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

Autor: De Cagna MR; Clinical Pathology Unit, 'SS. Annunziata' Hospital, Taranto, Italy., Colucci V; Nephrology and Dialysis Unit, 'SS. Annunziata' Hospital, Taranto, Italy., Di Maggio A; Nephrology and Dialysis Unit, 'SS. Annunziata' Hospital, Taranto, Italy., Notaristefano N; Clinical Pathology Unit, 'SS. Annunziata' Hospital, Taranto, Italy., Cianciotta F; Nephrology and Dialysis Unit, 'SS. Annunziata' Hospital, Taranto, Italy., Danza K; Clinical Pathology Unit, 'SS. Annunziata' Hospital, Taranto, Italy., Salvatore F; Nephrology and Dialysis Unit, 'Valle d'Itria' Hospital, Martina Franca, Italy., Santoniccolo A; Clinical Pathology Unit, 'SS. Annunziata' Hospital, Taranto, Italy., Lanzillotta SG; Clinical Pathology Unit, 'Valle d'Itria' Hospital, Martina Franca, Italy., Perniola MA; Nephrology and Dialysis Unit, 'Valle d'Itria' Hospital, Martina Franca, Italy., Marangi AL; Nephrology and Dialysis Unit, 'Valle d'Itria' Hospital, Martina Franca, Italy., Morrone LFP; Nephrology and Dialysis Unit, 'SS. Annunziata' Hospital, Taranto, Italy. luigifrancescopio.morrone@asl.taranto.it., Tampoia M; Clinical Pathology Unit, 'SS. Annunziata' Hospital, Taranto, Italy.
Jazyk: angličtina
Zdroj: Clinical and experimental nephrology [Clin Exp Nephrol] 2023 May; Vol. 27 (5), pp. 445-453. Date of Electronic Publication: 2023 Feb 16.
DOI: 10.1007/s10157-023-02317-1
Abstrakt: 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.
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.
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 (p = 0.0002) and RTx groups (p = 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.
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.
(© 2023. The Author(s), under exclusive licence to The Japanese Society of Nephrology.)
Databáze: MEDLINE
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