Acorde con dos nuevos estudios se determinó que la inmunidad al coronavirus dura al menos un año, llegando a mejorar con el tiempo, especialmente después de la vacunación, lo que permitiría que se extienda incluso por toda la vida. Los hallazgos pueden ayudar a disipar los temores persistentes de que la protección contra el virus sea de corta duración.
Ambos estudios sugieren que la mayoría de las personas que se han recuperado del COVID-19 y que luego fueron inmunizadas no necesitarán refuerzos. Sin embargo, las personas vacunadas que nunca se infectaron probablemente necesitarán las inyecciones, al igual que una minoría que se infectó pero no produjo una respuesta inmunitaria sólida.
Los dos informes analizaron a personas que habían estado expuestas al coronavirus aproximadamente un año antes. Las células que conservan una memoria del virus persisten en la médula ósea y pueden producir anticuerpos cuando sea necesario, según uno de los estudios, publicado el lunes en la revista Nature.
El otro estudio, publicado en línea en BioRxiv, un sitio de investigación en biología, encontró que estas llamadas células B de memoria, continúan madurando y fortaleciéndose durante al menos 12 meses después de la infección inicial.
“Los artículos son consistentes con el creciente número de documentos que sugieren que la inmunidad provocada por la infección y la vacunación contra el SARS-CoV-2 parece ser de larga duración”, dijo Scott Hensley, inmunólogo de la Universidad de Pensilvania que no participó en la investigación.
Los estudios pueden calmar los temores de que la inmunidad al virus sea transitoria, como es el caso de los coronavirus que causan resfriados comunes. Pero esos virus cambian significativamente cada pocos años, dijo el Dr. Hensley. “La razón por la que nos infectamos con coronavirus comunes repetidamente a lo largo de la vida podría tener mucho más que ver con la variación de estos virus que con la inmunidad”, dijo.
De hecho, las células B de memoria producidas en respuesta a la infección con SARS-CoV-2 y mejoradas con la vacunación son tan potentes que frustran incluso las variantes del virus, lo que anula la necesidad de refuerzos, según Michel Nussenzweig, inmunólogo de la Universidad Rockefeller en Nueva York, quien dirigió el estudio sobre la maduración de la memoria.
“Las personas que se infectaron y se vacunaron realmente tienen una respuesta excelente, un conjunto excelente de anticuerpos, porque continúan desarrollando sus anticuerpos”, dijo el Dr. Nussenzweig. “Espero que duren mucho tiempo”.
Es posible que el resultado no se aplique a la protección derivada de las vacunas solamente, ya que es probable que la memoria inmunológica se organice de manera diferente después de la inmunización, en comparación con la que sigue a una infección natural.
Eso significa que las personas que no han tenido covid-19 y fueron inmunizadas pueden eventualmente necesitar una vacuna de refuerzo, dijo el Dr. Nussenzweig. “Ese es el tipo de cosas las sabremos muy, muy pronto”, agregó.
Al encontrarse por primera vez con un virus, las células B proliferan rápidamente y producen anticuerpos en grandes cantidades. Una vez que se resuelve la infección aguda, una pequeña cantidad de células se instala en la médula ósea, bombeando de manera constante niveles modestos de anticuerpos.
Para observar las células B de memoria específicas del nuevo coronavirus, los investigadores dirigidos por Ali Ellebedy de la Universidad de Washington en St. Louis, analizaron la sangre de 77 personas en intervalos de tres meses, comenzando aproximadamente un mes después de su infección con el coronavirus. Solo seis de ellos habían sido hospitalizados por COVID-19; el resto tenía síntomas leves.
Los niveles de anticuerpos en estos individuos disminuyeron rápidamente cuatro meses después de la infección y continuaron disminuyendo lentamente durante meses después, resultados que están en sintonía con los de otros estudios.
Algunos científicos han interpretado esta disminución como un signo de inmunidad menguante, pero es exactamente lo que se esperaba, dijeron otros expertos. Si la sangre contuviera grandes cantidades de anticuerpos contra todos los patógenos que el cuerpo haya encontrado, se transformaría rápidamente en una especie de lodo espeso.
