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Humoral and cellular response after BNT162b2 vaccine booster in hemodialysis patients and kidney transplant recipients.

Authors :
De Cagna MR
Colucci V
Di Maggio A
Notaristefano N
Cianciotta F
Danza K
Salvatore F
Santoniccolo A
Lanzillotta SG
Perniola MA
Marangi AL
Morrone LFP
Tampoia M
Source :
Clinical and experimental nephrology [Clin Exp Nephrol] 2023 May; Vol. 27 (5), pp. 445-453. Date of Electronic Publication: 2023 Feb 16.
Publication Year :
2023

Abstract

Background: Vulnerable populations, such as hemodialysis (HD) patients and kidney transplant (RTx) recipients, have priority for anti-COVID-19 vaccination, because of their impaired immune status. Here, we investigated the immune response after vaccination with BNT162b2 (two doses plus booster) in HD and RTx patients.<br />Methods: A prospective, observational study was started in two homogeneous groups of 55 HD and 51 RTx patients previously matched from a cohort of 336 patients. Anti-RBD IgG levels, assayed after the second dose with BNT162b2 mRNA, were used to stratify subjects into quintiles. After the second dose and after booster, anti-RBD and IGRA test were evaluated in RTx and HD, belonging to the first and fifth quintiles.<br />Results: After the second dose of vaccine, the median circulating levels of anti-RBD IgG were significantly higher in HD (1456 AU/mL) compared to RTx (27.30 AU/mL). IGRA test showed significantly higher values in the HD (382 mIU/mL) compared with the RTx (73 mIU/mL). After the booster, humoral response increased significantly in both HD (pā€‰=ā€‰0.0002) and RTx groups (pā€‰=ā€‰0.009), whereas the T-cellular immunity remained essentially stable in most patients. In RTx patients with a low humoral response after the second dose, the third dose did not significantly strengthen either humoral or cellular immunity.<br />Conclusions: For HD and RTx, there is great variability in the humoral response to anti-COVID-19 vaccination, with a stronger response in the HD group. The booster dose was ineffective at reinforcing the humoral and cellular immune response in most RTx patients hyporesponsive to the second dose.<br /> (© 2023. The Author(s), under exclusive licence to The Japanese Society of Nephrology.)

Details

Language :
English
ISSN :
1437-7799
Volume :
27
Issue :
5
Database :
MEDLINE
Journal :
Clinical and experimental nephrology
Publication Type :
Academic Journal
Accession number :
36795176
Full Text :
https://doi.org/10.1007/s10157-023-02317-1