Anti-SARS-CoV-2 Revaccination Success in Kidney Transplant Recipients With No Initial Humoral Response Is Linked to Primary Vaccine Type.

Autor:	Stumpf J; Medizinische Klinik und Poliklinik III, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.; Kuratorium für Heimdialyse (KfH)-Nierenzentrum Dresden, Dresden, Germany., Schwöbel J; Dialysezentrum Chemnitz, Chemnitz, Germany., Karger C; Kuratorium für Heimdialyse (KfH)-Nierenzentrum am Klinikum St. Georg, Leipzig, Germany., Schirutschke H; Patienten-Heimversorgung Gemeinnützige Stiftung (PHV) Dialysezentrum Dresden Friedrichstadt, Dresden, Germany., Mauer R; Faculty of Medicine Carl Gustav Carus, Institute for Medical Informatics and Biometry, Technische Universität Dresden, Dresden, Germany., Klimova A; National Center for Tumor Diseases Dresden, Dresden, Germany., Tonn T; Institute for Transfusion Medicine, German Red Cross Blood Donation Service North-East, Dresden, Germany.; Faculty of Medicine Carl Gustav Carus, Transfusion Medicine, Technische Universität Dresden, Dresden, Germany., Hugo C; Medizinische Klinik und Poliklinik III, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.; Kuratorium für Heimdialyse (KfH)-Nierenzentrum Dresden, Dresden, Germany.
Jazyk:	angličtina
Zdroj:	Frontiers in medicine [Front Med (Lausanne)] 2022 Jul 04; Vol. 9, pp. 910987. Date of Electronic Publication: 2022 Jul 04 (Print Publication: 2022).
DOI:	10.3389/fmed.2022.910987
Abstrakt:	Background: While anti-SARS-CoV-2 vaccination success in kidney transplant recipients (KTR) after two doses and 1273-mRNA was associated with higher seroconversion rates compared to BNT162b2-mRNA in our "DIA-Vacc Study" (NCT04799808), it remains unclear whether this may also be the case in non-responding KTR after a third vaccination dose. Materials and Methods: Non-responding KTR (after two mRNA vaccinations) were investigated 4.5-6 months after study enrollment at first vaccination. One hundred sixty-six of 193 received a third vaccination between 3.5 and 5 months after the initial study enrollment and were always investigated 4 weeks later, exploring humoral immune response (ELISA) and specific cellular responses (interferon-γ release assay). Sixty-seven of 193 measurements in KTR were done immediately before the third vaccination or in KTR without further vaccination at 4.5-6 months. Results: Of 193 KTR with no initial immune response 4 weeks after the second vaccination, 106/87 were immunized twice with 1273-mRNA/BNT162b2-mRNA, respectively. Additional mRNA booster vaccination led to positive seroconversion rates of 30-50%, while 16% of the initial non-responders demonstrated a delayed seroconversion without any booster vaccination. Using logistic regression analysis, a positive IgG response after the third vaccination was 23% more likely if the primary vaccine type was 1273-mRNA compared to BNT162b2-mRNA (OR = 4.420, 95% CI [1.208-16.173], p = 0.025). Primary vaccine type, a weak anti-SpikeS1 IgG response 4 weeks after second vaccination (3.2-35.2 BAU/ml, p < 0.001) and a lack of MMF/MPA as part of the immunosuppressive treatment (trend, p = 0.06) but no other variables studied correlated with seroconversion success. Conclusion: This observational study adds important evidence toward using 1273-mRNA as the primary mRNA vaccine type for immunosuppressed KTR. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Stumpf, Schwöbel, Karger, Schirutschke, Mauer, Klimova, Tonn and Hugo.)
Databáze:	MEDLINE
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