En cambio, los niveles sanguíneos de anticuerpos caen drásticamente después de una infección aguda, mientras que las células B de memoria permanecen inactivas en la médula ósea, listas para actuar cuando sea necesario.
El equipo del Dr. Ellebedy obtuvo muestras de médula ósea de 19 personas aproximadamente siete meses después de haber sido infectadas. Quince tenían células B de memoria detectables, pero cuatro no, lo que sugiere que algunas personas pueden tener muy pocas células o ninguna.
“Me dice que incluso si se infecta, no significa que tenga una respuesta superinmune”, dijo el Dr. Ellebedy. Los hallazgos refuerzan la idea de que las personas que se han recuperado de covid-19 deben vacunarse, sugirió.
Cinco de los participantes en el estudio del Dr. Ellebedy donaron muestras de médula ósea siete u ocho meses después de haberse infectado inicialmente y nuevamente cuatro meses después. Él y sus colegas descubrieron que la cantidad de células B de memoria se mantuvo estable durante ese tiempo.
Los resultados son particularmente notables porque es difícil obtener muestras de médula ósea, dijo Jennifer Gommerman, inmunóloga de la Universidad de Toronto que no participó en el trabajo.
Un estudio histórico realizado en 2007 mostró que, en teoría, los anticuerpos podrían sobrevivir décadas, quizás incluso mucho más allá del promedio de vida, lo que sugiere la presencia a largo plazo de células B de memoria. Pero el nuevo estudio ofreció una prueba poco común de su existencia, dijo el Dr. Gommerman.
El equipo del Dr. Nussenzweig observó cómo maduran las células B de memoria con el tiempo. Los investigadores analizaron sangre de 63 personas que se habían recuperado de covid-19 aproximadamente un año antes. La gran mayoría de los participantes presentaba síntomas leves y 26 también habían recibido al menos una dosis de la vacuna Moderna o Pfizer-BioNTech.
Los llamados anticuerpos neutralizantes, necesarios para prevenir la reinfección del virus, permanecieron sin cambios entre seis y 12 meses, mientras que los anticuerpos relacionados pero menos importantes desaparecieron lentamente, según encontró el equipo.
A medida que las células B de memoria continuaron evolucionando, los anticuerpos que produjeron desarrollaron la capacidad de neutralizar un grupo aún más amplio de variantes.
Un año después de la infección, la actividad neutralizante en los participantes que no habían sido vacunados fue menor contra todas las formas del virus, con la mayor pérdida observada contra la variante identificada por primera vez en Sudáfrica.
La vacunación amplificó significativamente los niveles de anticuerpos, lo que confirma los resultados de otros estudios.
El senador republicano de Kentucky, Rand Paul, dijo el pasado domingo que, no recibiría una vacuna contra el coronavirus porque se había infectado en marzo del año pasado y, por lo tanto, era inmune.
Pero no hay garantía de que dicha inmunidad sea lo suficientemente poderosa como para protegerlo durante años, particularmente dada la aparición de variantes del coronavirus que pueden eludir parcialmente las defensas del cuerpo.
Los resultados del estudio del Dr. Nussenzweig sugieren que las personas que se han recuperado de covid-19 y que luego han sido vacunadas continuarán teniendo niveles extremadamente altos de protección contra variantes emergentes, incluso sin recibir una vacuna de refuerzo en el futuro.
“Se parece exactamente a lo que esperaríamos que fuera una buena respuesta de las células B de memoria”, dijo Marion Pepper, inmunóloga de la Universidad de Washington en Seattle que no participó en la nueva investigación.
Todos los expertos estuvieron de acuerdo en que es probable que la inmunidad se desarrolle de manera muy diferente en personas que nunca han tenido covid-19. Luchar contra un virus vivo es diferente a responder a una sola proteína viral introducida por una vacuna. Y en aquellos que tenían coronavirus, la respuesta inmune inicial tuvo tiempo de madurar entre seis y 12 meses antes de ser desafiada por la vacuna.
“Esa cinética es diferente a la de alguien que se inmunizó y luego se inmunizó de nuevo tres semanas después”, dijo el Dr. Pepper. “Eso no quiere decir que no tengan una respuesta tan amplia, pero podría ser muy diferente”. Infobae.
Por Agencia
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