Airway and Systemic Immune Responses Following the Third COVID-19 Vaccination in COPD Patients

• Published in: International journal of chronic obstructive pulmonary disease 2023-01, Vol.18, p.3027-3036
• Main Authors: Southworth, Thomas, Jackson, Natalie, Singh, Dave
• Format: Article
• Language: English
• Subjects: Angiotensin-Converting Enzyme 2; Antibodies, Viral; COVID-19 - prevention & control; covid-19 vaccination chronic obstructive pulmonary disease omicron airway immunoglobulin; COVID-19 Vaccines - adverse effects; Cross-Sectional Studies; Development and progression; Humans; Immune response; Immunoglobulin A; Immunoglobulin G; Infection; Longitudinal Studies; Lung diseases, Obstructive; Original Research; Pulmonary Disease, Chronic Obstructive - diagnosis; SARS-CoV-2; Vaccination
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S433269

Booster vaccinations are required to maintain protection against COVID-19. COPD patients are at higher risk of developing severe illness following SARS-CoV-2 infection. Previous cross-sectional analysis after the second COVID-19 booster showed similar immune responses in COPD patients and controls, but pre-vaccination samples were not available. This longitudinal study evaluated systemic and airway immune responses in COPD patients using samples obtained pre- and post-third COVID-19 vaccination. Twelve COPD patients were recruited, with plasma, nasal and sputum (n = 10) samples collected pre-vaccination and 4- and 14-weeks post vaccination. Samples were analyzed for anti-spike IgA and IgG and cellular immunity. The ability of plasma and nasal samples to block ACE2-spike protein interaction was assessed for Wild type, Delta, and Omicron spike variants. Vaccinations increased anti-spike IgG in plasma (p < 0.001), nasal (IgG p < 0.001) and sputum (p = 0.002) samples, IgA in plasma (p < 0.001) and blood cellular immunity (p = 0.001). Plasma and nasal anti-spike IgA levels correlated (rho: 0.6, p = 0.02), with similar results for IgG (rho: 0.79, p = 0.003). Post-vaccination nasal (p = 0.002) and plasma (p < 0.001) samples were less effective at blocking Omicron spike binding to ACE2 compared to the Wild type spike variant. Airway and systemic immune responses against SARS-CoV-2 increased in COPD patients following a third COVID-19 vaccination. Nasal and systemic responses in COPD patients were less effective against Omicron variant compared to previous variants.