STAR LIGHT Study: XBB.1.5 COVID-19 mRNA Vaccines Boost Systemic but Not Mucosal Immunity Against the SARS-CoV-2 JN.1 Variant in Patients with Chronic Liver Disease

STAR LIGHT Study: XBB.1.5 COVID-19 mRNA Vaccines Boost Systemic but Not Mucosal Immunity Against the SARS-CoV-2 JN.1 Variant in Patients with Chronic Liver Disease

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Background: Patients with chronic liver disease (CLD) have impaired vaccine immunogenicity and an excess risk of severe COVID-19.While variant-adapted COVID-19 mRNA vaccines are recommended for vulnerable individuals, their efficacy in patients with CLD has not been studied.Methods: We present the first evaluation of XBB.

1.5 COVID-19 vaccine immunogenicity against the SARS-CoV-2 JN.1 variant in patients with CLD.

Serum anti-receptor binding domain (RBD) skull bride and groom IgG, neutralization, and saliva anti-RBD IgG and IgA against wild-type SARS-CoV-2 (WT) and the XBB.1.5, EG.

5.1, BA.2.

86, and JN.1 variants were quantified before and 2–4 weeks following a fourth dose of XBB.1.

5 mRNA vaccines.Results: Vaccination boosted anti-RBD IgG and neutralization against all tested variants including JN.1 (each p < 0.

001).Following immunization, neutralization was lower against JN.1 compared to WT, XBB.

1.5, and EG.5.

1 (p < 0.001, p < 0.001, and p < 0.

01, respectively).Vaccination reduced neutralization failure rates against BA.2.

86 and JN.1 (each p < 0.05).

The evasion of vaccine-induced antibodies by the tested variants was low, indicated by the positive correlation between anti-RBD echofix spring reverb IgG and neutralization.At mucosal sites, vaccination boosted anti-RBD IgG (each p < 0.01) but failed to induce infection-blocking IgA (each p > 0.

05).Conclusion: XBB.1.

5 vaccines protect CLD patients against recent SARS-CoV-2 variants, but developing vaccines with optimized mucosal immunogenicity is required to prevent SARS-CoV-2 transmission and recurrent seasonal COVID-19 outbreaks.