migliorini P. Repeated SARS-CoV-2 vaccination in cancer patients treated with immune checkpoint inhibitors: induction of high-avidity anti-RBD neutralizing antibodies. Int J Clin Oncol 2023; 28:363-369. [PMID: 36689013 PMCID: PMC9869844 DOI: 10.1007/s10147-023-02295-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 01/04/2023] [Indexed: 01/24/2023]
Abstract
BACKGROUND Cancer patients are more vulnerable to COVID-19 and are thus given high priority in vaccination campaigns. In solid cancer patients treated with checkpoint inhibitors, we evaluated the amount of anti-RBD and neutralizing antibodies and antibody avidity after two or three doses of the vaccine. METHODS Thirty-eight solid cancer patients, 15 untreated hematological patients and 21 healthy subjects were enrolled in the study. Blood was collected before the first dose (T0), 21 days after the second (T2) and in 18 solid cancer patients also 15 days after the third dose of vaccine (T3). IgG, IgM and IgA anti-RBD antibodies were detected by ELISA. Neutralizing antibodies were measured testing the inhibition of RBD binding to ACE2. Antibody avidity was evaluated in 18 patients by a urea avidity ELISA. RESULTS IgG anti-RBD antibodies were produced in 65.8% of the cancer patients at T2, and in 60% of hematological patients at levels lower than healthy controls. IgM and IgA anti-RBD antibodies were also produced in 5.3% and 21% cancer patients, respectively. At T3, a significant increase in anti-RBD IgG levels was observed. Neutralizing antibodies were produced in 68.4% of cancer patients as compared with 93% of untreated hematological patients and 100% of controls, at titers lower than in healthy subjects. At T3, neutralizing antibodies and avidity of IgG anti-RBD increased; 6/18 patients negative at T2 developed neutralizing antibodies at T3. CONCLUSION The data indicate that in cancer patients mRNA vaccine induces high avidity anti-RBD antibodies and neutralizing antibodies that increase after the third dose. The process of induction and selection of high-affinity antibodies is apparently unaffected by the treatment with anti-PD-1 or anti-PD-L1 antibodies.
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Affiliation(s)
- Teresita Caruso
- Clinical Immunology and Allergy Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56126, Pisa, Italy
| | - Francesca Salani
- Oncology Unit, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy.,Sant'Anna School of Advanced Studies, Pisa, Italy
| | - Silvia Catanese
- Department of Translational Medicine and New Technologies for Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Federico Pratesi
- Clinical Immunology and Allergy Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56126, Pisa, Italy
| | - Chiara Mercinelli
- Oncology Unit, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Giuseppe Motta
- Clinical Immunology and Allergy Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56126, Pisa, Italy
| | - Virginia Genovesi
- Oncology Unit, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Adele Bonato
- Oncology Unit, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Galimberti Sara
- Hematology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gianluca Masi
- Department of Translational Medicine and New Technologies for Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Paola Migliorini
- Clinical Immunology and Allergy Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56126, Pisa, Italy.
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14
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Sugiura T, Sugiura H, Kato H, Nariai Y, Mizumoto Y, Hanada K, Takahashi R, Hinotubo Y, Tanaka N, Sasaki M, Eguchi H, Kamino H, Urano T. Kinetics of Anti-SARS-CoV-2 Antibody Response Following Two Doses of the BNT162b2 mRNA Vaccine: A Japanese Single-Center Primary Care Clinic Report Involving Volunteers and Patients with Autoimmune Disease. Infect Dis Rep 2022; 15:24-33. [PMID: 36648857 PMCID: PMC9844396 DOI: 10.3390/idr15010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/07/2022] [Accepted: 12/18/2022] [Indexed: 12/28/2022] Open
Abstract
Despite the promising effectiveness of the coronavirus disease 2019 vaccination using an mRNA vaccine, the short efficacy duration and some poor responses to the vaccination remain major concerns. We aimed to clarify the monthly kinetics of the anti-SARS-CoV-2 spike receptor-binding domain antibody response after two doses of the BNT162b2 vaccine in a Japanese population. A chemiluminescent enzyme immunoassay (CLIA) and an enzyme-linked immunosorbent assay were used to measure the antibody levels in 81 Japanese adults (age, <65 years). The antibody levels increased 10-fold at 2−3 weeks following the second dose of BNT162b2 and declined thereafter to approximately 50%, 20%, and 10% of the peak levels at 2, 3, and 6 months, respectively. To compare the antibody titers among different groups, older adults (age, >65 years; n = 38) and patients with systemic lupus erythematosus (SLE, n = 14) were also investigated. A decline in the mean relative antibody titers was observed in older men compared with younger men and in patients with SLE compared with individuals aged <65 years. Although the antibody levels increased drastically following two BNT162b2 doses, they then declined rapidly. Furthermore, poor responders to the vaccination were observed. Repeated vaccinations are required to maintain high antibody levels.
