tetano
Editor, Senior Moderator
Am J Transplant
. 2023 Jan 3;S1600-6135(22)30227-7.
doi: 10.1016/j.ajt.2022.12.022. Online ahead of print.
Augmented humoral and cellular immunity against severe acute respiratory syndrome coronavirus 2 after breakthrough infection in kidney transplant recipients who received 3 doses of coronavirus disease 2019 vaccine
Jinyoung Yang[SUP] 1 [/SUP], Kyo Won Lee[SUP] 2 [/SUP], Jin Yang Baek[SUP] 3 [/SUP], Seongman Bae[SUP] 4 [/SUP], Young Ho Lee[SUP] 1 [/SUP], Haein Kim[SUP] 1 [/SUP], Kyungmin Huh[SUP] 1 [/SUP], Sun Young Cho[SUP] 1 [/SUP], Cheol-In Kang[SUP] 1 [/SUP], Doo Ryeon Chung[SUP] 1 [/SUP], Kyong Ran Peck[SUP] 1 [/SUP], Jae Berm Park[SUP] 2 [/SUP], Sung-Han Kim[SUP] 4 [/SUP], Tae-Jong Kim[SUP] 5 [/SUP], Dong-Min Kim[SUP] 6 [/SUP], Jae-Hoon Ko[SUP] 7 [/SUP]
Affiliations
Abstract
Diminished immune response to coronavirus disease 2019 (COVID-19) vaccines and breakthrough infection (BI) is a major concern for solid organ transplant recipients. Humoral and cellular immune responses of kidney transplant (KT) recipients after a third COVID-19 vaccination were investigated compared to matched health care workers. Anti-severe acute respiratory syndrome coronavirus 2 spike protein antibody and severe acute respiratory syndrome coronavirus 2 specific interferon-gamma releasing assay (IGRA) were assessed. A total of 38 KT recipients, including 20 BI and 18 noninfection, were evaluated. In the KT BI group, antibody titers were significantly increased (median 5 to 724, binding antibody units/mL (P = 0.002) after the third vaccination, but IGRA responses were negligible. After BI, antibody titers increased (median 11 355 binding antibody unit/mL; P < 0.001) and there was a significant increase of IGRA responses to spike proteins (Spike[SUB]1[/SUB]-Nil, median 0.05 to 0.41 IU/mL; P = 0.009). Antibody titers and IGRA responses were significantly higher in the BI than in the noninfection group after 6 months. Immune responses were stronger in the health care worker than in the KT cohort, but the gap became narrower after BI. In conclusion, KT recipients who experienced BI after 3 COVID-19 vaccinations acquired augmented humoral and cellular immune responses.
Keywords: breakthrough infection (BI); cellular immunity; humoral immunity; kidney transplant; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
. 2023 Jan 3;S1600-6135(22)30227-7.
doi: 10.1016/j.ajt.2022.12.022. Online ahead of print.
Augmented humoral and cellular immunity against severe acute respiratory syndrome coronavirus 2 after breakthrough infection in kidney transplant recipients who received 3 doses of coronavirus disease 2019 vaccine
Jinyoung Yang[SUP] 1 [/SUP], Kyo Won Lee[SUP] 2 [/SUP], Jin Yang Baek[SUP] 3 [/SUP], Seongman Bae[SUP] 4 [/SUP], Young Ho Lee[SUP] 1 [/SUP], Haein Kim[SUP] 1 [/SUP], Kyungmin Huh[SUP] 1 [/SUP], Sun Young Cho[SUP] 1 [/SUP], Cheol-In Kang[SUP] 1 [/SUP], Doo Ryeon Chung[SUP] 1 [/SUP], Kyong Ran Peck[SUP] 1 [/SUP], Jae Berm Park[SUP] 2 [/SUP], Sung-Han Kim[SUP] 4 [/SUP], Tae-Jong Kim[SUP] 5 [/SUP], Dong-Min Kim[SUP] 6 [/SUP], Jae-Hoon Ko[SUP] 7 [/SUP]
Affiliations
- PMID: 36739177
- DOI: 10.1016/j.ajt.2022.12.022
Abstract
Diminished immune response to coronavirus disease 2019 (COVID-19) vaccines and breakthrough infection (BI) is a major concern for solid organ transplant recipients. Humoral and cellular immune responses of kidney transplant (KT) recipients after a third COVID-19 vaccination were investigated compared to matched health care workers. Anti-severe acute respiratory syndrome coronavirus 2 spike protein antibody and severe acute respiratory syndrome coronavirus 2 specific interferon-gamma releasing assay (IGRA) were assessed. A total of 38 KT recipients, including 20 BI and 18 noninfection, were evaluated. In the KT BI group, antibody titers were significantly increased (median 5 to 724, binding antibody units/mL (P = 0.002) after the third vaccination, but IGRA responses were negligible. After BI, antibody titers increased (median 11 355 binding antibody unit/mL; P < 0.001) and there was a significant increase of IGRA responses to spike proteins (Spike[SUB]1[/SUB]-Nil, median 0.05 to 0.41 IU/mL; P = 0.009). Antibody titers and IGRA responses were significantly higher in the BI than in the noninfection group after 6 months. Immune responses were stronger in the health care worker than in the KT cohort, but the gap became narrower after BI. In conclusion, KT recipients who experienced BI after 3 COVID-19 vaccinations acquired augmented humoral and cellular immune responses.
Keywords: breakthrough infection (BI); cellular immunity; humoral immunity; kidney transplant; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).