Dataset Information

Effect of a Third Dose of SARS-CoV-2 mRNA BNT162b2 Vaccine on Humoral and Cellular Responses and Serum Anti-HLA Antibodies in Kidney Transplant Recipients.

ABSTRACT: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has severely impacted on public health, mainly on immunosuppressed patients, including solid organ transplant recipients. Vaccination represents a valuable tool for the prevention of severe SARS-CoV-2 infection, and the immunogenicity of mRNA vaccines has been evaluated in transplanted patients. In this study, we investigated the role of a third dose of the BNT162b2 vaccine in a cohort of kidney transplant recipients, analyzing both humoral and cell-mediated responses. We observed an increased immune response after the third dose of the vaccine, especially in terms of Spike-specific T cell response. The level of seroconversion remained lower than 50% even after the administration of the third dose. Mycophenolate treatment, steroid administration and age seemed to be associated with a poor immune response. In our cohort, 11/45 patients experienced a SARS-CoV-2 infection after the third vaccine dose. HLA antibodies appearance was recorded in 7 out 45 (15.5%) patients, but none of the patients developed acute renal rejection. Further studies for the evaluation of long-term immune responses are still ongoing, and the impact of a fourth dose of the vaccine will be evaluated.

SUBMITTER: Cassaniti I

PROVIDER: S-EPMC9227063 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Effect of a Third Dose of SARS-CoV-2 mRNA BNT162b2 Vaccine on Humoral and Cellular Responses and Serum Anti-HLA Antibodies in Kidney Transplant Recipients.

Cassaniti Irene I Gregorini Marilena M Bergami Federica F Arena Francesca F Sammartino Josè Camilla JC Percivalle Elena E Soleymaninejadian Ehsan E Abelli Massimo M Ticozzelli Elena E Nocco Angela A Minero Francesca F Pattonieri Eleonora Francesca EF Lilleri Daniele D Rampino Teresa T Baldanti Fausto F

Vaccines 20220609 6

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has severely impacted on public health, mainly on immunosuppressed patients, including solid organ transplant recipients. Vaccination represents a valuable tool for the prevention of severe SARS-CoV-2 infection, and the immunogenicity of mRNA vaccines has been evaluated in transplanted patients. In this study, we investigated the role of a third dose of the BNT162b2 vaccine in a cohort of kidney transplant recipients, anal ...[more]

PMID: 35746528

Similar Datasets

Project description:Background & aimsImmune responses of solid organ transplant recipients to 2 doses of the BNT162b2 mRNA anti-SARS-CoV-2 vaccine are impaired. The immunogenicity and safety of a third dose among liver transplant (LT) recipients are unknown. This work aimed to evaluate the immune response of LT recipients to a third dose of the BNT162b2 mRNA vaccine.MethodsConsecutive LT recipients (n = 61) in follow-up at Sheba Medical Center were included. Receptor binding domain (RBD) IgG, neutralizing antibody (NA) titers, and T-cell levels before and 21-28 days after a third vaccine dose were determined. Adverse effects after the third dose were monitored.ResultsThe median age of LT recipients was 65 years and 57.4% were male. The humoral immune response rate improved significantly, with 56% of patients showing a response before the third vaccine dose compared to 98% after the third dose. The cellular response in 12 evaluated patients improved significantly (p = 0.008). The geometric mean of anti-RBD IgG levels, NA levels, and T-cell count also increased significantly after the third dose. NA titers after the third dose negatively correlated with age (p = 0.03), mycophenolate mofetil treatment (p = 0.005), and combined immunosuppression as opposed to calcineurin inhibitor monotherapy (p = 0.001). After the third dose, adverse effects were reported by 37% of recipients and were mostly mild (local pain and fatigue).ConclusionAfter a third BNT162b2 mRNA vaccine, the immune response improved significantly among LT recipients, without serious adverse effects. Further studies are needed to evaluate immune response durability and to determine the optimal number and schedule of booster vaccine doses.Lay summaryThe Pfizer-Biotech BNT162b2SARS-CoV-2 vaccine induced significant immunity among liver transplant recipients after a third dose. The majority of the patients developed sufficient levels of both humoral and cellular immune responses. Factors that predict non-response were older age and immunosuppressive medications.