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Affiliation(s)
- Tomoko Sugiura
- Department of Biochemistry, Faculty of Medicine, Shimane University, 89-1, Enya-cho, Izumo City 693-0021, Japan
- Sugiura Clinic, 2-8-3, Kitahon-machi, Imachi-cho, Izumo City 693-0002, Japan
- Correspondence: ; Tel.: +81-853-20-2127
| | - Hiroaki Sugiura
- Sugiura Clinic, 2-8-3, Kitahon-machi, Imachi-cho, Izumo City 693-0002, Japan
| | - Hiroaki Kato
- Department of Biochemistry, Faculty of Medicine, Shimane University, 89-1, Enya-cho, Izumo City 693-0021, Japan
| | - Yuko Nariai
- Department of Biochemistry, Faculty of Medicine, Shimane University, 89-1, Enya-cho, Izumo City 693-0021, Japan
| | - Yuuki Mizumoto
- Department of Biochemistry, Faculty of Medicine, Shimane University, 89-1, Enya-cho, Izumo City 693-0021, Japan
| | - Kozue Hanada
- Sugiura Clinic, 2-8-3, Kitahon-machi, Imachi-cho, Izumo City 693-0002, Japan
| | - Rieko Takahashi
- Sugiura Clinic, 2-8-3, Kitahon-machi, Imachi-cho, Izumo City 693-0002, Japan
| | - Yukari Hinotubo
- Sugiura Clinic, 2-8-3, Kitahon-machi, Imachi-cho, Izumo City 693-0002, Japan
| | - Naoko Tanaka
- Sugiura Clinic, 2-8-3, Kitahon-machi, Imachi-cho, Izumo City 693-0002, Japan
| | - Mutsumi Sasaki
- Sugiura Clinic, 2-8-3, Kitahon-machi, Imachi-cho, Izumo City 693-0002, Japan
| | - Haruki Eguchi
- Eguchi Clinic, 6-43, Enya-Arihara-cho, Izumo City 693-0023, Japan
| | - Hiroki Kamino
- Department of Biochemistry, Faculty of Medicine, Shimane University, 89-1, Enya-cho, Izumo City 693-0021, Japan
- mAbProtein Co., Ltd. 89-1, Enya-cho, Izumo City 93-0021, Japan
| | - Takeshi Urano
- Department of Biochemistry, Faculty of Medicine, Shimane University, 89-1, Enya-cho, Izumo City 693-0021, Japan
- mAbProtein Co., Ltd. 89-1, Enya-cho, Izumo City 93-0021, Japan
- Vaccines and Therapeutic Antibodies for Emerging Infectious Diseases, Shimane University, Izumo City 693-0021, Japan
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15
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Immune Response and Effects of COVID-19 Vaccination in Patients with Lung Cancer-COVID Lung Vaccine Study. Cancers (Basel) 2022; 15:cancers15010137. [PMID: 36612134 PMCID: PMC9817972 DOI: 10.3390/cancers15010137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/16/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Lung cancer patients represent a subgroup of special vulnerability in whom the SARS-CoV-2 infection could attain higher rates of morbidity and mortality. Therefore, those patients were recommended to receive SARS-CoV-2 vaccines once they were approved. However, little was known at that time regarding the degree of immunity developed after vaccination or vaccine-related adverse events, and more uncertainty involved the real need for a third dose. We sought to evaluate the immune response developed after vaccination, as well as the safety and efficacy of SARS-CoV-2 vaccines in a cohort of patients with lung cancer. Patients were identified through the Oncology/Hematology Outpatient Vaccination Program. Anti-Spike IgG was measured before any vaccine and at 3-6-, 6-9- and 12-15-month time points after the 2nd dose. Detailed clinical data were also collected. In total, 126 patients with lung cancer participated and received at least one dose of the SARS-CoV-2 vaccine. At 3-6 months after 2nd dose, 99.1% of baseline seronegative patients seroconverted and anti-Spike IgG titers went from a median value of 9.45 to 720 UI/mL. At the 6-9-month time point, titers raised to a median value of 924 UI/mL, and at 12-15 months, after the boost dose, they reached a median value of 3064 UI/mL. Adverse events to the vaccine were mild, and no SARS- CoV-2 infection-related deaths were recorded. In this lung cancer cohort, COVID-19 vaccines were safe and effective irrespective of the systemic anticancer therapy. Most of the patients developed anti-Spike IgG after the second dose, and these titers were maintained over time with low infection and reinfection rates with a mild clinical course.
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16
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Immunogenicity and risks associated with impaired immune responses following SARS-CoV-2 vaccination and booster in hematologic malignancy patients: an updated meta-analysis. Blood Cancer J 2022; 12:173. [PMID: 36550105 PMCID: PMC9780106 DOI: 10.1038/s41408-022-00776-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
Patients with hematologic malignancies (HM) have demonstrated impaired immune responses following SARS-CoV-2 vaccination. Factors associated with poor immunogenicity remain largely undetermined. A literature search was conducted using PubMed, EMBASE, Cochrane, and medRxiv databases to identify studies that reported humoral or cellular immune responses (CIR) following complete SARS-CoV-2 vaccination. The primary aim was to estimate the seroconversion rate (SR) following complete SARS-CoV-2 vaccination across various subtypes of HM diseases and treatments. The secondary aims were to determine the rates of development of neutralizing antibodies (NAb) and CIR following complete vaccination and SR following booster doses. A total of 170 studies were included for qualitative and quantitative analysis of primary and secondary outcomes. A meta-analysis of 150 studies including 20,922 HM patients revealed a pooled SR following SARS-CoV-2 vaccination of 67.7% (95% confidence interval [CI], 64.8-70.4%; I2 = 94%). Meta-regression analysis showed that patients with lymphoid malignancies, but not myeloid malignancies, had lower seroconversion rates than those with solid cancers (R2 = 0.52, P < 0.0001). Patients receiving chimeric antigen receptor T-cells (CART), B-cell targeted therapies or JAK inhibitors were associated with poor seroconversion (R2 = 0.39, P < 0.0001). The pooled NAb and CIR rates were 52.8% (95% CI; 45.8-59.7%, I2 = 87%) and 66.6% (95% CI, 57.1-74.9%; I2 = 86%), respectively. Approximately 20.9% (95% CI, 11.4-35.1%, I2 = 90%) of HM patients failed to elicit humoral and cellular immunity. Among non-seroconverted patients after primary vaccination, only 40.5% (95% CI, 33.0-48.4%; I2 = 87%) mounted seroconversion after the booster. In conclusion, HM patients, especially those with lymphoid malignancies and/or receiving CART, B-cell targeted therapies, or JAK inhibitors, showed poor SR after SARS-CoV-2 vaccination. A minority of patients attained seroconversion after booster vaccination. Strategies to improve immune response in these severely immunosuppressed patients are needed.
