SARS-CoV-2 Spike-specific IFN-γ T-cell Response After COVID-19 Vaccination in Patients With Chronic Kidney Disease, on Dialysis, or Living With a Kidney Transplant
Background. Studies have shown that coronavirus disease 2019 (COVID-19) vaccination is associated with a lower humoral response in vulnerable kidney patients. Here, we investigated the T-cell response following COVID-19 vaccination in kidney patients compared with controls. Methods. Patients with ch...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2022-11-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001387 |
| _version_ | 1811304906525507584 |
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| author | Céline Imhof, MD A. Lianne Messchendorp, MD, PhD Marieke van der Heiden, PhD Carla C. Baan, PhD Renate G. van der Molen, PhD Ester B. M. Remmerswaal, PhD Rory D. de Vries, PhD Dimitri A. Diavatopoulos, PhD Annemarie Boerma, MSc Femke J. Bakker, BSc Emily Oosterhout, BSc Frederike J. Bemelman, MD, PhD Luuk B. Hilbrands, MD, PhD Marlies E. J. Reinders, MD, PhD Ron T. Gansevoort, MD, PhD Jan-Stephan Sanders, MD, PhD Debbie van Baarle, PhD on behalf of RECOVAC Consortium |
| author_facet | Céline Imhof, MD A. Lianne Messchendorp, MD, PhD Marieke van der Heiden, PhD Carla C. Baan, PhD Renate G. van der Molen, PhD Ester B. M. Remmerswaal, PhD Rory D. de Vries, PhD Dimitri A. Diavatopoulos, PhD Annemarie Boerma, MSc Femke J. Bakker, BSc Emily Oosterhout, BSc Frederike J. Bemelman, MD, PhD Luuk B. Hilbrands, MD, PhD Marlies E. J. Reinders, MD, PhD Ron T. Gansevoort, MD, PhD Jan-Stephan Sanders, MD, PhD Debbie van Baarle, PhD on behalf of RECOVAC Consortium |
| author_sort | Céline Imhof, MD |
| collection | DOAJ |
| description | Background. Studies have shown that coronavirus disease 2019 (COVID-19) vaccination is associated with a lower humoral response in vulnerable kidney patients. Here, we investigated the T-cell response following COVID-19 vaccination in kidney patients compared with controls.
Methods. Patients with chronic kidney disease (CKD) stage G4/5 [estimated glomerular filtration rate <30 mL/min/1.73 m2], on dialysis, or living with a kidney transplant and controls received 2 doses of the mRNA-1273 COVID-19 vaccine. Peripheral blood mononuclear cells were isolated at baseline and 28 d after the second vaccination. In 398 participants (50% of entire cohort; controls n = 95, CKD G4/5 n = 81, dialysis n = 78, kidney transplant recipients [KTRs] n = 144)‚ SARS-CoV-2-specific T cells were measured using an IFN-γ enzyme-linked immune absorbent spot assay.
Results. A significantly lower SARS-CoV-2-specific T-cell response was observed after vaccination of patients on dialysis (54.5%) and KTRs (42.6%) in contrast to CDK G4/5 (70%) compared with controls (76%). The use of calcineurin inhibitors was associated with a low T-cell response in KTRs. In a subset of 20 KTRs, we observed waning of the cellular response 6 mo after the second vaccination, which was boosted to some extent after a third vaccination, although T-cell levels remained low.
