Antibody responses to BNT162b2 mRNA vaccine: Infection‐naïve individuals with abdominal obesity warrant attention

  1. Alexis Elias Malavazos
  2. Sara Basilico
  3. Gianluca Iacobellis
  4. Valentina Milani
  5. Rosanna Cardani
  6. Federico Boniardi
  7. Carola Dubini
  8. Ilaria Prandoni
  9. Gloria Capitanio
  10. Laura Valentina Renna
  11. Sara Boveri
  12. Roberta Rigolini
  13. Matteo Carrara
  14. Giovanni Spuria
  15. Teresa Cuppone
  16. Aurelia D’acquisto
  17. Luca Carpinelli
  18. Marta Sacchi
  19. Lelio Morricone
  20. Francesco Secchi
  21. Elena Costa
  22. Lorenzo Menicanti
  23. Enzo Nisoli
  24. Michele Carruba
  25. Federico Ambrogi
  26. Massimiliano Marco Corsi Romanelli

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Abstract

Objective

The excess of visceral adipose tissue might hinder and delay immune response. How people with abdominal obesity (AO) will respond to mRNA vaccines against SARS‐CoV‐2 is yet to be established. SARS‐CoV‐2‐specific antibody responses were evaluated after the first and second dose of the BNT162b2 mRNA vaccine, comparing the response of individuals with AO with the response of those without, and discerning between individuals with or without prior infection.

Methods

Immunoglobulin G (IgG)‐neutralizing antibodies against the Trimeric complex (IgG‐TrimericS) were measured at four time points: at baseline, at day 21 after vaccine dose 1, and at 1 and 3 months after dose 2. Nucleocapsid antibodies were assessed to detect prior SARS‐CoV‐2 infection. Waist circumference was measured to determine AO.

Results

Between the first and third month after vaccine dose 2, the drop in IgG‐TrimericS levels was more remarkable in individuals with AO compared with those without AO (2.44‐fold [95% CI: 2.22‐2.63] vs. 1.82‐fold [95% CI: 1.69‐1.92], respectively, p < 0.001). Multivariable linear regression confirmed this result after inclusion of assessed confounders ( p < 0.001).

Conclusions

The waning antibody levels in individuals with AO may further support recent recommendations to offer booster vaccines to adults with high‐risk medical conditions, including obesity, and particularly to those with a more prevalent AO phenotype.

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  1. Version published to 10.1002/oby.23353
  2. ScreenIT

    SciScore for 10.1101/2021.09.10.21262710: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsConsent: All participants provided written informed consent.
    IRB: (Project code RC 5.17.01) and by National Ethics Committee of INMI IRCCS Lazzaro Spallanzani (Opinion No. 403 of the 2020/2021 Trial Registry).
    Sex as a biological variableThe cut-off to determine AO was 94 cm in men and 80 cm in women [8, 12].
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Serological testing for SARS-CoV-2 glycoprotein-specific anti-spike (S) IgG was performed using LIAISON® assay, which measures IgG neutralizing antibodies against the Trimeric complex (IgG-TrimericS), which includes the receptor-binding-domain (RBD) and N-terminal-domain (NTD) sites from the three S1 subunits.
    anti-spike (S) IgG
    suggested: None
    N-terminal-domain (NTD
    suggested: None
    Software and Algorithms
    SentencesResources
    All statistical analyses were done with SAS version 9.4 (SAS Institute, Cary, NC).
    SAS Institute
    suggested: (Statistical Analysis System, RRID:SCR_008567)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations of our study include lack of measurement of virus-specific T-cell. Anti-N antibodies were assessed only once to determine a prior SARS-CoV-2 infection. In addition, we did not evaluate pro-inflammatory markers of inflammation. Hence, our findings highlight the need to extend the duration of serological monitoring of antibody levels in infection-naïve individuals with AO, a higher risk population category in terms of possible weaker antibody response.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a protocol registration statement.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.09.10.21262710v1 on medRxiv