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17
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Noori M, Azizi S, Abbasi Varaki F, Nejadghaderi SA, Bashash D. A systematic review and meta-analysis of immune response against first and second doses of SARS-CoV-2 vaccines in adult patients with hematological malignancies. Int Immunopharmacol 2022; 110:109046. [PMID: 35843148 PMCID: PMC9273573 DOI: 10.1016/j.intimp.2022.109046] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/05/2022] [Accepted: 07/08/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cancer patients particularly those with hematological malignancies are at higher risk of affecting by severe coronavirus disease 2019 (COVID-19). Due to the immunocompromised nature of the disease and the immunosuppressive treatments, they are more likely to develop less antibody protection; therefore, we aimed to evaluate the immunogenicity of COVID-19 vaccines in patients with hematological malignancies. METHODS A comprehensive systematic search was conducted in PubMed, Scopus, and Web of Science databases, as well as Google scholar search engine as of December 10, 2021. Our primary outcomes of interest comprised of estimating the antibody seropositive rate following COVID-19 vaccination in patients with hematological malignancies and to compare it with those who were affected by solid tumors or healthy subjects. The secondary outcomes were to assess the vaccine's immunogenicity based on different treatments, status of the disease, and type of vaccine. After the two-step screening, the data were extracted and the summary measures were calculated using a random-effect model. RESULTS A total of 82 articles recording 13,804 patients with a diagnosis of malignancy were included in the present review. The seropositive rates in patients with hematological malignancies after first and second vaccine doses were 30.0% (95% confidence interval (95%CI): 11.9-52.0) and 62.3% (95%CI 56.0-68.5), respectively. These patients were less likely to develop antibody response as compared to cases with solid tumors (RR 0.73, 95%CI 0.67-0.79) and healthy subjects (RR 0.62, 95%CI 0.54-0.71) following complete immunization. Chronic lymphocytic leukemia (CLL) patients had the lowest response rate among all subtypes of hematological malignancies (first dose: 22.0%, 95%CI 13.5-31.8 and second dose: 47.8%, 95%CI 41.2-54.4). Besides, anti-CD20 therapies (5.7%, 95%CI 2.0-10.6) and bruton's tyrosine kinase inhibitors (26.8%, 95%CI 16.9-37.8) represented the lowest seropositiveness post first and second doses, respectively. Notably, patients who were in active status of disease showed lower antibody detection rate compared to those on remission status (RR 0.87, 95%CI 0.76-0.99). Furthermore, lower rate of seropositivity was found in patients received BNT162.b2 compared to ones who received mRNA-1273 (RR 0.89, 95%CI 0.79-0.99). CONCLUSION Our findings highlight the substantially low rate of seroprotection in patients with hematological malignancies with a wide range of rates among disease subgroups and different treatments; further highlighting the fact that booster doses might be acquired for these patients to improve immunity against SARS-CoV-2.
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Affiliation(s)
- Maryam Noori
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Azizi
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Farhan Abbasi Varaki
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Aria Nejadghaderi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Davood Bashash
- Department of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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18
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Evans JP, Zeng C, Qu P, Faraone J, Zheng YM, Carlin C, Bednash JS, Zhou T, Lozanski G, Mallampalli R, Saif LJ, Oltz EM, Mohler PJ, Xu K, Gumina RJ, Liu SL. Neutralization of SARS-CoV-2 Omicron sub-lineages BA.1, BA.1.1, and BA.2. Cell Host Microbe 2022; 30:1093-1102.e3. [PMID: 35526534 PMCID: PMC9035359 DOI: 10.1016/j.chom.2022.04.014] [Citation(s) in RCA: 83] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/07/2022] [Accepted: 04/20/2022] [Indexed: 01/28/2023]
Abstract
Recent reports of SARS-CoV-2 Omicron variant sub-lineages, BA.1, BA.1.1, and BA.2, have reignited concern over potential escape from vaccine- and infection-induced immunity. We examine the sensitivity of these sub-lineages and other major variants to neutralizing antibodies from mRNA-vaccinated and boosted individuals, as well as recovered COVID-19 patients, including those infected with Omicron. We find that all Omicron sub-lineages, especially BA.1 and BA.1.1, exhibit substantial immune escape that is largely overcome by mRNA vaccine booster doses. While Omicron BA.1.1 escapes almost completely from neutralization by early-pandemic COVID-19 patient sera and to a lesser extent from sera of Delta-infected patients, BA.1.1 is sensitive to Omicron-infected patient sera. Critically, all Omicron sub-lineages, including BA.2, are comparably neutralized by Omicron patient sera. These results highlight the importance of booster vaccine doses for protection against all Omicron variants and provide insight into the immunity from natural infection against Omicron sub-lineages.
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Affiliation(s)
- John P Evans
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA; Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA; Molecular, Cellular, and Developmental Biology Program, The Ohio State University, Columbus, OH 43210, USA
| | - Cong Zeng
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA; Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
| | - Panke Qu
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA; Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
| | - Julia Faraone
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA; Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA; Molecular, Cellular, and Developmental Biology Program, The Ohio State University, Columbus, OH 43210, USA
| | - Yi-Min Zheng
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA; Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
| | - Claire Carlin
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Joseph S Bednash
- Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Tongqing Zhou
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Gerard Lozanski
- Department of Pathology, The Ohio State University, Columbus, OH 43210, USA
| | - Rama Mallampalli
- Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Linda J Saif
- Center for Food Animal Health, Animal Sciences Department, OARDC, College of Food, Agricultural and Environmental Sciences, The Ohio State University, Wooster, OH 44691, USA; Veterinary Preventive Medicine Department, College of Veterinary Medicine, The Ohio State University, Wooster, OH 44691, USA; Viruses and Emerging Pathogens Program, Infectious Diseases Institute, The Ohio State University, Columbus, OH 43210, USA
| | - Eugene M Oltz
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH 43210, USA
| | - Peter J Mohler
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH 43210, USA; Frick Center for Heart Failure and Arrhythmia Research, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; Department of Physiology and Cell Biology, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Kai Xu
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA; Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
| | - Richard J Gumina
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH 43210, USA; Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; Department of Physiology and Cell Biology, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Shan-Lu Liu
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA; Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA; Viruses and Emerging Pathogens Program, Infectious Diseases Institute, The Ohio State University, Columbus, OH 43210, USA; Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH 43210, USA.
