Preserved recognition of Omicron spike following COVID-19 messenger RNA vaccination in pregnancy - 23/08/22
Abstract |
Background |
SARS-CoV-2 infection is associated with enhanced disease severity in pregnant women. Despite the potential of COVID-19 vaccines to reduce severe disease, vaccine uptake remained relatively low among pregnant women. Just as coordinated messaging from the Centers for Disease Control and Prevention and leading obstetrics organizations began to increase vaccine confidence in this vulnerable group, the evolution of SARS-CoV-2 variants of concerns, including the Omicron variant, raised new concerns about vaccine efficacy because of their ability to escape vaccine-induced neutralizing antibodies. Early data point to a milder disease course following infection with the Omicron variant in vaccinated individuals. Thus, these data suggest that alternate vaccine-induced immunity beyond neutralization may continue to attenuate Omicron variant–induced disease, such as Fc-mediated antibody activity.
Objective |
This study aimed to test whether vaccine-induced antibodies raised during pregnancy continue to bind to and leverage Fc receptors to protect against variants of concern including the Omicron variant.
Study Design |
The receptor binding domain or whole spike-specific antibody isotype binding titers and Fc gamma receptor binding directed toward variants of concern, including the Omicron variant, were analyzed in pregnant women after receiving the full dose regimen of either the Pfizer/BioNTech BNT62b2 (n=10) or Moderna mRNA-1273 (n=10) vaccination using a multiplexing Luminex assay.
Results |
Reduced isotype recognition of the Omicron receptor binding domain was observed following administration of either vaccine with relatively preserved, albeit reduced, recognition of the whole Omicron spike by immunoglobulin M and G antibodies. Despite the near complete loss of Fc receptor binding to the Omicron receptor binding domain, Fc receptor binding to the Omicron spike was more variable but largely preserved.
Conclusion |
Reduced binding titers to the Omicron receptor binding domain aligns with the observed loss of neutralizing activity. Despite the loss of neutralization, preserved, albeit reduced, Omicron spike recognition and Fc receptor binding potentially continue to attenuate disease severity in pregnant women.
Le texte complet de cet article est disponible en PDF.Key words : antibodies, Fcγ receptor, mRNA vaccine, Omicron variant, pregnancy, SARS-CoV-2, variants of concern
Plan
G.A. is a founder and equity holder of Seromyx Systems, a company developing a platform technology to profile antibody immunity. G.A. is an employee and equity holder of Leyden Labs, a company developing pandemic prevention therapeutics. G.A.’s interests were reviewed and are managed by Massachusetts General Hospital and Partners HealthCare in accordance with their conflict-of-interest policies. All other authors report no conflict of interest. |
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This study was funded by the National Institutes of Health (NIH) under grants 3R37AI080289-11S1, R01AI146785, U19AI42790-01, U19AI135995-02, 1U01CA260476-01, and CIVIC75N93019C00052, and by the Bill and Melinda Gates Foundation: Global Health Vaccine Accelerator Platform under grants OPP1146996 and INV-001650. A.G.E. received funding from the NIH under grant R01HD100022-S2 and from the March of Dimes Foundation under grant 6-FY-20-223 to support sample collection. |
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Cite this as: Bartsch YC, Atyeo C, Kang J, et al. Preserved recognition of Omicron spike following COVID-19 messenger RNA vaccination in pregnancy. Am J Obstet Gynecol 2022;227:493.e1-7. |
Vol 227 - N° 3
P. 493.e1-493.e7 - septembre 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.