TY - JOUR
T1 - Humoral and cellular immune correlates of protection against COVID-19 in kidney transplant recipients
AU - Kemlin, Delphine
AU - Gemander, Nicolas
AU - Depickère, Stéphanie
AU - Olislagers, Véronique
AU - Georges, Daphnée
AU - Waegemans, Alexandra
AU - Pannus, Pieter
AU - Lemy, Anne
AU - Goossens, Maria E
AU - Desombere, Isabelle
AU - Michiels, Johan
AU - Vandevenne, Marylène
AU - Heyndrickx, Leo
AU - Ariën, Kevin K
AU - Matagne, André
AU - Ackerman, Margaret E
AU - Le Moine, Alain
AU - Marchant, Arnaud
N1 - PPU
PY - 2023
Y1 - 2023
N2 - As solid organ transplant recipients are at high risk of severe COVID-19 and respond poorly to primary SARS-CoV-2 mRNA vaccination, they have been prioritized for booster vaccination. However, an immunological correlate of protection has not been identified in this vulnerable population. We conducted a prospective monocentric cohort study of 65 kidney transplant recipients who received 3 doses of BNT162b2 mRNA vaccine. Associations among breakthrough infection (BTI), vaccine responses, and patient characteristics were explored in 54 patients. Symptomatic COVID-19 was diagnosed in 32% of kidney transplant recipients during a period of 6 months after booster vaccination. During this period, SARS-CoV-2 delta and omicron were the dominant variants in the general population. Univariate Analyses identified the avidity of SARS-CoV-2 receptor binding domain binding IgG, neutralizing antibodies, and SARS-CoV-2 S2-specific interferon gamma responses as correlates of protection against BTI. No demographic or clinical parameter correlated with the risk of BTI. In multivariate analysis, the risk of BTI was best predicted by neutralizing antibody and S2-specific interferon gamma responses. In conclusion, T cell responses may help compensate for the suboptimal antibody response to booster vaccination in kidney transplant recipients. Further studies are needed to confirm these findings.
AB - As solid organ transplant recipients are at high risk of severe COVID-19 and respond poorly to primary SARS-CoV-2 mRNA vaccination, they have been prioritized for booster vaccination. However, an immunological correlate of protection has not been identified in this vulnerable population. We conducted a prospective monocentric cohort study of 65 kidney transplant recipients who received 3 doses of BNT162b2 mRNA vaccine. Associations among breakthrough infection (BTI), vaccine responses, and patient characteristics were explored in 54 patients. Symptomatic COVID-19 was diagnosed in 32% of kidney transplant recipients during a period of 6 months after booster vaccination. During this period, SARS-CoV-2 delta and omicron were the dominant variants in the general population. Univariate Analyses identified the avidity of SARS-CoV-2 receptor binding domain binding IgG, neutralizing antibodies, and SARS-CoV-2 S2-specific interferon gamma responses as correlates of protection against BTI. No demographic or clinical parameter correlated with the risk of BTI. In multivariate analysis, the risk of BTI was best predicted by neutralizing antibody and S2-specific interferon gamma responses. In conclusion, T cell responses may help compensate for the suboptimal antibody response to booster vaccination in kidney transplant recipients. Further studies are needed to confirm these findings.
KW - Humans
KW - COVID-19/prevention & control
KW - SARS-CoV-2
KW - BNT162 Vaccine
KW - Cohort Studies
KW - Interferon-gamma
KW - Kidney Transplantation/adverse effects
KW - Prospective Studies
KW - Antibodies, Neutralizing
KW - Antibodies, Viral
KW - Breakthrough Infections
KW - Immunoglobulin G
KW - Transplant Recipients
KW - Vaccination
U2 - 10.1016/j.ajt.2023.02.015
DO - 10.1016/j.ajt.2023.02.015
M3 - A1: Web of Science-article
C2 - 36773936
SN - 1600-6135
VL - 23
SP - 649
EP - 658
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 5
ER -