Changes in humoral immune response after SARS-CoV-2 infection in liver transplant recipients compared to immunocompetent patients

Caballero-Marcos, Aránzazu; Salcedo, Magdalena; Alonso-Fernández, Roberto; Rodríguez‐Perálvarez, Manuel; Olmedo, María; Morales, Javier Graus; Cuervas-Mons, V.; Cachero, Alba; Loinaz, Carmelo; Iñarrairaegui, Mercedes; Castells, L.; Pascual, Sonia; Vinaixa‐Aunés, Carmen; González‐Grande, Rocío; Otero, Alejandra; Tomé, Santiago; Tejedor-Tejada, Javier; Álamo-Martínez, J.M.; González‐Diéguez, Luisa; Nogueras-López, Flor; Blanco‐Fernández, Gerardo; Muñoz‐Bartolo, Gema; Bustamante, Francisco Javier; Fábrega, Emilio; Romero‐Cristóbal, Mario; Martín-Mateos, Rosa; Rio‐Izquierdo, Julia Del; Arias‐Milla, Ana; Calatayud, Laura; Marcacuzco, Alberto; Fernández‐Alonso, Víctor; Gómez‐Gavara, Concepción; Colmenero, Jordi; Muñóz, Patricia; Pons, José Antonio

doi:10.1111/ajt.16599

Cited by 34 publications

(54 citation statements)

References 26 publications

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“…Nonetheless, a certain delay in achieving such strong immune response was observed among TX patients [23]. In addition, liver transplanted patients exhibited lower persistence of anti-N IgG antibodies within the first 6 months post-infection and a more pronounced antibody levels decline [19], as also observed in our study.…”

Section: Discussionsupporting

confidence: 84%

“…So far, few studies investigated antibody and T-cell immunity in COVID-19 TX patients [19,21]. However, these studies have exclusively focused on the acute infection and convalescent phase, while reports on long-term persistence of immunity are missing.…”

Section: Discussionmentioning

confidence: 99%

“…However, the characteristics of the immune response to SARS-CoV-2 in immunocompromised patients, such as transplant recipients, has been poorly investigated. A first study analysing the anti-SARS-CoV-2 N IgG antibody in liver transplanted patients showed an earlier and more pronounced decline of IgG serum levels in transplant recipients compared with immunocompetent controls, although anti-N IgG antibody was still detectable 6 months after symptoms onset in most patients [19]. Another study showed no difference in humoral and cellular antiviral immunity between transplanted and nonimmunosuppressed patients [20].…”

Section: Introductionmentioning

confidence: 99%

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Robust and Persistent B- and T-Cell Responses after COVID-19 in Immunocompetent and Solid Organ Transplant Recipient Patients

Zavaglio

Frangipane

Morosini

et al. 2021

Viruses

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The development and persistence of SARS-CoV-2-specific immune response in immunocompetent (IC) and immunocompromised patients is crucial for long-term protection. Immune response to SARS-CoV-2 infection was analysed in 57 IC and 15 solid organ transplanted (TX) patients. Antibody responses were determined by ELISA and neutralization assay. T-cell response was determined by stimulation with peptide pools of the Spike, Envelope, Membrane, and Nucleocapsid proteins with a 20-h Activation Induced Marker (AIM) and 7-day lymphoproliferative assays. Antibody response was detected at similar levels in IC and TX patients. Anti-Spike IgG, IgA and neutralizing antibodies persisted for at least one year, while anti-Nucleocapsid IgG declined earlier. Patients with pneumonia developed higher antibody levels than patients with mild symptoms. Similarly, both rapid and proliferative T-cell responses were detected within the first two months after infection at comparable levels in IC and TX patients, and were higher in patients with pneumonia. T-cell response persisted for at least one year in both IC and TX patients. Spike, Membrane, and Nucleocapsid proteins elicited the major CD4+ and CD8+ T-cell responses, whereas the T-cell response to Envelope protein was negligible. After SARS-CoV-2 infection, antibody and T-cell responses develop rapidly and persist over time in both immunocompetent and transplanted patients.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Robust and Persistent B- and T-Cell Responses after COVID-19 in Immunocompetent and Solid Organ Transplant Recipient Patients