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19
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Qu P, Faraone JN, Evans JP, Zheng YM, Carlin C, Lozanski G, Saif LJ, Oltz EM, Gumina RJ, Liu SL. Durability of the Neutralizing Antibody Response to mRNA Booster Vaccination Against SARS-CoV-2 BA.2.12.1 and BA.4/5 Variants. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2022:2022.07.21.501010. [PMID: 35898337 PMCID: PMC9327628 DOI: 10.1101/2022.07.21.501010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The recent emergence of the SARS-CoV-2 BA.4/5 and BA.2.12.1 variants has led to rising COVID-19 case numbers and concerns over the continued efficacy of mRNA booster vaccination. Here we examine the durability of neutralizing antibody (nAb) responses against these SARS-CoV-2 Omicron subvariants in a cohort of health care workers 1-40 weeks after mRNA booster dose administration. Neutralizing antibody titers fell by ~1.5-fold 4-6 months and by ~2.5-fold 7-9 months after booster dose, with average nAb titers falling by 11-15% every 30 days, far more stable than two dose induced immunity. Notably, nAb titers from booster recipients against SARS-CoV-2 BA.1, BA.2.12.1, and BA.4/5 variants were ~4.7-, 7.6-, and 13.4-fold lower than against the ancestral D614G spike. However, the rate of waning of booster dose immunity was comparable across variants. Importantly, individuals reporting prior infection with SARS-CoV-2 exhibited significantly higher nAb titers compared to those without breakthrough infection. Collectively, these results highlight the broad and stable neutralizing antibody response induced by mRNA booster dose administration, implicating a significant role of virus evolution to evade nAb specificity, versus waning humoral immunity, in increasing rates of breakthrough infection.
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Affiliation(s)
- Panke Qu
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
| | - Julia N. Faraone
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
- Molecular, Cellular, and Developmental Biology Program, The Ohio State University, Columbus, OH 43210, USA
| | - John P. Evans
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
- Molecular, Cellular, and Developmental Biology Program, The Ohio State University, Columbus, OH 43210, USA
| | - Yi-Min Zheng
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
| | - Claire Carlin
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Gerard Lozanski
- Department of Pathology, The Ohio State University, Columbus, OH 43210, USA
| | - Linda J. Saif
- Center for Food Animal Health, Animal Sciences Department, OARDC, College of Food, Agricultural and Environmental Sciences, The Ohio State University, Wooster, OH 44691, USA
- Veterinary Preventive Medicine Department, College of Veterinary Medicine, The Ohio State University, Wooster, OH 44691, USA
- Viruses and Emerging Pathogens Program, Infectious Diseases Institute, The Ohio State University, Columbus, OH 43210, USA
| | - Eugene M. Oltz
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH 43210, USA
| | - Richard J. Gumina
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH 43210, USA
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
- Department of Physiology and Cell Biology, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
| | - Shan-Lu Liu
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
- Viruses and Emerging Pathogens Program, Infectious Diseases Institute, The Ohio State University, Columbus, OH 43210, USA
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH 43210, USA
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20
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Bergamaschi C, Pagoni M, Rosati M, Angel M, Tzannou I, Vlachou M, Darmani I, Ullah A, Bear J, Devasundaram S, Burns R, Baltadakis I, Gigantes S, Dimopoulos MA, Pavlakis GN, Terpos E, Felber BK. Reduced Antibodies and Innate Cytokine Changes in SARS-CoV-2 BNT162b2 mRNA Vaccinated Transplant Patients With Hematological Malignancies. Front Immunol 2022; 13:899972. [PMID: 35693807 PMCID: PMC9174567 DOI: 10.3389/fimmu.2022.899972] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 04/28/2022] [Indexed: 12/29/2022] Open
Abstract
Immunocompromised individuals including patients with hematological malignancies constitute a population at high risk of developing severe disease upon SARS-CoV-2 infection. Protection afforded by vaccination is frequently low and the biology leading to altered vaccine efficacy is not fully understood. A patient cohort who had received bone marrow transplantation or CAR-T cells was studied following a 2-dose BNT162b2 mRNA vaccination and compared to healthy vaccine recipients. Anti-Spike antibody and systemic innate responses were compared in the two vaccine cohorts. The patients had significantly lower SARS-CoV-2 Spike antibodies to the Wuhan strain, with proportional lower cross-recognition of Beta, Delta, and Omicron Spike-RBD proteins. Both cohorts neutralized the wildtype WA1 and Delta but not Omicron. Vaccination elicited an innate cytokine signature featuring IFN-γ, IL-15 and IP-10/CXCL10, but most patients showed a diminished systemic cytokine response. In patients who failed to develop antibodies, the innate systemic response was dominated by IL-8 and MIP-1α with significant attenuation in the IFN-γ, IL-15 and IP-10/CXCL10 signature response. Changes in IFN-γ and IP-10/CXCL10 at priming vaccination and IFN-γ, IL-15, IL-7 and IL-10 upon booster vaccination correlated with the Spike antibody magnitude and were predictive of successful antibody development. Overall, the patients showed heterogeneous adaptive and innate responses with lower humoral and reduced innate cytokine responses to vaccination compared to naïve vaccine recipients. The pattern of responses described offer novel prognostic approaches for potentiating the effectiveness of COVID-19 vaccination in transplant patients with hematological malignancies.