Project description:BackgroundHigh rates of nonresponse to 2 doses of mRNA severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine have been reported in transplant recipients. Several studies have investigated the efficacy of a third dose in this population. However, efficacy remains unclear, as response rates vary across studies. Therefore, we conducted a systematic review and meta-analysis to determine the efficacy of a third dose of any mRNA SARS-CoV-2 vaccine in transplant recipients.MethodsPreferred Reporting Items for Systematic Review and Meta-Analysis reporting guidelines (PROSPERO:CRD42021281498) were followed. Medline, Embase, and CENTRAL were searched from inception to December 2, 2021, without restrictions. All full-text studies reporting on the efficacy of a third dose of any mRNA SARS-CoV-2 vaccine in pediatric and adult transplant recipients were included. The National Institutes of Health quality assessment tool for case series and the Cochrane risk of bias tool determined study quality. Meta-analysis was performed via the DerSimonian-Laird random-effect model.ResultsOf 84 records, 12 studies totaling 1257 patients met inclusion criteria. One study was a randomized controlled trial, whereas all other studies were observational. Across 7 studies (801 patients), humoral response after 3 doses was observed in 66.1% (95% confidence interval, 62.8%-69.4%; I2 = 0%) of transplant recipients. Triple immunosuppression, mycophenolate, antiproliferatives, and belatacept use were associated with reduced odds of humoral response in studies reporting multivariate analyses. Transplant recipients receiving a third dose displayed higher levels of neutralizing antibodies to SARS-CoV-2 variants (Alpha, Beta, and Delta) compared with placebo.ConclusionsA third dose SARS-CoV-2 mRNA vaccine should be strongly considered in transplant recipients. Limitations included lack of controlled studies and clinically relevant thresholds to determine response to vaccination.

Project description:Abstract BACKGROUND AND AIMS Mortality due to SARS-COV-2 infection in hemodialysis (HD) patients and kidney transplant recipients(KTRs) is high. Despite increased rates of administration of two doses of mRNA vaccines among these vulnerable populations, the adequacy of the respective generated immune responses is reported lower than general population, especially in KTRs. A third booster dose has been officially recommended in these immunocompromised patients while the humoral and cellular immune responses to SARS-COV-2 vaccination remains to be elucidated in HD patients and KTRs. The aim of our study was to investigate the antibody (Ab) response status together with vaccine-induced alterations in circulating lymphocytes subsets, following the administration of three doses of the BNT162b2 vaccine in a cohort of maintenance HD patients and KTRs. METHOD The initial cohort of this prospective study (ClinicalTrials.gov, NCT04932876) included 34 HD patients and 54 KTRs who received two doses of the BNT162b2 (Pfizer–BioNTech). Of this cohort, 24 HD patients and 30 KTRs, who remained free of SARS-CoV2 infection and receive a third dose 6 months after the second dose, were finally analyzed. Lymphocyte subpopulations, including B cells, CD4+and CD8+T cells as well as naïve and memory T lymphocytes subpopulations among others, were analyzed by flow cytometry at four time points, before vaccination (T0), before the second dose (T1), 2 weeks after the second dose (T2) and 2–3 weeks after the third dose (T3). The anti-SARS-CoV2 antibody (Ab) response was assessed by using the ARCHITECT IgG II Quant test (Abbott). Titers >50 arbitrary units (AU)/mL were considered positive for seroconversion at T1 and at T2 and T3. RESULTS Of the initial cohort 31 HD patients (91.8%) and 16 KTRs (29.6%) became seropositive at T2. Of the final cohort (24 HD and 30 KTRs), almost all HD patients (23, 96%) became seropositive since T2 and this finding remained at T3 (Figure 1). In KTRs the percentage of responders was doubled between T2 and T3, T2 9 KTRs (30%) versus T3 18 KTRs (60%) (Figure 1). KTRs who developed Ab at T1 ``respond'' better to the third dose, maximizing the levels of Ab. HD patients who became seropositive at T1 displayed higher CD19+B lymphocytes compared with their seronegative HD counterparts. In HD patients, a positive correlation was established between CD19+B cells counts and Ab titers at all time-points (P < 0.001). In KTRs, Ab at T1 showed an inverse correlation with T+B+NK at T1 (P = 0.006). T2-Ab showed inverse correlation with CD45RA+CD45RO at T0 (P = 0.01) and with CD3+at T3 (P = 0.02). T3-Ab showed positive correlation with CD3+CD16+56+at T2 (P = 0.003) and with CD3-CD16+56+at T3 (P = 0.01). CD19+at T3 correlated positively with Ab at T1 and T3 (P = 0.003 and P = 0.03, respectively). CONCLUSION Our study confirms the improved immunogenicity after the third dose of BNT162b2 vaccine in KTRs. The positive correlation between CD19+B cells and Ab in both groups of patients, more stable and constant in HD patients in comparison with KTR, possibly reflects successful humoral immunity. However, a big proportion of kidney patients remain at high risk for COVID-19 infection considering the new more transmissible variants such as the Omicron variant.

Dataset Information

Effect of a Third Dose of SARS-CoV-2 mRNA BNT162b2 Vaccine on Humoral and Cellular Responses and Serum Anti-HLA Antibodies in Kidney Transplant Recipients.

Publications

Effect of a Third Dose of SARS-CoV-2 mRNA BNT162b2 Vaccine on Humoral and Cellular Responses and Serum Anti-HLA Antibodies in Kidney Transplant Recipients.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets