Hybrid Immunity Overcomes Defective Immune Response to COVID-19 Vaccination in Kidney Transplant Recipients

Hybrid Immunity Overcomes Defective Immune Response to COVID-19 Vaccination in Kidney Transplant Recipients

Introduction: Comorbidities and immunosuppressive therapies are associated with reduced immune responses to primary COVID-19 mRNA vaccination in kidney transplant recipients (KTRs). In healthy individuals, prior SARS-COV-2 infection is associated with increased vaccine responses, a phenotype called...

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Main Authors: Nicolas Gemander, Delphine Kemlin, Stéphanie Depickère, Natasha S. Kelkar, Pieter Pannus, Shilpee Sharma, Alexandra Waegemans, Véronique Olislagers, Daphnée Georges, Emilie Dhondt, Margarida Braga, Leo Heyndrickx, Johan Michiels, Anaïs Thiriard, Anne Lemy, Marylène Vandevenne, Maria E. Goossens, André Matagne, Isabelle Desombere, Kevin K. Ariën, Margaret E. Ackerman, Alain Le Moine, Arnaud Marchant
Format: Article
Language:English
Published: Elsevier 2024-03-01
Series:Kidney International Reports
Subjects:
COVID-19
hybrid immunity
kidney transplantation
mRNA vaccination
nonneutralizing antibodies
systems immunology
Online Access:http://www.sciencedirect.com/science/article/pii/S2468024923016303
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Summary:Introduction: Comorbidities and immunosuppressive therapies are associated with reduced immune responses to primary COVID-19 mRNA vaccination in kidney transplant recipients (KTRs). In healthy individuals, prior SARS-COV-2 infection is associated with increased vaccine responses, a phenotype called hybrid immunity. In this study, we explored the potential influence of immune suppression on hybrid immunity in KTRs. Methods: Eighty-two KTRs, including 59 SARS-CoV-2-naïve (naïve KTRs [N-KTRs]) and 23 SARS-CoV-2-experienced (experienced KTRs [E-KTRs]) patients, were prospectively studied and compared to 106 healthy controls (HCs), including 40 SARS-CoV-2-naïve (N-HCs) and 66 SARS-CoV-2-experienced (E-HCs) subjects. Polyfunctional antibody and T cell responses were measured following 2 doses of BNT162b2 mRNA vaccine. Associations between vaccine responses and clinical characteristics were studied by univariate and multivariate analyses. Results: In naïve KTRs, vaccine responses were markedly lower than in HCs and were correlated with older age, more recent transplantation, kidney retransplantation after graft failure, arterial hypertension, and treatment with mycophenolate mofetil (MMF). In contrast, vaccine responses of E-KTRs were similar to those of HCs and were associated with time between transplantation and vaccination, but not with the other risk factors associated with low vaccine responses in naïve KTRs. Conclusion: In conclusion, hybrid immunity overcomes immune suppression and provides potent humoral and cellular immunity to SARS-CoV-2 in KTRs.
ISSN:2468-0249

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