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Affiliation(s)
- Cristina Bergamaschi
- Human Retrovirus Pathogenesis Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute at Frederick, Frederick, MD, United States
| | - Maria Pagoni
- Department of Hematology & Lymphomas and Bone Marrow Transplantation Unit, Evangelismos General Hospital, Athens, Greece
| | - Margherita Rosati
- Human Retrovirus Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute at Frederick, Frederick, MD, United States
| | - Matthew Angel
- Vaccine Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, United States.,Center for Cancer Research Collaborative Bioinformatics Resource, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, United States
| | - Ifigeneia Tzannou
- Department of Hematology & Lymphomas and Bone Marrow Transplantation Unit, Evangelismos General Hospital, Athens, Greece
| | | | - Ismini Darmani
- Department of Hematology & Lymphomas and Bone Marrow Transplantation Unit, Evangelismos General Hospital, Athens, Greece
| | - Amirah Ullah
- Human Retrovirus Pathogenesis Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute at Frederick, Frederick, MD, United States
| | - Jenifer Bear
- Human Retrovirus Pathogenesis Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute at Frederick, Frederick, MD, United States
| | - Santhi Devasundaram
- Human Retrovirus Pathogenesis Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute at Frederick, Frederick, MD, United States
| | - Robert Burns
- Human Retrovirus Pathogenesis Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute at Frederick, Frederick, MD, United States
| | - Ioannis Baltadakis
- Department of Hematology & Lymphomas and Bone Marrow Transplantation Unit, Evangelismos General Hospital, Athens, Greece
| | - Stavros Gigantes
- Department of Hematology & Lymphomas and Bone Marrow Transplantation Unit, Evangelismos General Hospital, Athens, Greece
| | | | - George N Pavlakis
- Human Retrovirus Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute at Frederick, Frederick, MD, United States
| | - Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Barbara K Felber
- Human Retrovirus Pathogenesis Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute at Frederick, Frederick, MD, United States
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21
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Mencoboni M, Fontana V, Damiani A, Spitaleri A, Raso A, Bottaro LC, Rossi G, Canobbio L, La Camera A, Filiberti RA, Taveggia P, Cavo A. Antibody Response to COVID-19 mRNA Vaccines in Oncologic and Hematologic Patients Undergoing Chemotherapy. Curr Oncol 2022; 29:3364-3374. [PMID: 35621663 PMCID: PMC9139308 DOI: 10.3390/curroncol29050273] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/01/2022] [Accepted: 05/03/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Information on immune responses in cancer patients following mRNA COVID-19 vaccines is still insufficient, but generally, patients had impaired serological responses, especially those with hematological malignancies. We evaluated serological response to COVID-19 mRNA vaccine in cancer patients receiving chemotherapy compared with healthy controls. METHODS In total, 195 cancer patients and 400 randomly selected controls who had been administered a Pfizer-BioNTech or Moderna COVID-19 vaccines in two doses were compared. The threshold of positivity was 4.33 BAU/mL. Patients were receiving anticancer treatment after the first and second dose of the vaccines. RESULTS a TOTAL OF 169 patients (87%) had solid tumors and 26 hemolymphopoietic diseases. Seropositivity rate was lower in patients than controls (91% vs. 96%), with an age/gender-adjusted rate ratio (RR) of 0.95 (95% CL = 0.89-1.02). Positivity was found in 97% of solid cancers and in 50% of hemolymphopoietic tumors. Both advanced and adjuvant therapy seemed to slightly reduce seropositivity rates in patients when compared to controls (RR = 0.97, 95% CL = 0.89-1.06; RR = 0.94, 95% CL = 0.87-1.01). CONCLUSIONS the response to vaccination is similar in patients affected by solid tumors to controls. On the contrary, hemolymphopietic patients show a much lower response than controls.
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Affiliation(s)
- Manlio Mencoboni
- Oncology Unit, ASL 3, Villa Scassi Hospital, Corso Scassi 1, 16149 Genoa, Italy; (M.M.); (A.D.); (A.L.C.); (P.T.); (A.C.)
| | - Vincenzo Fontana
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 12, 16100 Genoa, Italy;
| | - Azzurra Damiani
- Oncology Unit, ASL 3, Villa Scassi Hospital, Corso Scassi 1, 16149 Genoa, Italy; (M.M.); (A.D.); (A.L.C.); (P.T.); (A.C.)
| | - Antonino Spitaleri
- Analysis Laboratory, ASL 3, Via Bertani 4, 16125 Genoa, Italy; (A.S.); (A.R.)
| | - Alessandro Raso
- Analysis Laboratory, ASL 3, Via Bertani 4, 16125 Genoa, Italy; (A.S.); (A.R.)
| | | | - Giovanni Rossi
- Oncology Unit, Antero Micone Hospital, Largo Nevio Rosso 2, 16100 Genoa, Italy; (G.R.); (L.C.)
| | - Luciano Canobbio
- Oncology Unit, Antero Micone Hospital, Largo Nevio Rosso 2, 16100 Genoa, Italy; (G.R.); (L.C.)
| | - Antonella La Camera
- Oncology Unit, ASL 3, Villa Scassi Hospital, Corso Scassi 1, 16149 Genoa, Italy; (M.M.); (A.D.); (A.L.C.); (P.T.); (A.C.)
| | - Rosa Angela Filiberti
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 12, 16100 Genoa, Italy;
| | - Paola Taveggia
- Oncology Unit, ASL 3, Villa Scassi Hospital, Corso Scassi 1, 16149 Genoa, Italy; (M.M.); (A.D.); (A.L.C.); (P.T.); (A.C.)
| | - Alessia Cavo
- Oncology Unit, ASL 3, Villa Scassi Hospital, Corso Scassi 1, 16149 Genoa, Italy; (M.M.); (A.D.); (A.L.C.); (P.T.); (A.C.)
