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Determinantes inmunológicos y clínicos de la respuesta de anticuerpos neutralizantes frente al SARS-COV-2 en individuos inmunocompetentes e inmunocomprometidos
Resumen
Los anticuerpos neutralizantes son un componente esencial de la inmunidad humoral frente al SARS-CoV-2. Su eficacia varía en función del estado inmunológico del huésped, el tipo de exposición (infección natural, vacunación o inmunidad híbrida) y la evolución viral. En individuos inmunocompetentes, las vacunas de ARNm y la inmunidad híbrida inducen respuestas humorales robustas y duraderas. En contraste, los pacientes inmunocomprometidos presentan respuestas atenuadas, con menor seroconversión, títulos reducidos y menor persistencia, lo que exige esquemas vacunales personalizados y refuerzos más frecuentes. La aparición de variantes con capacidad de escape inmunológico, como Ómicron y sus sublinajes, ha reducido la eficacia de los anticuerpos neutralizantes frente a infecciones leves. No obstante, la inmunidad celular, mediada por linfocitos T, se mantiene relativamente conservada y continúa ofreciendo protección frente a formas graves de la enfermedad. En este contexto, la vigilancia inmunológica, la adaptación de las plataformas vacunales y el desarrollo de vacunas de amplio espectro son estrategias clave. El objetivo de esta revisión fue analizar los determinantes inmunológicos y clínicos que modulan la respuesta de anticuerpos neutralizantes frente al SARS-CoV-2 en individuos inmunocompetentes e inmunocomprometidos.
Recibido: 20 de Julio de 2025.
Aceptado: 19 de Enero de 2026.
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