Humoral immunity against SARS-CoV-2 variants including omicron in solid organ transplant recipients after three doses of a COVID-19 mRNA vaccine.

Autor: Saharia KK; Institute of Human Virology University of Maryland School of Medicine Baltimore MD USA.; Divison of Infectious Diseases University of Maryland School of Medicine Baltimore MD USA., Husson JS; Institute of Human Virology University of Maryland School of Medicine Baltimore MD USA.; Divison of Infectious Diseases University of Maryland School of Medicine Baltimore MD USA., Niederhaus SV; Department of Surgery University of Maryland School of Medicine Baltimore MD USA., Iraguha T; Department of Medicine University of Maryland School of Medicine Baltimore MD USA.; Transplant and Cellular Therapy Program University of Maryland Greenebaum Comprehensive Cancer Center Baltimore MD USA., Avila SV; Department of Medicine University of Maryland School of Medicine Baltimore MD USA.; Transplant and Cellular Therapy Program University of Maryland Greenebaum Comprehensive Cancer Center Baltimore MD USA., Yoo YJ; Institute of Human Virology University of Maryland School of Medicine Baltimore MD USA., Hardy NM; Department of Medicine University of Maryland School of Medicine Baltimore MD USA.; Transplant and Cellular Therapy Program University of Maryland Greenebaum Comprehensive Cancer Center Baltimore MD USA., Fan X; Department of Medicine University of Maryland School of Medicine Baltimore MD USA., Omili D; Department of Medicine University of Maryland School of Medicine Baltimore MD USA.; Transplant and Cellular Therapy Program University of Maryland Greenebaum Comprehensive Cancer Center Baltimore MD USA., Crane A; Department of Surgery University of Maryland School of Medicine Baltimore MD USA., Carrier A; Department of Surgery University of Maryland School of Medicine Baltimore MD USA., Xie WY; University of Maryland Greenebaum Comprehensive Cancer Center Baltimore MD USA.; Department of Surgery University of Florida College of Medicine Gainesville FL USA., Vander Mause E; Department of Medicine University of Maryland School of Medicine Baltimore MD USA.; Transplant and Cellular Therapy Program University of Maryland Greenebaum Comprehensive Cancer Center Baltimore MD USA., Hankey K; Transplant and Cellular Therapy Program University of Maryland Greenebaum Comprehensive Cancer Center Baltimore MD USA., Bauman S; Transplant and Cellular Therapy Program University of Maryland Greenebaum Comprehensive Cancer Center Baltimore MD USA., Lesho P; Transplant and Cellular Therapy Program University of Maryland Greenebaum Comprehensive Cancer Center Baltimore MD USA., Mannuel HD; University of Maryland Greenebaum Comprehensive Cancer Center Baltimore MD USA.; Baltimore Veterans Affairs Medical Center Baltimore MD USA., Ahuja A; Department of Medicine University of Maryland School of Medicine Baltimore MD USA., Mathew M; Divison of Infectious Diseases University of Maryland School of Medicine Baltimore MD USA., Avruch J; Department of Surgery University of Maryland School of Medicine Baltimore MD USA., Baddley J; Institute of Human Virology University of Maryland School of Medicine Baltimore MD USA.; Divison of Infectious Diseases University of Maryland School of Medicine Baltimore MD USA.; University of Maryland Greenebaum Comprehensive Cancer Center Baltimore MD USA., Goloubeva O; Department of Epidemiology and Public Health University of Maryland Greenebaum Comprehensive Cancer Center Baltimore MD USA., Shetty K; Division of Hepatology/Liver Transplantation University of Maryland School of Medicine Baltimore MD USA., Dahiya S; Department of Medicine University of Maryland School of Medicine Baltimore MD USA.; Transplant and Cellular Therapy Program University of Maryland Greenebaum Comprehensive Cancer Center Baltimore MD USA., Rapoport AP; Department of Medicine University of Maryland School of Medicine Baltimore MD USA.; Transplant and Cellular Therapy Program University of Maryland Greenebaum Comprehensive Cancer Center Baltimore MD USA., Luetkens T; Transplant and Cellular Therapy Program University of Maryland Greenebaum Comprehensive Cancer Center Baltimore MD USA.; Department of Microbiology and Immunology University of Maryland Baltimore MD USA., Atanackovic D; Department of Medicine University of Maryland School of Medicine Baltimore MD USA.; Transplant and Cellular Therapy Program University of Maryland Greenebaum Comprehensive Cancer Center Baltimore MD USA.; Department of Microbiology and Immunology University of Maryland Baltimore MD USA.
Jazyk: angličtina
Zdroj: Clinical & translational immunology [Clin Transl Immunology] 2022 Apr 29; Vol. 11 (5), pp. e1391. Date of Electronic Publication: 2022 Apr 29 (Print Publication: 2022).
DOI: 10.1002/cti2.1391
Abstrakt: Objectives: Solid organ transplant recipients (SOTR) receiving post-transplant immunosuppression show increased COVID-19-related mortality. It is unclear whether an additional dose of COVID-19 vaccines can overcome the reduced immune responsiveness against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants.
Methods: We analysed humoral immune responses against SARS-CoV-2 and its variants in 53 SOTR receiving SARS-CoV-2 vaccination.
Results: Following the initial vaccination series, 60.3% of SOTR showed no measurable neutralisation and only 18.9% demonstrated neutralising activity of > 90%. More intensive immunosuppression, antimetabolites in particular, negatively impacted antiviral immunity. While absolute IgG levels were lower in SOTR than controls, antibody titres against microbial recall antigens were higher. By contrast, SOTR showed reduced vaccine-induced IgG/IgA antibody titres against SARS-CoV-2 and its delta variants and fewer linear B-cell epitopes, indicating reduced B-cell diversity. Importantly, a third vaccine dose led to an increase in anti-SARS-CoV-2 antibody titres and neutralising activity across alpha, beta and delta variants and to the induction of anti-SARS-CoV-2 CD4 + T cells in a subgroup of patients analysed. By contrast, we observed significantly lower antibody titres after the third dose with the omicron variant compared to the ancestral SARS-CoV-2 and the improvement in neutralising activity was much less pronounced than for all the other variants.
Conclusion: Only a small subgroup of solid organ transplant recipients is able to generate functional antibodies after an initial vaccine series; however, an additional vaccine dose resulted in dramatically improved antibody responses against all SARS-CoV-2 variants except omicron where antibody responses and neutralising activity remained suboptimal.
Competing Interests: The authors declare no conflict of interest.
(© 2022 The Authors. Clinical & Translational Immunology published by John Wiley & Sons Australia, Ltd on behalf of Australian and New Zealand Society for Immunology, Inc.)
Databáze: MEDLINE
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