Circulating Spike Protein Detected in Post-COVID-19 mRNA Vaccine Myocarditis

Cases of adolescents and young adults developing myocarditis after vaccination with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-targeted mRNA vaccines have been reported globally, but the underlying immunoprofiles of these individuals have not been described in detail. From January...

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Veröffentlicht in:	Circulation (New York, N.Y.) Jg. 147; H. 11; S. 867
Hauptverfasser:	Yonker, Lael M, Swank, Zoe, Bartsch, Yannic C, Burns, Madeleine D, Kane, Abigail, Boribong, Brittany P, Davis, Jameson P, Loiselle, Maggie, Novak, Tanya, Senussi, Yasmeen, Cheng, Chi-An, Burgess, Eleanor, Edlow, Andrea G, Chou, Janet, Dionne, Audrey, Balaguru, Duraisamy, Lahoud-Rahme, Manuella, Arditi, Moshe, Julg, Boris, Randolph, Adrienne G, Alter, Galit, Fasano, Alessio, Walt, David R
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	United States 14.03.2023
Schlagworte:	Adolescent Antibodies, Viral Autoantibodies Child COVID-19 - prevention & control COVID-19 Vaccines - adverse effects Cytokines Humans Myocarditis - etiology SARS-CoV-2 Spike Glycoprotein, Coronavirus Young Adult COVID-19 SARS-CoV-2 vaccine mRNA myocarditis
ISSN:	1524-4539, 1524-4539
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Abstract	Cases of adolescents and young adults developing myocarditis after vaccination with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-targeted mRNA vaccines have been reported globally, but the underlying immunoprofiles of these individuals have not been described in detail. From January 2021 through February 2022, we prospectively collected blood from 16 patients who were hospitalized at Massachusetts General for Children or Boston Children's Hospital for myocarditis, presenting with chest pain with elevated cardiac troponin T after SARS-CoV-2 vaccination. We performed extensive antibody profiling, including tests for SARS-CoV-2-specific humoral responses and assessment for autoantibodies or antibodies against the human-relevant virome, SARS-CoV-2-specific T-cell analysis, and cytokine and SARS-CoV-2 antigen profiling. Results were compared with those from 45 healthy, asymptomatic, age-matched vaccinated control subjects. Extensive antibody profiling and T-cell responses in the individuals who developed postvaccine myocarditis were essentially indistinguishable from those of vaccinated control subjects, despite a modest increase in cytokine production. A notable finding was that markedly elevated levels of full-length spike protein (33.9±22.4 pg/mL), unbound by antibodies, were detected in the plasma of individuals with postvaccine myocarditis, whereas no free spike was detected in asymptomatic vaccinated control subjects (unpaired test; <0.0001). Immunoprofiling of vaccinated adolescents and young adults revealed that the mRNA vaccine-induced immune responses did not differ between individuals who developed myocarditis and individuals who did not. However, free spike antigen was detected in the blood of adolescents and young adults who developed post-mRNA vaccine myocarditis, advancing insight into its potential underlying cause.
AbstractList	Cases of adolescents and young adults developing myocarditis after vaccination with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-targeted mRNA vaccines have been reported globally, but the underlying immunoprofiles of these individuals have not been described in detail. From January 2021 through February 2022, we prospectively collected blood from 16 patients who were hospitalized at Massachusetts General for Children or Boston Children's Hospital for myocarditis, presenting with chest pain with elevated cardiac troponin T after SARS-CoV-2 vaccination. We performed extensive antibody profiling, including tests for SARS-CoV-2-specific humoral responses and assessment for autoantibodies or antibodies against the human-relevant virome, SARS-CoV-2-specific T-cell analysis, and cytokine and SARS-CoV-2 antigen profiling. Results were compared with those from 45 healthy, asymptomatic, age-matched vaccinated control subjects. Extensive antibody profiling and T-cell responses in the individuals who developed postvaccine myocarditis were essentially indistinguishable from those of vaccinated control subjects, despite a modest increase in cytokine production. A notable finding was that markedly elevated levels of full-length spike protein (33.9±22.4 pg/mL), unbound by antibodies, were detected in the plasma of individuals with postvaccine myocarditis, whereas no free spike was detected in asymptomatic vaccinated control subjects (unpaired test; <0.0001). Immunoprofiling of vaccinated adolescents and young adults revealed that the mRNA vaccine-induced immune responses did not differ between individuals who developed myocarditis and individuals who did not. However, free spike antigen was detected in the blood of adolescents and young adults who developed post-mRNA vaccine myocarditis, advancing insight into its potential underlying cause. Cases of adolescents and young adults developing myocarditis after vaccination with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-targeted mRNA vaccines have been reported globally, but the underlying immunoprofiles of these individuals have not been described in detail.BACKGROUNDCases of adolescents and young adults developing myocarditis after vaccination with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-targeted mRNA vaccines have been reported globally, but the underlying immunoprofiles of these individuals have not been described in detail.From January 2021 through February 2022, we prospectively collected blood from 16 patients who were hospitalized at Massachusetts General for Children or Boston Children's Hospital for myocarditis, presenting with chest pain with elevated cardiac troponin T after SARS-CoV-2 vaccination. We performed extensive antibody profiling, including tests for SARS-CoV-2-specific humoral responses and assessment for autoantibodies or antibodies against the human-relevant virome, SARS-CoV-2-specific T-cell analysis, and cytokine and SARS-CoV-2 antigen profiling. Results were compared with those from 45 healthy, asymptomatic, age-matched vaccinated control subjects.METHODSFrom January 2021 through February 2022, we prospectively collected blood from 16 patients who were hospitalized at Massachusetts General for Children or Boston Children's Hospital for myocarditis, presenting with chest pain with elevated cardiac troponin T after SARS-CoV-2 vaccination. We performed extensive antibody profiling, including tests for SARS-CoV-2-specific humoral responses and assessment for autoantibodies or antibodies against the human-relevant virome, SARS-CoV-2-specific T-cell analysis, and cytokine and SARS-CoV-2 antigen profiling. Results were compared with those from 45 healthy, asymptomatic, age-matched vaccinated control subjects.Extensive antibody profiling and T-cell responses in the individuals who developed postvaccine myocarditis were essentially indistinguishable from those of vaccinated control subjects, despite a modest increase in cytokine production. A notable finding was that markedly elevated levels of full-length spike protein (33.9±22.4 pg/mL), unbound by antibodies, were detected in the plasma of individuals with postvaccine myocarditis, whereas no free spike was detected in asymptomatic vaccinated control subjects (unpaired t test; P<0.0001).RESULTSExtensive antibody profiling and T-cell responses in the individuals who developed postvaccine myocarditis were essentially indistinguishable from those of vaccinated control subjects, despite a modest increase in cytokine production. A notable finding was that markedly elevated levels of full-length spike protein (33.9±22.4 pg/mL), unbound by antibodies, were detected in the plasma of individuals with postvaccine myocarditis, whereas no free spike was detected in asymptomatic vaccinated control subjects (unpaired t test; P<0.0001).Immunoprofiling of vaccinated adolescents and young adults revealed that the mRNA vaccine-induced immune responses did not differ between individuals who developed myocarditis and individuals who did not. However, free spike antigen was detected in the blood of adolescents and young adults who developed post-mRNA vaccine myocarditis, advancing insight into its potential underlying cause.CONCLUSIONSImmunoprofiling of vaccinated adolescents and young adults revealed that the mRNA vaccine-induced immune responses did not differ between individuals who developed myocarditis and individuals who did not. However, free spike antigen was detected in the blood of adolescents and young adults who developed post-mRNA vaccine myocarditis, advancing insight into its potential underlying cause.
Author	Walt, David R Cheng, Chi-An Dionne, Audrey Edlow, Andrea G Balaguru, Duraisamy Burns, Madeleine D Kane, Abigail Yonker, Lael M Loiselle, Maggie Boribong, Brittany P Lahoud-Rahme, Manuella Burgess, Eleanor Julg, Boris Swank, Zoe Bartsch, Yannic C Chou, Janet Davis, Jameson P Alter, Galit Novak, Tanya Senussi, Yasmeen Fasano, Alessio Arditi, Moshe Randolph, Adrienne G
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PublicationTitle	Circulation (New York, N.Y.)
PublicationTitleAlternate	Circulation
PublicationYear	2023
References	37695829 - Circulation. 2023 Sep 12;148(11):910-911 37695830 - Circulation. 2023 Sep 12;148(11):908-909 37695833 - Circulation. 2023 Sep 12;148(11):906-907
References_xml	– reference: 37695833 - Circulation. 2023 Sep 12;148(11):906-907 – reference: 37695830 - Circulation. 2023 Sep 12;148(11):908-909 – reference: 37695829 - Circulation. 2023 Sep 12;148(11):910-911
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Snippet	Cases of adolescents and young adults developing myocarditis after vaccination with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-targeted mRNA...
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SubjectTerms	Adolescent Antibodies, Viral Autoantibodies Child COVID-19 - prevention & control COVID-19 Vaccines - adverse effects Cytokines Humans Myocarditis - etiology SARS-CoV-2 Spike Glycoprotein, Coronavirus Young Adult
Title	Circulating Spike Protein Detected in Post-COVID-19 mRNA Vaccine Myocarditis
URI	https://www.ncbi.nlm.nih.gov/pubmed/36597886 https://www.proquest.com/docview/2760821287
Volume	147
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