Immune Profile Determines Response to Vaccination against COVID-19 in Kidney Transplant Recipients

• Published in: Vaccines (Basel) Vol. 11; no. 10; p. 1583
• Main Authors: Stai, Stamatia, Fylaktou, Asimina, Kasimatis, Efstratios, Xochelli, Aliki, Lioulios, Georgios, Nikolaidou, Vasiliki, Papadopoulou, Anastasia, Myserlis, Grigorios, Iosifidou, Artemis Maria, Iosifidou, Myrto Aikaterini, Papagianni, Aikaterini, Yannaki, Evangelia, Tsoulfas, Georgios, Stangou, Maria
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01.10.2023; MDPI
• Subjects: CD3 antigen; CD4 antigen; CD8 antigen; Cell number; Cells; cellular response; COVID-19; COVID-19 vaccination; COVID-19 vaccines; Cytotoxicity; Disease; ELISpot; Enzymes; Evaluation; Immune response (humoral); Immune status; Immune system; Immunoassay; Immunosuppression; Infections; Kidney transplantation; Kidney transplants; Kidneys; Lymphocytes; Lymphocytes B; Lymphocytes T; Memory cells; Methods; Natural killer cells; Observational studies; Organ transplant recipients; Outpatient care facilities; Patients; PD-1 protein; protective humoral response; Severe acute respiratory syndrome coronavirus 2; Vaccination; Viral infections; Greece
• ISSN: 2076-393X; 2076-393X
• DOI: 10.3390/vaccines11101583

Background and Aim: Immune status profile can predict response to vaccination, while lymphocyte phenotypic alterations represent its effectiveness. We prospectively evaluated these parameters in kidney transplant recipients (KTRs) regarding Tozinameran (BNT162b2) vaccination. Method: In this prospective monocenter observational study, 39 adult KTRs, on stable immunosuppression, naïve to COVID-19, with no protective humoral response after two Tozinameran doses, received the third vaccination dose, and, based on their immunity activation, they were classified as responders or non-responders. Humoral and cellular immunities were assessed at predefined time points (T0: 48 h before the first, T1: 48 h prior to the third and T2: three weeks after the third dose). Results: Responders, compared to non-responders, had a higher total and transitional B-lymphocyte count at baseline (96.5 (93) vs. 51 (52)cells/μL, p: 0.045 and 9 (17) vs. 1 (2)cells/μL, p: 0.031, respectively). In the responder group, there was a significant increase, from T0 to T1, in the concentrations of activated CD4+ (from 6.5 (4) to 10.08 (11)cells/μL, p: 0.001) and CD8+ (from 8 (19) to 14.76 (16)cells/μL, p: 0.004) and a drop in CD3+PD1+ T-cells (from 130 (121) to 30.44 (25)cells/μL, p: 0.001), while naïve and transitional B-cells increased from T1 to T2 (from 57.55 (66) to 1149.3 (680)cells/μL, p < 0.001 and from 1.4 (3) to 17.5 (21)cells/μL, p: 0.003). The percentages of memory and marginal zone B-lymphocytes, and activated CD4+, CD8+ and natural killer (NK) T-cells significantly increased, while those of naïve B-cells and CD3+PD1+ T-cells reduced from T0 to T1. Conclusions: Responders and non-responders to the third BNT162b2 dose demonstrated distinct initial immune cell profiles and changes in cellular subpopulation composition following vaccination.