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22
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Sharafeldin N, Bates B, Vachhani P. How the COVID-19 Pandemic Reshaped the Management of Leukemia and Affected Patient Outcomes. Curr Treat Options Oncol 2022; 23:688-702. [PMID: 35334062 PMCID: PMC8951659 DOI: 10.1007/s11864-022-00975-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2022] [Indexed: 11/29/2022]
Abstract
The coronavirus disease-19 (COVID-19) pandemic has posed numerous challenges to the global healthcare system. Of particular gravity is adult and pediatric patients with hematologic malignancies who are among the most vulnerable groups of patients at risk of severe COVID-19 outcomes. In the early phases of the pandemic, several treatment modifications were proposed for patients with leukemia. Largely speaking, these were adopting less-intense therapies and more utilization of the outpatient setting. Over time, our understanding and management have become more nuanced. Furthermore, equipped with vaccinations to prevent COVID-19 infection and availability of treatments in the presence of COVID-19 infection, the recommendations on management of patients with leukemia have evolved. Patient’s leukemia characteristics, possibility of targeted therapy, vaccination status, symptomatology, comorbidities, goal of anti-leukemic therapy, the intensity of therapy, the setting of treatment, as well as loco regional factors like dynamic incidence of COVID-19 in the community and hospital/ICU bed status are among many factors that influence the decisions. Furthermore, the oncology community has adopted delaying the anti-leukemia therapy for a limited time frame, if clinically possible, so as to still deliver most appropriate therapy while minimizing risks. Early adoption of growth factor support and conservative blood transfusion practices have helped as well. In this review, we discuss the impact of COVID-19 on outcomes and share considerations for treatments of leukemias. We describe the impact on both clinical care (from diagnosis to treatment) and research, and cover the literature on vaccines and treatments for COVID-19 in relation to leukemia.
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Affiliation(s)
- Noha Sharafeldin
- Division of Hematology and Oncology and O'Neal Comprehensive Cancer Center, Heersink School of Medicine, University of Alabama at Birmingham (UAB), 1600 7th Avenue South, Lowder 500, Birmingham, AL, 35233, USA.
| | - Benjamin Bates
- The Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA
| | - Pankit Vachhani
- Division of Hematology and Oncology and O'Neal Comprehensive Cancer Center, Heersink School of Medicine, University of Alabama at Birmingham (UAB), 1600 7th Avenue South, Lowder 500, Birmingham, AL, 35233, USA
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23
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Evans JP, Zeng C, Carlin C, Lozanski G, Saif LJ, Oltz EM, Gumina RJ, Liu SL. Neutralizing antibody responses elicited by SARS-CoV-2 mRNA vaccination wane over time and are boosted by breakthrough infection. Sci Transl Med 2022; 14:eabn8057. [PMID: 35166573 PMCID: PMC8939766 DOI: 10.1126/scitranslmed.abn8057] [Citation(s) in RCA: 119] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/03/2022] [Indexed: 12/21/2022]
Abstract
The waning efficacy of SARS-CoV-2 vaccines, combined with the continued emergence of variants resistant to vaccine-induced immunity, has reignited debate over the need for booster vaccine doses. To address this, we examined the neutralizing antibody response against the spike protein of five major SARS-CoV-2 variants, D614G, Alpha (B.1.1.7), Beta (B.1.351), Delta (B.1.617.2), and Omicron (B.1.1.529), in health care workers (HCWs) vaccinated with SARS-CoV-2 mRNA vaccines. Serum samples were collected before vaccination, 3 weeks after first vaccination, 1 month after second vaccination, and 6 months after second vaccination. Minimal neutralizing antibody titers were detected against Omicron pseudovirus at all four time points, including for most patients who had SARS-CoV-2 breakthrough infections. Neutralizing antibody titers against all other variant spike protein-bearing pseudoviruses declined markedly from 1 to 6 months after the second mRNA vaccine dose, although SARS-CoV-2 infection boosted vaccine responses. In addition, mRNA-1273-vaccinated HCWs exhibited about twofold higher neutralizing antibody titers than BNT162b2-vaccinated HCWs. Together, these results demonstrate possible waning of antibody-mediated protection against SARS-CoV-2 variants that is dependent on prior infection status and the mRNA vaccine received. They also show that the Omicron variant spike protein can almost completely escape from neutralizing antibodies elicited in recipients of only two mRNA vaccine doses.
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Affiliation(s)
- John P. Evans
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
- Molecular, Cellular, and Developmental Biology Program, The Ohio State University, Columbus, OH 43210, USA
| | - Cong Zeng
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
| | - Claire Carlin
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Gerard Lozanski
- Department of Pathology, The Ohio State University, Columbus, OH 43210, USA
| | - Linda J. Saif
- Center for Food Animal Health, Animal Sciences Department, OARDC, College of Food, Agricultural and Environmental Sciences, The Ohio State University, Wooster, OH 44691, USA
- Veterinary Preventive Medicine Department, College of Veterinary Medicine, The Ohio State University, Wooster, OH 44691, USA
- Viruses and Emerging Pathogens Program, Infectious Diseases Institute, The Ohio State University, Columbus, OH 43210, USA
| | - Eugene M. Oltz
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH 43210, USA
| | - Richard J. Gumina
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Shan-Lu Liu
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
- Viruses and Emerging Pathogens Program, Infectious Diseases Institute, The Ohio State University, Columbus, OH 43210, USA
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH 43210, USA
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24
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Azzolini E, Pozzi C, Germagnoli L, Oresta B, Carriglio N, Calleri M, Selmi C, De Santis M, Finazzi S, Carlo-Stella C, Bertuzzi A, Motta F, Ceribelli A, Mantovani A, Bonelli F, Rescigno M. mRNA COVID-19 vaccine booster fosters B- and T-cell responses in immunocompromised patients. Life Sci Alliance 2022; 5:5/6/e202201381. [PMID: 35169017 PMCID: PMC8860093 DOI: 10.26508/lsa.202201381] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 12/20/2022] Open
Abstract
Immunocompromised patients poorly respond to two doses of SARS-CoV-2 mRNA vaccines. However, an additional booster dose elicits a strong humoral and cellular immune response in these subjects. SARS-CoV-2 vaccination has proven effective in inducing an immune response in healthy individuals and is progressively us allowing to overcome the pandemic. Recent evidence has shown that response to vaccination in some vulnerable patients may be diminished, and it has been proposed a booster dose. We tested the kinetic of development of serum antibodies to the SARS-CoV-2 Spike protein, their neutralizing capacity, the CD4 and CD8 IFN-γ T-cell response in 328 subjects, including 131 immunocompromised individuals (cancer, rheumatologic, and hemodialysis patients), 160 health-care workers (HCW) and 37 subjects older than 75 yr, after vaccination with two or three doses of mRNA vaccines. We stratified the patients according to the type of treatment. We found that immunocompromised patients, depending on the type of treatment, poorly respond to SARS-CoV-2 mRNA vaccines. However, an additional booster dose of vaccine induced a good immune response in almost all of the patients except those receiving anti-CD20 antibody. Similarly to HCW, previously infected and vaccinated immunocompromised individuals demonstrate a stronger SARS-CoV-2–specific immune response than those who are vaccinated without prior infection.
