tetano
Editor, Senior Moderator
Br J Haematol
. 2022 May 16.
doi: 10.1111/bjh.18245. Online ahead of print.
Anti-severe acute respiratory syndrome coronavirus-2 adenoviral-vector vaccines trigger subclinical antiplatelet autoimmunity and increase of soluble platelet activation markers
Eleonora Petito[SUP] 1 [/SUP], Elisabetta Colonna[SUP] 1 [/SUP], Emanuela Falcinelli[SUP] 1 [/SUP], Anna Maria Mezzasoma[SUP] 1 [/SUP], Enrica Cesari[SUP] 1 [/SUP], Elisa Giglio[SUP] 1 [/SUP], Tiziana Fiordi[SUP] 2 [/SUP], Fabio Almerigogna[SUP] 3 [/SUP], Alfredo Villa[SUP] 4 [/SUP], Paolo Gresele[SUP] 1 [/SUP]
Affiliations
Abstract
To slow down the coronavirus disease 2019 (COVID-19) pandemic an unequalled vaccination campaign was initiated. Despite proven efficacy and safety, a rare but potentially fatal complication of adenoviral-vector vaccines, called vaccine-induced immune thrombotic thrombocytopenia (VITT), has emerged the pathogenesis of which seems to be related to the development of platelet-activating anti-platelet factor 4 (PF4) antibodies. While a few studies have evaluated the incidence of anti-PF4 positivity in anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine recipients, to date no studies have assessed whether an antiplatelet immunological response develops and if this associates with platelet and blood clotting activation. We carried out a prospective study in healthy subjects who received the first dose of ChAdOx1 or Ad26.COV2.S or BNT162b2 vaccines to evaluate platelet-specific and non-specific immune response and in vivo platelet activation and blood clotting activation. Individuals receiving ChAdOx1 and, less so, Ad26.COV2.S developed with high frequency auto- or alloantiplatelet antibodies, increased circulating platelet-derived microvesicles and soluble P-selectin associated with mild blood clotting activation. Our study shows that an immunological reaction involving platelets is not uncommon in individuals receiving anti-SARS-CoV-2 vaccination, especially after ChAdOx1 and Ad26.COV2.S, and that it associates with in vivo platelet and blood clotting activation.
Keywords: anti-SARS-CoV-2 vaccines; antiplatelet autoantibodies; blood clotting; platelet activation; platelet-derived microvesicles.
. 2022 May 16.
doi: 10.1111/bjh.18245. Online ahead of print.
Anti-severe acute respiratory syndrome coronavirus-2 adenoviral-vector vaccines trigger subclinical antiplatelet autoimmunity and increase of soluble platelet activation markers
Eleonora Petito[SUP] 1 [/SUP], Elisabetta Colonna[SUP] 1 [/SUP], Emanuela Falcinelli[SUP] 1 [/SUP], Anna Maria Mezzasoma[SUP] 1 [/SUP], Enrica Cesari[SUP] 1 [/SUP], Elisa Giglio[SUP] 1 [/SUP], Tiziana Fiordi[SUP] 2 [/SUP], Fabio Almerigogna[SUP] 3 [/SUP], Alfredo Villa[SUP] 4 [/SUP], Paolo Gresele[SUP] 1 [/SUP]
Affiliations
- PMID: 35577507
- DOI: 10.1111/bjh.18245
Abstract
To slow down the coronavirus disease 2019 (COVID-19) pandemic an unequalled vaccination campaign was initiated. Despite proven efficacy and safety, a rare but potentially fatal complication of adenoviral-vector vaccines, called vaccine-induced immune thrombotic thrombocytopenia (VITT), has emerged the pathogenesis of which seems to be related to the development of platelet-activating anti-platelet factor 4 (PF4) antibodies. While a few studies have evaluated the incidence of anti-PF4 positivity in anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine recipients, to date no studies have assessed whether an antiplatelet immunological response develops and if this associates with platelet and blood clotting activation. We carried out a prospective study in healthy subjects who received the first dose of ChAdOx1 or Ad26.COV2.S or BNT162b2 vaccines to evaluate platelet-specific and non-specific immune response and in vivo platelet activation and blood clotting activation. Individuals receiving ChAdOx1 and, less so, Ad26.COV2.S developed with high frequency auto- or alloantiplatelet antibodies, increased circulating platelet-derived microvesicles and soluble P-selectin associated with mild blood clotting activation. Our study shows that an immunological reaction involving platelets is not uncommon in individuals receiving anti-SARS-CoV-2 vaccination, especially after ChAdOx1 and Ad26.COV2.S, and that it associates with in vivo platelet and blood clotting activation.
Keywords: anti-SARS-CoV-2 vaccines; antiplatelet autoantibodies; blood clotting; platelet activation; platelet-derived microvesicles.