tetano
Editor, Senior Moderator
Ann Lab Med
. 2023 Sep 1;43(5):451-460.
doi: 10.3343/alm.2023.43.5.451.
Effect of Lymphocyte Phenotypic Alterations on the Humoral Response to Vaccination Against SARS-COV-2 in Dialysis Patients
Georgios Lioulios[SUP] 1 [/SUP], Asimina Fylaktou[SUP] 2 [/SUP], Despina Asouchidou[SUP] 2 [/SUP], Aliki Xochelli[SUP] 2 [/SUP], Vasiliki Nikolaidou[SUP] 2 [/SUP], Stamatia Stai[SUP] 1 [/SUP], Michalis Christodoulou[SUP] 1 [/SUP], Panagiotis Giamalis[SUP] 1 [/SUP], Ioannis Tsouchnikas[SUP] 1 [/SUP], Aikaterini Papagianni[SUP] 1 [/SUP], Maria Stangou[SUP] 1 [/SUP]
Affiliations
Abstract
Background: The response to vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) varies depending on comorbidities. This study evaluated the clinical and immunological factors affecting the humoral response of patients with end-stage renal disease (ESRD) to the BNT162b2 vaccine.
Methods: Humoral immunity was evaluated in 54 ESRD patients using serum levels of anti-receptor-binding domain (RBD) and neutralizing antibodies (NAbs), measured by a chemiluminescent immunoassay 30 (T1), 60 (T2), and 120 (T3) days after the second vaccine dose. The results were correlated to baseline patient T- and B-lymphocyte subpopulations determined by flow cytometry.
Results: The proportion of seroconverted patients based on the NAb titer decreased from 83.3% at T1 to 53.7% at T3. Age was negatively correlated to the NAb titer at T1 and T2. Patients receiving hemodiafiltration had higher NAb titers at T3. Diabetes was associated with a lower response rate at T3. Univariate analysis revealed a positive correlation between the naïve CD4 T-lymphocyte population and RBD titer at T1 and the NAb titer at T3, with no association observed with naïve CD8 T lymphocytes. NAb titers at T3 were significantly correlated with late-differentiated CD4 T lymphocytes and terminally differentiated effector memory cells re-expressing CD45RA (TEMRA) CD8 T lymphocytes. RBD levels were positively correlated with naïve and memory B-lymphocyte counts at T3.
Conclusions: Age, diabetes, and hemodialysis prescription had significant impacts on the response to vaccination. T- and B-lymphocyte phenotypes are major determinants of the humoral response potency to SARS-CoV-2 vaccination with BNT162b2 in patients with ESRD.
Keywords: BNT162b2; COVID-19 vaccination; End-stage renal disease; Hemodiafiltration; Immune senescence.
. 2023 Sep 1;43(5):451-460.
doi: 10.3343/alm.2023.43.5.451.
Effect of Lymphocyte Phenotypic Alterations on the Humoral Response to Vaccination Against SARS-COV-2 in Dialysis Patients
Georgios Lioulios[SUP] 1 [/SUP], Asimina Fylaktou[SUP] 2 [/SUP], Despina Asouchidou[SUP] 2 [/SUP], Aliki Xochelli[SUP] 2 [/SUP], Vasiliki Nikolaidou[SUP] 2 [/SUP], Stamatia Stai[SUP] 1 [/SUP], Michalis Christodoulou[SUP] 1 [/SUP], Panagiotis Giamalis[SUP] 1 [/SUP], Ioannis Tsouchnikas[SUP] 1 [/SUP], Aikaterini Papagianni[SUP] 1 [/SUP], Maria Stangou[SUP] 1 [/SUP]
Affiliations
- PMID: 37080746
- DOI: 10.3343/alm.2023.43.5.451
Abstract
Background: The response to vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) varies depending on comorbidities. This study evaluated the clinical and immunological factors affecting the humoral response of patients with end-stage renal disease (ESRD) to the BNT162b2 vaccine.
Methods: Humoral immunity was evaluated in 54 ESRD patients using serum levels of anti-receptor-binding domain (RBD) and neutralizing antibodies (NAbs), measured by a chemiluminescent immunoassay 30 (T1), 60 (T2), and 120 (T3) days after the second vaccine dose. The results were correlated to baseline patient T- and B-lymphocyte subpopulations determined by flow cytometry.
Results: The proportion of seroconverted patients based on the NAb titer decreased from 83.3% at T1 to 53.7% at T3. Age was negatively correlated to the NAb titer at T1 and T2. Patients receiving hemodiafiltration had higher NAb titers at T3. Diabetes was associated with a lower response rate at T3. Univariate analysis revealed a positive correlation between the naïve CD4 T-lymphocyte population and RBD titer at T1 and the NAb titer at T3, with no association observed with naïve CD8 T lymphocytes. NAb titers at T3 were significantly correlated with late-differentiated CD4 T lymphocytes and terminally differentiated effector memory cells re-expressing CD45RA (TEMRA) CD8 T lymphocytes. RBD levels were positively correlated with naïve and memory B-lymphocyte counts at T3.
Conclusions: Age, diabetes, and hemodialysis prescription had significant impacts on the response to vaccination. T- and B-lymphocyte phenotypes are major determinants of the humoral response potency to SARS-CoV-2 vaccination with BNT162b2 in patients with ESRD.
Keywords: BNT162b2; COVID-19 vaccination; End-stage renal disease; Hemodiafiltration; Immune senescence.