Longitudinal evaluation of the impact of immunosuppressive regimen on immune responses to COVID-19 vaccination in kidney transplant recipients.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_3A74857F7FD8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Longitudinal evaluation of the impact of immunosuppressive regimen on immune responses to COVID-19 vaccination in kidney transplant recipients.
Journal
Frontiers in medicine
Author(s)
Wiedemann A., Pellaton C., Dekeyser M., Guillaumat L., Déchenaud M., Krief C., Lacabaratz C., Grimbert P., Pantaleo G., Lévy Y., Durrbach A.
ISSN
2296-858X (Print)
ISSN-L
2296-858X
Publication state
Published
Issued date
2022
Peer-reviewed
Oui
Volume
9
Pages
978764
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Immunocompromised patients have a high risk of death from SARS-CoV-2 infection. Vaccination with an mRNA vaccine may protect these patients against severe COVID-19. Several studies have evaluated the impact of immune-suppressive drug regimens on cellular and humoral responses to SARS-CoV-2 variants of concern in this context. We performed a prospective longitudinal study assessing specific humoral (binding and neutralizing antibodies against spike (S) and T-lymphocyte (cytokine secretion and polyfunctionality) immune responses to anti-COVID-19 vaccination with at least two doses of BNT162b2 mRNA vaccine in stable kidney transplant recipients (KTR) on calcineurin inhibitor (CNI)- or belatacept-based treatment regimens. Fifty-two KTR-31 receiving CNI and 21 receiving belatacept-were enrolled in this study. After two doses of vaccine, 46.9% of patients developed anti-S IgG. Anti-spike IgG antibodies were produced in only 21.4% of the patients in the belatacept group, vs. 83.3% of those in the CNI group. The Beta and Delta variants and, more importantly, the Omicron variant, were less well neutralized than the Wuhan strain. T-cell functions were also much weaker in the belatacept group than in the CNI group. Renal transplant patients have an impaired humoral response to BNT162b2 vaccination. Belatacept-based regimens severely weaken both humoral and cellular vaccine responses. Clinically, careful evaluations of at least binding IgG responses, and prophylactic or post-exposure strategies are strongly recommended for transplant recipients on belatacept-based regimens.
Keywords
COVID-19, immune responses, immunocompromised, immunosuppressive regimen, mRNA vaccine
Pubmed
Web of science
Open Access
Yes
Create date
20/09/2022 13:45
Last modification date
08/08/2024 6:32
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