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Affiliation(s)
- Elena Azzolini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele MI, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano MI, Italy
| | - Chiara Pozzi
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano MI, Italy
| | - Luca Germagnoli
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano MI, Italy
| | | | | | | | - Carlo Selmi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele MI, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano MI, Italy
| | - Maria De Santis
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele MI, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano MI, Italy
| | - Silvia Finazzi
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano MI, Italy
| | - Carmelo Carlo-Stella
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele MI, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano MI, Italy
| | - Alexia Bertuzzi
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano MI, Italy
| | - Francesca Motta
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele MI, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano MI, Italy
| | - Angela Ceribelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele MI, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano MI, Italy
| | - Alberto Mantovani
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele MI, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano MI, Italy.,William Harvey Research Institute, Queen Mary University of London, London, UK
| | | | - Maria Rescigno
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele MI, Italy .,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano MI, Italy
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25
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Zeng C, Evans JP, Chakravarthy K, Qu P, Reisinger S, Song NJ, Rubinstein MP, Shields PG, Li Z, Liu SL. COVID-19 mRNA booster vaccines elicit strong protection against SARS-CoV-2 Omicron variant in patients with cancer. Cancer Cell 2022; 40:117-119. [PMID: 34986328 PMCID: PMC8716174 DOI: 10.1016/j.ccell.2021.12.014] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Cong Zeng
- Center for Retrovirus Research, Ohio State University, Columbus, OH 43210, USA; Department of Veterinary Biosciences, Ohio State University, Columbus, OH 43210, USA
| | - John P Evans
- Center for Retrovirus Research, Ohio State University, Columbus, OH 43210, USA; Department of Veterinary Biosciences, Ohio State University, Columbus, OH 43210, USA; Molecular, Cellular and Developmental Biology Program, Ohio State University, Columbus, OH 43210, USA
| | - Karthik Chakravarthy
- Division of Medical Oncology, Department of Internal Medicine, Pelotonia Institute for Immuno-Oncology, Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Panke Qu
- Center for Retrovirus Research, Ohio State University, Columbus, OH 43210, USA; Department of Veterinary Biosciences, Ohio State University, Columbus, OH 43210, USA
| | - Sarah Reisinger
- Comprehensive Cancer Center, James Cancer Hospital, Ohio State University, Columbus, OH 43210, USA
| | - No-Joon Song
- Division of Medical Oncology, Department of Internal Medicine, Pelotonia Institute for Immuno-Oncology, Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Mark P Rubinstein
- Division of Medical Oncology, Department of Internal Medicine, Pelotonia Institute for Immuno-Oncology, Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Peter G Shields
- Comprehensive Cancer Center, James Cancer Hospital, Ohio State University, Columbus, OH 43210, USA.
| | - Zihai Li
- Division of Medical Oncology, Department of Internal Medicine, Pelotonia Institute for Immuno-Oncology, Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA.
| | - Shan-Lu Liu
- Center for Retrovirus Research, Ohio State University, Columbus, OH 43210, USA; Department of Veterinary Biosciences, Ohio State University, Columbus, OH 43210, USA; Viruses and Emerging Pathogens Program, Infectious Diseases Institute, Ohio State University, Columbus, OH 43210, USA; Department of Microbial Infection and Immunity, Ohio State University, Columbus, OH 43210, USA.
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26
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Rizzo A, Palmiotti G. SARS-CoV-2 Omicron variant in cancer patients: an insight into the vaccine booster debate. Future Oncol 2022; 18:1301-1302. [PMID: 35109688 PMCID: PMC8826832 DOI: 10.2217/fon-2022-0024] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Alessandro Rizzo
- Struttura Semplice Dipartimentale di Oncologia Medica per la Presa in Carico Globale del Paziente Oncologico "Don Tonino Bello," I.R.C.C.S. Istituto Tumori "Giovanni Paolo II," Viale Orazio Flacco 65, Bari, 70124, Italy
| | - Gennaro Palmiotti
- Struttura Semplice Dipartimentale di Oncologia Medica per la Presa in Carico Globale del Paziente Oncologico "Don Tonino Bello," I.R.C.C.S. Istituto Tumori "Giovanni Paolo II," Viale Orazio Flacco 65, Bari, 70124, Italy
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27
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Gyang TV, Evans JP, Miller JS, Alcorn K, Peng J, Bell EH, Zeng C, Gumina R, Liu SL, Segal BM. Neutralizing antibody responses against SARS-CoV-2 in vaccinated people with multiple sclerosis. Mult Scler J Exp Transl Clin 2022; 8:20552173221087357. [PMID: 35342640 PMCID: PMC8941285 DOI: 10.1177/20552173221087357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/25/2022] [Indexed: 11/27/2022] Open
Abstract
Background Patients with multiple sclerosis (pwMS) are often treated with disease
modifying therapies (DMT) with immunomodulatory effects. This is of
particular concern following the development of several vaccines to combat
coronavirus disease 19 (COVD-19), a potentially fatal illness caused by
SARS-CoV-2. Objectives To determine the efficacy of SARS-CoV-2 vaccination in pwMS and the impact of
disease modifying therapies (DMT) on vaccine response. Methods This is a prospective longitudinal study in pwMS. Longitudinal serum samples
were obtained prior to, and after SARS-CoV-2 mRNA vaccination. A novel
neutralizing antibody (nAb) assay was used to determine nAbs titres against
SARS-CoV-2 spike. Results We observed that (1) pwMS on B-cell depleting therapies exhibited reduced
response to vaccination compared to other pwMS, correlating with time from
last anti-CD20 infusion, (2) prior COVID-19 illness, DMT category, and
pyramidal function were significant predictors of vaccine responsiveness,
and (3) circulating absolute lymphocyte count (ALC) and IgG levels
correlated with nAb levels. Conclusions We demonstrate that pwMS exhibit reduced nAb response to mRNA vaccination
dependent on DMT status and identify predictive biomarkers for vaccine
efficacy. We conclude that additional vaccination strategies may be
necessary to achieve protective immunity in pwMS.
