Antibody response to inactivated COVID-19 vaccine in patients with type 2 diabetes mellitus after the booster immunization

J Diabetes. 2023 Nov;15(11):931-943. doi: 10.1111/1753-0407.13448. Epub 2023 Jul 30.

Abstract
in English, Chinese

Background: The immunogenicity of booster inactivated COVID-19 vaccines in patients with type 2 diabetes mellitus (T2DM) has remained unclear. Our study aims to investigate the antibody response to inactivated COVID-19 vaccine following booster vaccination in patients with T2DM.

Methods: A total of 201 patients with T2DM and 102 healthy controls (HCs) were enrolled. The levels of anti-SARS-CoV-2 total antibodies, anti-receptor-binding domain (RBD)-specific IgG, neutralizing antibody (NAb) toward SARS-CoV-2 wild type (WT), and NAb toward SARS-CoV-2 Omicron BA.4/5 subvariant were measured to evaluate the vaccine-induced immunological responses.

Results: The titers of anti-RBD-specific IgG (p = 0.018) and inhibition rates of NAb toward WT (p = 0.007) were significantly decreased in patients with T2DM compared to HCs after booster vaccination for more than 6 months. Both HCs and patients with T2DM showed poor resistance against BA.4/5 due to the detected inhibition rates being lower than the positive threshold. The levels of anti-RBD-specific IgG were positively associated with the proportions of CD3+ CD4- CD8- T cells (p = 0.045), and patients with T2DM who had anti-RBD-specific IgG positivity showed higher proportions of CD3+ CD4- CD8- T cells compared to those negative (p = 0.005).

Conclusions: Patients with T2DM showed impaired antibody responses after booster vaccination for more than 6 months. Decreased anti-BA.4/5 responses give rise to the possibility of breakthrough infections for both patients with T2DM and HCs.

背景:目前尚不清楚2型糖尿病(T2DM)患者接种增强剂次灭活新型冠状病毒病(COVID-19)疫苗后的免疫原性。本研究旨在调查T2DM患者在接种增强剂次灭活COVID-19疫苗后的抗体反应。 方法:共纳入201例T2DM患者和102名健康对照(HCs)。测量抗严重急性呼吸综合症冠状病毒2(SARS-CoV-2)总抗体、针对受体结合结构域(RBD)特异性IgG、针对SARS-CoV-2野生型(WT)的中和抗体(NAb)以及针对SARS-CoV-2Omicron BA.4/5亚变体的NAb水平, 以评估疫苗接种诱导的免疫学反应。 结果:与HCs相比, T2DM患者在接种增强剂次疫苗后超过6个月的抗RBD特异性IgG滴度(P = 0.018)和针对WT的NAb抑制率(P = 0.007)显著降低。HCs和T2DM均表现出对BA.4/5的抵抗力较差, 因为检测到的抑制率低于阳性阈值。抗RBD特异性IgG水平与CD3+CD4-CD8- T细胞的比例呈正相关(P = 0.045), 与阴性相比, T2DM患者的抗RBD特异性IgG阳性显示出更高比例的CD3+CD4-CD8- T细胞(P = 0.005)。 结论:T2DM患者在接种增强剂次疫苗后超过6个月表现出抗体反应受损。针对BA.4/5的反应减弱使得T2DM患者和HCs都可能出现突破感染的可能性。.

Keywords: 2型糖尿病; SARS-CoV-2; antibodies; immune response; type 2 diabetes mellitus; vaccination; 免疫反应; 抗体; 疫苗接种.

MeSH terms

  • Antibody Formation
  • COVID-19 Vaccines
  • COVID-19* / prevention & control
  • Diabetes Mellitus, Type 2*
  • Humans
  • Immunization, Secondary
  • Immunoglobulin G
  • SARS-CoV-2

Substances

  • COVID-19 Vaccines
  • Immunoglobulin G