SARS-CoV-2-Spike Antibody and T-Cell Responses Elicited by a Homologous Third mRNA COVID-19 Dose in Hemodialysis and Kidney Transplant Recipients

Abstract

The effect of a third vaccine dose (3D) of homologous mRNA vaccine on blood levels of SARS-CoV-2-receptor binding domain (RBD)-total antibodies was assessed in 40 hemodialysis patients (HD) and 21 kidney transplant recipients (KTR) at a median of 46 days after 3D. Anti-RBD antibodies were detected in 39/40 HD and 19/21 KTR. Overall, 3D boosted anti-RBD antibody levels (median: 58-fold increase). Neutralizing antibodies (NtAb) against the Wuhan-Hu-1, Delta, and Omicron variants were detected in 14, 13, and 11 out of 14 HD patients, and in 5, 5, and 4 out of 8 KTR patients, respectively. The median fold increase in NtAb titers in HD patients was 77, 28, and 5 and 56, 37, and 9 in KTR patients for each respective variant. SARS-CoV-2-S S-IFN-γ-producing CD8+ and CD4+ T-cell responses were detected in the majority of HD (35 and 36/37, respectively) and all KTR (16/16) patients at 3D. Overall, the administration of 3D boosted T-cell levels in both population groups. In conclusion, a homologous mRNA COVID-19 vaccine 3D exerts a booster effect on anti-RBD antibodies, NtAb binding to Wuhan-Hu-1, Delta, and Omicron variants, and SARS-CoV-2-S-IFN-γ-producing T cells in both HD and KTR patients. The magnitude of the effect was more marked in HD than KTR patients.

Booster Dose of SARS-CoV-2 mRNA Vaccine in Kidney Transplanted Patients Induces Wuhan-Hu-1 Specific Neutralizing Antibodies and T Cell Activation but Lower Response against Omicron Variant

“…As in AIMs assay, the magnitude of IFN-γ production detected against Omicron was lower in both groups. While the vast majority of the scientific studies aimed at measuring the cellular immune response elicited by vaccination were based on ELISA or ELISPOT instead that on activation markers, the results obtained were congruent with our observations [ 22 , 44 ].…”

“…The booster shot induced production of nAbs against the ancestral SARS-CoV-2 strain also in primary non-responder KTR subjects [ 13 , 14 , 15 ], although some of the recipients did not mount a detectable humoral immune response following the 3rd dose [ 16 ], while nAb titers were lower against Alpha, Beta, Delta and Omicron variants in both KTR and the general population [ 17 , 18 ], as confirmed by pseudotyped lentivirus [ 19 ] and live virus-based tests [ 20 ]. Moreover, the role of T cells in conferring protection has been underlined [ 21 , 22 ].…”

Prevention and treatment strategies for kidney transplant recipients in the context of long-term existence of COVID-19

“…However, their ability to neutralize Omicron is lower than that of SARS-CoV-2 or other variants. Similarly, Panizo et al ( 109 ) examined the impact of a third dose of a matching mRNA vaccine on SARS-CoV-2 RBD total antibody levels in a cohort of 21 KTRs. They detected RBD-specific antibodies in 19 of the 21 KTRs and identified neutralizing antibodies against the SARS-CoV-2, Delta, and Omicron variants, indicating the effectiveness of the third dose.…”

Prevalence of COVID-19 in Kidney Transplant Patients in Relation to Their Immune Status after Repeated Anti-SARS-CoV-2 Vaccination

“…Meanwhile, CD4 + helper T cells provide signals that support the development of antibody responses and other functions [ 3 ]. However, the immune response is suboptimal in patients with chronic diseases (such as hypertension and cardiovascular disease) and those receiving immunosuppressive therapy, such as kidney transplant patients or patients requiring dialysis [ 4 , 5 , 6 ]. Anti-SARS-CoV-2 vaccine data showed that seroconversion rates remained reduced in immunocompromised groups (organ transplant recipients, patients with solid or hematological cancers, or patients with immune-mediated inflammatory disorders) compared with immunocompetent controls [ 7 ].…”