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Affiliation(s)
- Tirisham V Gyang
- Department of Neurology, The Ohio State University, Columbus, OH 43210, USA
| | - John P Evans
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
| | - Joseph S Miller
- Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
| | - Kariss Alcorn
- College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Juan Peng
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Erica H Bell
- Department of Neurology, The Ohio State University, Columbus, OH 43210, USA
| | - Cong Zeng
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
| | - Richard Gumina
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Shan-Lu Liu
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
| | - Benjamin M Segal
- Department of Neurology, The Ohio State University, Columbus, OH 43210, USA
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28
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Zeng C, Evans JP, Qu P, Faraone J, Zheng YM, Carlin C, Bednash JS, Zhou T, Lozanski G, Mallampalli R, Saif LJ, Oltz EM, Mohler P, Xu K, Gumina RJ, Liu SL. Neutralization and Stability of SARS-CoV-2 Omicron Variant. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2021. [PMID: 34981053 DOI: 10.1101/2021.10.04.463034] [Citation(s) in RCA: 890] [Impact Index Per Article: 296.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The SARS-CoV-2 B.1.1.529/Omicron variant was first characterized in South Africa and was swiftly designated a variant of concern 1 . Of great concern is its high number of mutations, including 30-40 mutations in the virus spike (S) protein compared to 7-10 for other variants. Some of these mutations have been shown to enhance escape from vaccine-induced immunity, while others remain uncharacterized. Additionally, reports of increasing frequencies of the Omicron variant may indicate a higher rate of transmission compared to other variants. However, the transmissibility of Omicron and its degree of resistance to vaccine-induced immunity remain unclear. Here we show that Omicron exhibits significant immune evasion compared to other variants, but antibody neutralization is largely restored by mRNA vaccine booster doses. Additionally, the Omicron spike exhibits reduced receptor binding, cell-cell fusion, S1 subunit shedding, but increased cell-to-cell transmission, and homology modeling indicates a more stable closed S structure. These findings suggest dual immune evasion strategies for Omicron, due to altered epitopes and reduced exposure of the S receptor binding domain, coupled with enhanced transmissibility due to enhanced S protein stability. These results highlight the importance of booster vaccine doses for maintaining protection against the Omicron variant, and provide mechanistic insight into the altered functionality of the Omicron spike protein.
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29
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Zeng C, Evans JP, Qu P, Faraone J, Zheng YM, Carlin C, Bednash JS, Zhou T, Lozanski G, Mallampalli R, Saif LJ, Oltz EM, Mohler P, Xu K, Gumina RJ, Liu SL. Neutralization and Stability of SARS-CoV-2 Omicron Variant. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2021:2021.12.16.472934. [PMID: 34981053 PMCID: PMC8722590 DOI: 10.1101/2021.12.16.472934] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The SARS-CoV-2 B.1.1.529/Omicron variant was first characterized in South Africa and was swiftly designated a variant of concern1. Of great concern is its high number of mutations, including 30-40 mutations in the virus spike (S) protein compared to 7-10 for other variants. Some of these mutations have been shown to enhance escape from vaccine-induced immunity, while others remain uncharacterized. Additionally, reports of increasing frequencies of the Omicron variant may indicate a higher rate of transmission compared to other variants. However, the transmissibility of Omicron and its degree of resistance to vaccine-induced immunity remain unclear. Here we show that Omicron exhibits significant immune evasion compared to other variants, but antibody neutralization is largely restored by mRNA vaccine booster doses. Additionally, the Omicron spike exhibits reduced receptor binding, cell-cell fusion, S1 subunit shedding, but increased cell-to-cell transmission, and homology modeling indicates a more stable closed S structure. These findings suggest dual immune evasion strategies for Omicron, due to altered epitopes and reduced exposure of the S receptor binding domain, coupled with enhanced transmissibility due to enhanced S protein stability. These results highlight the importance of booster vaccine doses for maintaining protection against the Omicron variant, and provide mechanistic insight into the altered functionality of the Omicron spike protein.
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Affiliation(s)
- Cong Zeng
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
| | - John P. Evans
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
- Molecular, Cellular, and Developmental Biology Program, The Ohio State University, Columbus, OH 43210, USA
| | - Panke Qu
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
| | - Julia Faraone
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
- Molecular, Cellular, and Developmental Biology Program, The Ohio State University, Columbus, OH 43210, USA
| | - Yi-Min Zheng
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
| | - Claire Carlin
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Joseph S. Bednash
- Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Tongqing Zhou
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Gerard Lozanski
- Department of Pathology, The Ohio State University, Columbus, OH 43210, USA
| | - Rama Mallampalli
- Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Linda J. Saif
- Center for Food Animal Health, Animal Sciences Department, OARDC, College of Food, Agricultural and Environmental Sciences, The Ohio State University, Wooster, OH 44691, USA
- Veterinary Preventive Medicine Department, College of Veterinary Medicine, The Ohio State University, Wooster, OH 44691, USA
- Viruses and Emerging Pathogens Program, Infectious Diseases Institute, The Ohio State University, Columbus, OH 43210, USA
| | - Eugene M. Oltz
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH 43210, USA
| | - Peter Mohler
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH 43210, USA
- Frick Center for Heart Failure and Arrhythmia Research, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
- Department of Physiology and Cell Biology, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
| | - Kai Xu
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
| | - Richard J. Gumina
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH 43210, USA
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
- Department of Physiology and Cell Biology, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA
| | - Shan-Lu Liu
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
- Viruses and Emerging Pathogens Program, Infectious Diseases Institute, The Ohio State University, Columbus, OH 43210, USA
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH 43210, USA
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