Zavaglio

Frangipane

Morosini

et al. 2021

Viruses

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“…Caballero-Marcos et al [48] showed a decline over time of IgG-antinucleocapsid, with lower incidence at 3 months (77.4% vs. 100%, p < 0.001) and at 6 months (63.4% vs. 90.1%, p < 0.001) when compared with a matched cohort of immunocompetent subjects. A more comprehensive analysis performed in 28 SOT patients (of which five were LT patients) of the immunological response, which also considered T-cell responses, showed that the overall response was not impaired in the SOT patients.…”

Section: Immunological Response After Covid-19 In Lt Recipientsmentioning

confidence: 96%

COVID-19 in Liver Transplant Recipients: A Systematic Review

Becchetti

Gschwend

Dufour

et al. 2021

JCM

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Liver transplant (LT) recipients are considered a vulnerable population amidst the COVID-19 pandemic. To date, available data have been heterogeneous and scarce. Therefore, we conducted a systematic literature review identifying English-language articles published in PubMed between November 2019 and 30th May 2021. We aimed to explore three areas: (1) outcome and clinical course; (2) immunological response after COVID-19 in LT recipients; and (3) vaccination response. After systematic selection, 35, 4, and 5 articles, respectively, were considered suitable for each area of analysis. Despite the heterogeneity of the reports included in this study, we found that gastrointestinal symptoms were common in LT recipients. The outcome of the LT population was not per se worse compared to the general population, although careful management of immunosuppressive therapy is required. While a complete therapy discontinuation is not encouraged, caution needs to be taken with use of mycophenolate mofetil (MMF), favoring tacrolimus (TAC) use. Although data conflicted about acquired immunity after SARS-CoV-2 infection, vaccine immunogenicity appeared to be low, suggesting that the level of surveillance should be kept high in this population.

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“…The length of viral shedding was not influenced by antibody presence [ 67 ]. A matched analysis of 71 liver transplant recipients and immunocompetent controls after COVID-19 showed a lower incidence of anti-nucleocapsid IgG antibodies at 3 and 6 months [ 68 ]. Therefore, compared with immunocompetent patients, liver transplant recipients had a lower prevalence of anti-SARS-CoV-2 antibodies and a more pronounced decline of antibody levels.…”

Section: The Immunology Of Sars-cov-2 Infectionmentioning

confidence: 99%

The Immunology of SARS-CoV-2 Infection and Vaccines in Solid Organ Transplant Recipients

Dęborska−Materkowska

Kamińska

2021

Viruses

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Since its outbreak in December 2019, the coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), led to an enormous rise in scientific response with an excess of COVID-19-related studies on the pathogenesis and potential therapeutic approaches. Solid organ transplant (SOT) recipients are a heterogeneous population with long-lasting immunosuppression as a joining element. Immunocompromised patients are a vulnerable population with a high risk of severe infections and an increased infection-related mortality rate. It was postulated that the hyperinflammatory state due to cytokine release syndrome during severe COVID-19 could be alleviated by immunosuppressive therapy in SOT patients. On the other hand, it was previously established that T cell-mediated immunity, which is significantly weakened in SOT recipients, is the main component of antiviral immune responses. In this paper, we present the current state of science on COVID-19 immunology in relation to solid organ transplantation with prospective therapeutic and vaccination strategies in this population.

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Changes in humoral immune response after SARS-CoV-2 infection in liver transplant recipients compared to immunocompetent patients

Cited by 34 publications

References 26 publications

Robust and Persistent B- and T-Cell Responses after COVID-19 in Immunocompetent and Solid Organ Transplant Recipient Patients

Robust and Persistent B- and T-Cell Responses after COVID-19 in Immunocompetent and Solid Organ Transplant Recipient Patients

COVID-19 in Liver Transplant Recipients: A Systematic Review

The Immunology of SARS-CoV-2 Infection and Vaccines in Solid Organ Transplant Recipients

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