tetano
Editor, Senior Moderator
J Clin Immunol
. 2022 Jun 17.
doi: 10.1007/s10875-022-01296-4. Online ahead of print.
Defining Clinical and Immunological Predictors of Poor Immune Responses to COVID-19 mRNA Vaccines in Patients with Primary Antibody Deficiency
Junghee Jenny Shin[SUP] 1 [/SUP], Jennefer Par-Young[SUP] 1 [/SUP], Serhan Unlu[SUP] 1 [/SUP], Andrew McNamara[SUP] 2 3 [/SUP], Hong-Jai Park[SUP] 1 [/SUP], Min Sun Shin[SUP] 1 [/SUP], Renelle J Gee[SUP] 1 [/SUP], Hester Doyle[SUP] 1 [/SUP], Yuliya Afinogenova[SUP] 1 [/SUP], Elena Zidan[SUP] 4 [/SUP], Jason Kwah[SUP] 1 [/SUP], Armand Russo[SUP] 5 [/SUP], Mark Mamula[SUP] 1 [/SUP], Florence Ida Hsu[SUP] 1 [/SUP], Jason Catanzaro[SUP] 6 [/SUP], Michael Racke[SUP] 7 [/SUP], Richard Bucala[SUP] 1 [/SUP], Craig Wilen[SUP] 2 3 [/SUP], Insoo Kang[SUP] 8 [/SUP]
Affiliations
Abstract
Immune responses to coronavirus disease 2019 (COVID-19) mRNA vaccines in primary antibody deficiencies (PADs) are largely unknown. We investigated antibody and CD4[SUP]+[/SUP] T-cell responses specific for SARS-CoV-2 spike protein (S) before and after vaccination and associations between vaccine response and patients' clinical and immunological characteristics in PADs. The PAD cohort consisted of common variable immune deficiency (CVID) and other PADs, not meeting the criteria for CVID diagnosis (oPADs). Anti-S IgG, IgA, and IgG subclasses 1 and 3 increased after vaccination and correlated with neutralization activity in HCs and patients with oPADs. However, 42% of CVID patients developed such responses after the 2nd dose. A similar pattern was also observed with S-specific CD4[SUP]+[/SUP] T-cells as determined by OX40 and 4-1BB expression. Patients with poor anti-S IgG response had significantly lower levels of baseline IgG, IgA, CD19[SUP]+[/SUP] B-cells, switched memory B-cells, naïve CD8[SUP]+[/SUP] T-cells, and a higher frequency of EM CD8[SUP]+[/SUP] T-cells and autoimmunity compared to patients with adequate anti-S IgG responses. Patients with oPADs can develop humoral and cellular immune responses to vaccines similar to HCs. However, a subset of CVID patients exhibit impairment in developing such responses, which can be predicted by the baseline immune profile and history of autoimmunity.
Keywords: Autoimmunity; COVID-19 mRNA vaccines; Common variable immune deficiency; Coronavirus disease 2019; IgG deficiency; Moderna mRNA vaccine; Pfizer-BioNTech mRNA vaccine; Primary antibody deficiency; Selective IgG subclass deficiency; Specific antibody deficiency.
. 2022 Jun 17.
doi: 10.1007/s10875-022-01296-4. Online ahead of print.
Defining Clinical and Immunological Predictors of Poor Immune Responses to COVID-19 mRNA Vaccines in Patients with Primary Antibody Deficiency
Junghee Jenny Shin[SUP] 1 [/SUP], Jennefer Par-Young[SUP] 1 [/SUP], Serhan Unlu[SUP] 1 [/SUP], Andrew McNamara[SUP] 2 3 [/SUP], Hong-Jai Park[SUP] 1 [/SUP], Min Sun Shin[SUP] 1 [/SUP], Renelle J Gee[SUP] 1 [/SUP], Hester Doyle[SUP] 1 [/SUP], Yuliya Afinogenova[SUP] 1 [/SUP], Elena Zidan[SUP] 4 [/SUP], Jason Kwah[SUP] 1 [/SUP], Armand Russo[SUP] 5 [/SUP], Mark Mamula[SUP] 1 [/SUP], Florence Ida Hsu[SUP] 1 [/SUP], Jason Catanzaro[SUP] 6 [/SUP], Michael Racke[SUP] 7 [/SUP], Richard Bucala[SUP] 1 [/SUP], Craig Wilen[SUP] 2 3 [/SUP], Insoo Kang[SUP] 8 [/SUP]
Affiliations
- PMID: 35713752
- DOI: 10.1007/s10875-022-01296-4
Abstract
Immune responses to coronavirus disease 2019 (COVID-19) mRNA vaccines in primary antibody deficiencies (PADs) are largely unknown. We investigated antibody and CD4[SUP]+[/SUP] T-cell responses specific for SARS-CoV-2 spike protein (S) before and after vaccination and associations between vaccine response and patients' clinical and immunological characteristics in PADs. The PAD cohort consisted of common variable immune deficiency (CVID) and other PADs, not meeting the criteria for CVID diagnosis (oPADs). Anti-S IgG, IgA, and IgG subclasses 1 and 3 increased after vaccination and correlated with neutralization activity in HCs and patients with oPADs. However, 42% of CVID patients developed such responses after the 2nd dose. A similar pattern was also observed with S-specific CD4[SUP]+[/SUP] T-cells as determined by OX40 and 4-1BB expression. Patients with poor anti-S IgG response had significantly lower levels of baseline IgG, IgA, CD19[SUP]+[/SUP] B-cells, switched memory B-cells, naïve CD8[SUP]+[/SUP] T-cells, and a higher frequency of EM CD8[SUP]+[/SUP] T-cells and autoimmunity compared to patients with adequate anti-S IgG responses. Patients with oPADs can develop humoral and cellular immune responses to vaccines similar to HCs. However, a subset of CVID patients exhibit impairment in developing such responses, which can be predicted by the baseline immune profile and history of autoimmunity.
Keywords: Autoimmunity; COVID-19 mRNA vaccines; Common variable immune deficiency; Coronavirus disease 2019; IgG deficiency; Moderna mRNA vaccine; Pfizer-BioNTech mRNA vaccine; Primary antibody deficiency; Selective IgG subclass deficiency; Specific antibody deficiency.