O impacto da alergia e do exercício físico na efetividade da vacina contra SARS-CoV-2 em indivíduos vacinados para COVID-19

Abstract

COVID-19, caused by SARS-CoV-2 and initially identified in 2019 in Wuhan, China, triggered an emergency global health crisis. In response to this status, vaccines were quickly developed to contain the spread of the disease and mitigate severe cases. In Brazil, most of these vaccine platforms have been used, including those based on mRNA (BNT162), adenovirus vector (ChAdOx1), and inactivated virus (CoronaVac). Groups with comorbidities and chronic diseases were considered a priority to receive the vaccines, highlighting the importance of evaluating the post-vaccination immune response in individuals with respiratory allergies, given the route of entry of SARS-CoV-2 through the respiratory tract. Assessing the impact of physical activity level on the vaccine immune response can also provide important information about the immunological mechanisms underlying the protection conferred by vaccination. This study has been presented in three chapters. First, we investigated the adverse effects postvaccination against SARS-CoV-2 in individuals with atopy and healthy controls. We observed that atopic individuals vaccinated with ChAdOx1 had a higher incidence of adverse effects compared to non-atopic individuals, although no participants reported severe allergic reactions or anaphylaxis. In the second chapter, we investigate the performance of a point-of-care (POC) testing platform, which is based on the rapid lateral flow immunochromatography test. This platform proved to be an important tool in determining the prevalence of neutralizing antibodies (NAbs) in vaccinated individuals. We observed that vaccinated individuals had higher levels of antibodies compared to convalescents and those without previous infection (naïve), highlighting the usefulness of this platform in monitoring infection, accurate tracking of risk groups, and assessment of vaccine effectiveness. In the third chapter, we investigated the humoral immune response post-vaccination for COVID-19 among men and women in relation to their level of physical activity, through the quantitative evaluation of pro and antiinflammatory adipokines. Regardless of their status of sedentary lifestyle or activity, women showed a greater tendency of vaccine effectiveness, evidenced by elevated levels of anti-S IgG antibodies (Spike), compared to men, despite the increased presence of inflammatory adipokines, like leptin and resistin. The levels of these adipokines may play an important role in vaccine efficacy although other biological features must be investigated, such as genetic and hormonal factors. In conclusion, the immune response patterns identified in this study indicate that allergy/atopy status can influence the vaccine response with several aspects, especially in women, denoting the need to take different profiles into account when developing public policies that guide strategies of vaccination in a specific population. In the fourth chapter, we investigated the relationship between atopy, adipokines and the impact of physical activity, assessed atopy through IgE levels and skin prick test for aeroallergens, quantification of serum adipokines, such as leptin, resistin and adiponectin. We observed that atopic individuals regardless of the level of physical activity have lower leptin production compared to non-atopic individuals, and that this behavior continues when we add the variable physical activity, with higher levels of resistin and lower levels of leptin compared to non-atopic. On the other hand, atopic individuals who practice physical activity have increased levels of adiponectin, antiinflammatory, compared to sedentary behavior. The body mass index can influence the production of these adipokines in atopic and obese individuals who had higher levels of leptin compared to non-obese individuals. With this study, we conclude that physical exercise is capable of modulating immune responses in atopic individuals and may alter the symptoms of allergic rhinitis.