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Free poster and book downloads, Circulating Spike Protein Detected in Post-COVID-19 mRNA Vaccine Myocarditis Background Cases of adolescents and young adults developing myocarditis, after vaccination with (SARS-CoV-2)-targeted mRNA vaccines, reported globally, underlying immunoprofiles of these individuals have not been described in detail. Methods January 2021 through February 2022 Prospectively collected blood, from 16 patients, (12 to 21 years) 13 male 12 after 2nd dose Onset 4 days post vaccination hospitalized at Massachusetts General for Children, or Boston Children's Hospital, for myocarditis Presentation Chest pain 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. Comparator group 45 healthy, asymptomatic, age-matched vaccinated control subjects. Results, things that were the same (Between the myocarditis group and non myocarditis group) Antibody profiling IgG and IgM the same T-cell responses the same (were essentially indistinguishable) Results, things that were different (Between the myocarditis group and non myocarditis group) In the myocarditis group Modest increase in cytokine production (reminiscent of the profile seen in MIS-C) Total leukocytes, specifically neutrophils, significantly increased 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, No free spike was detected in asymptomatic vaccinated control subjects (unpaired t test; P less than ). Why spike protein persisted? In postvaccine myocarditis, the spike protein appears to evade antibody recognition, because the anti-spike antibodies that are generated are produced in adequate quantities with normal functional and neutralization capacity. UK
