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Bakos T, Mészáros T, Kozma GT, Berényi P, Facskó R, Farkas H, Dézsi L, Heirman C, de Koker S, Schiffelers R, Glatter KA, Radovits T, Szénási G, Szebeni J. mRNA-LNP COVID-19 Vaccine Lipids Induce Complement Activation and Production of Proinflammatory Cytokines: Mechanisms, Effects of Complement Inhibitors, and Relevance to Adverse Reactions. Int J Mol Sci 2024; 25:3595. [PMID: 38612407 PMCID: PMC11012056 DOI: 10.3390/ijms25073595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/16/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
A small fraction of people vaccinated with mRNA-lipid nanoparticle (mRNA-LNP)-based COVID-19 vaccines display acute or subacute inflammatory symptoms whose mechanism has not been clarified to date. To better understand the molecular mechanism of these adverse events (AEs), here, we analyzed in vitro the vaccine-induced induction and interrelations of the following two major inflammatory processes: complement (C) activation and release of proinflammatory cytokines. Incubation of Pfizer-BioNTech's Comirnaty and Moderna's Spikevax with 75% human serum led to significant increases in C5a, sC5b-9, and Bb but not C4d, indicating C activation mainly via the alternative pathway. Control PEGylated liposomes (Doxebo) also induced C activation, but, on a weight basis, it was ~5 times less effective than that of Comirnaty. Viral or synthetic naked mRNAs had no C-activating effects. In peripheral blood mononuclear cell (PBMC) cultures supplemented with 20% autologous serum, besides C activation, Comirnaty induced the secretion of proinflammatory cytokines in the following order: IL-1α < IFN-γ < IL-1β < TNF-α < IL-6 < IL-8. Heat-inactivation of C in serum prevented a rise in IL-1α, IL-1β, and TNF-α, suggesting C-dependence of these cytokines' induction, although the C5 blocker Soliris and C1 inhibitor Berinert, which effectively inhibited C activation in both systems, did not suppress the release of any cytokines. These findings suggest that the inflammatory AEs of mRNA-LNP vaccines are due, at least in part, to stimulation of both arms of the innate immune system, whereupon C activation may be causally involved in the induction of some, but not all, inflammatory cytokines. Thus, the pharmacological attenuation of inflammatory AEs may not be achieved via monotherapy with the tested C inhibitors; efficacy may require combination therapy with different C inhibitors and/or other anti-inflammatory agents.
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Affiliation(s)
- Tamás Bakos
- Nanomedicine Research and Education Center, Department of Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (T.B.); (T.M.); (G.T.K.); (P.B.); (R.F.); (L.D.); (G.S.)
| | - Tamás Mészáros
- Nanomedicine Research and Education Center, Department of Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (T.B.); (T.M.); (G.T.K.); (P.B.); (R.F.); (L.D.); (G.S.)
- SeroScience LCC., 1089 Budapest, Hungary
- Department of Cardiology, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary;
- Department of Surgical Research and Techniques, Heart and Vascular Center, Semmelweis University, 1089 Budapest, Hungary
| | - Gergely Tibor Kozma
- Nanomedicine Research and Education Center, Department of Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (T.B.); (T.M.); (G.T.K.); (P.B.); (R.F.); (L.D.); (G.S.)
- SeroScience LCC., 1089 Budapest, Hungary
| | - Petra Berényi
- Nanomedicine Research and Education Center, Department of Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (T.B.); (T.M.); (G.T.K.); (P.B.); (R.F.); (L.D.); (G.S.)
- SeroScience LCC., 1089 Budapest, Hungary
| | - Réka Facskó
- Nanomedicine Research and Education Center, Department of Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (T.B.); (T.M.); (G.T.K.); (P.B.); (R.F.); (L.D.); (G.S.)
- SeroScience LCC., 1089 Budapest, Hungary
- Department of Cardiology, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary;
- Department of Surgical Research and Techniques, Heart and Vascular Center, Semmelweis University, 1089 Budapest, Hungary
| | - Henriette Farkas
- Hungarian Center of Reference and Excellence, Department of Internal Medicine and Hematology, Semmelweis University, 1088 Budapest, Hungary;
| | - László Dézsi
- Nanomedicine Research and Education Center, Department of Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (T.B.); (T.M.); (G.T.K.); (P.B.); (R.F.); (L.D.); (G.S.)
| | - Carlo Heirman
- Etherna Biopharmaceuticals, 2845 Niel, Belgium; (C.H.); (S.d.K.)
| | - Stefaan de Koker
- Etherna Biopharmaceuticals, 2845 Niel, Belgium; (C.H.); (S.d.K.)
| | - Raymond Schiffelers
- Division of Laboratories and Pharmacy, University Medical Center, 3584 CX Utrecht, The Netherlands;
| | | | - Tamás Radovits
- Department of Cardiology, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary;
- Department of Surgical Research and Techniques, Heart and Vascular Center, Semmelweis University, 1089 Budapest, Hungary
| | - Gábor Szénási
- Nanomedicine Research and Education Center, Department of Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (T.B.); (T.M.); (G.T.K.); (P.B.); (R.F.); (L.D.); (G.S.)
| | - János Szebeni
- Nanomedicine Research and Education Center, Department of Translational Medicine, Semmelweis University, 1085 Budapest, Hungary; (T.B.); (T.M.); (G.T.K.); (P.B.); (R.F.); (L.D.); (G.S.)
- SeroScience LCC., 1089 Budapest, Hungary
- Department of Nanobiotechnology and Regenerative Medicine, Faculty of Health Sciences, Miskolc University, 3530 Miskolc, Hungary
- Translational Nanobioscience Research Center, Sungkyunkwan University, Suwon 06351, Republic of Korea
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