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Impaired humoral and cellular immunity after SARS-CoV-2 BNT162b2 (tozinameran) prime-boost vaccination in kidney transplant recipients

Authors :
Sattler, Arne
Schrezenmeier, Eva
Weber, Ulrike A.
Potekhin, Alexander
Bachmann, Friederike
Straub-Hohenbleicher, Henriette
Budde, Klemens
Storz, Elena
Pross, Vanessa
Bergmann, Yasmin
Thole, Linda M.L.
Tizian, Caroline
Holsken, Oliver
Diefenbach, Andreas
Schrezenmeier, Hubert
Jahrsdorfer, Bernd
Zemojtel, Tomasz
Jechow, Katharina
Conrad, Christian
Lukassen, Soren
Stauch, Diana
Lachmann, Nils
Choi, Mira
Halleck, Fabian
Kotsch, Katja
Source :
Journal of Clinical Investigation. July 15, 2021, Vol. 131 Issue 14
Publication Year :
2021

Abstract

Novel mRNA-based vaccines have been proven to be powerful tools in combating the global pandemic caused by SARS-CoV-2, with BNT162b2 (trade name: Comirnaty) efficiently protecting individuals from COVID-19 across a broad age range. Still, it remains largely unknown how renal insufficiency and immunosuppressive medication affect development of vaccine-induced immunity. We therefore comprehensively analyzed humoral and cellular responses in kidney transplant recipients after the standard second vaccination dose. As opposed to all healthy vaccinees and the majority of hemodialysis patients, only 4 of 39 and 1 of 39 transplanted individuals showed IgA and IgG seroconversion at day 8 [+ or -] 1 after booster immunization, with minor changes until day 23 [+ or -] 5, respectively. Although most transplanted patients mounted spike-specific T helper cell responses, frequencies were significantly reduced compared with those in controls and dialysis patients and this was accompanied by a broad impairment in effector cytokine production, memory differentiation, and activation-related signatures. Spike-specific [CD8.sup.+] T cell responses were less abundant than their [CD4.sup.+] counterparts in healthy controls and hemodialysis patients and almost undetectable in transplant patients. Promotion of anti-HLA antibodies or acute rejection was not detected after vaccination. In summary, our data strongly suggest revised vaccination approaches in immunosuppressed patients, including individual immune monitoring for protection of this vulnerable group at risk of developing severe COVID-19.<br />Introduction Kidney transplant (KTx) recipients and patients suffering from kidney failure are imperiled by increased infection risks, either due to dialysis-associated (reviewed in ref. 1) or therapeutic immunosuppression (IS). This [...]

Details

Language :
English
ISSN :
00219738
Volume :
131
Issue :
14
Database :
Gale General OneFile
Journal :
Journal of Clinical Investigation
Publication Type :
Academic Journal
Accession number :
edsgcl.669344438
Full Text :
https://doi.org/10.1172/JCI150175