Conclusion. Our data suggest that vaccination is less effective in these patient groups, with humoral nonresponders also failing to mount an adequate cellular response, even after the third vaccination. Given the important role of T cells in protection against disease and cross-reactivity to SARS-CoV-2 variants, alternative vaccination strategies are urgently needed in these high-risk patient groups. |
| first_indexed | 2024-04-13T08:15:46Z |
| format | Article |
| id | doaj.art-7afa0ccb8ef14bc0b3e6b150791cf86b |
| institution | Directory Open Access Journal |
| issn | 2373-8731 |
| language | English |
| last_indexed | 2024-04-13T08:15:46Z |
| publishDate | 2022-11-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj.art-7afa0ccb8ef14bc0b3e6b150791cf86b2022-12-22T02:54:46ZengWolters KluwerTransplantation Direct2373-87312022-11-01811e138710.1097/TXD.0000000000001387202211000-00012SARS-CoV-2 Spike-specific IFN-γ T-cell Response After COVID-19 Vaccination in Patients With Chronic Kidney Disease, on Dialysis, or Living With a Kidney TransplantCéline Imhof, MD0A. Lianne Messchendorp, MD, PhD1Marieke van der Heiden, PhD2Carla C. Baan, PhD3Renate G. van der Molen, PhD4Ester B. M. Remmerswaal, PhD5Rory D. de Vries, PhD6Dimitri A. Diavatopoulos, PhD7Annemarie Boerma, MSc8Femke J. Bakker, BSc9Emily Oosterhout, BSc10Frederike J. Bemelman, MD, PhD11Luuk B. Hilbrands, MD, PhD12Marlies E. J. Reinders, MD, PhD13Ron T. Gansevoort, MD, PhD14Jan-Stephan Sanders, MD, PhD15Debbie van Baarle, PhD16on behalf of RECOVAC Consortium1 Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.1 Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.2 Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, Groningen, The Netherlands.3 Department of Internal Medicine, Nephrology and Transplantation, Erasmus MC Transplant Institute, Erasmus Medical Center, Rotterdam, The Netherlands.4 Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine, Laboratory of Medical Immunology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands.5 Department of Experimental Immunology, Amsterdam Infection and Immunity Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.6 Department of Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands.4 Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine, Laboratory of Medical Immunology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands.2 Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, Groningen, The Netherlands.2 Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, Groningen, The Netherlands.2 Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, Groningen, The Netherlands.8 Renal Transplant Unit, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.9 Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.3 Department of Internal Medicine, Nephrology and Transplantation, Erasmus MC Transplant Institute, Erasmus Medical Center, Rotterdam, The Netherlands.1 Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.1 Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.2 Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, Groningen, The Netherlands.Background. Studies have shown that coronavirus disease 2019 (COVID-19) vaccination is associated with a lower humoral response in vulnerable kidney patients. Here, we investigated the T-cell response following COVID-19 vaccination in kidney patients compared with controls. Methods. Patients with chronic kidney disease (CKD) stage G4/5 [estimated glomerular filtration rate <30 mL/min/1.73 m2], on dialysis, or living with a kidney transplant and controls received 2 doses of the mRNA-1273 COVID-19 vaccine. Peripheral blood mononuclear cells were isolated at baseline and 28 d after the second vaccination. In 398 participants (50% of entire cohort; controls n = 95, CKD G4/5 n = 81, dialysis n = 78, kidney transplant recipients [KTRs] n = 144)‚ SARS-CoV-2-specific T cells were measured using an IFN-γ enzyme-linked immune absorbent spot assay. Results. A significantly lower SARS-CoV-2-specific T-cell response was observed after vaccination of patients on dialysis (54.5%) and KTRs (42.6%) in contrast to CDK G4/5 (70%) compared with controls (76%). The use of calcineurin inhibitors was associated with a low T-cell response in KTRs. In a subset of 20 KTRs, we observed waning of the cellular response 6 mo after the second vaccination, which was boosted to some extent after a third vaccination, although T-cell levels remained low. Conclusion. Our data suggest that vaccination is less effective in these patient groups, with humoral nonresponders also failing to mount an adequate cellular response, even after the third vaccination. Given the important role of T cells in protection against disease and cross-reactivity to SARS-CoV-2 variants, alternative vaccination strategies are urgently needed in these high-risk patient groups.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001387 |
| spellingShingle | Céline Imhof, MD A. Lianne Messchendorp, MD, PhD Marieke van der Heiden, PhD Carla C. Baan, PhD Renate G. van der Molen, PhD Ester B. M. Remmerswaal, PhD Rory D. de Vries, PhD Dimitri A. Diavatopoulos, PhD Annemarie Boerma, MSc Femke J. Bakker, BSc Emily Oosterhout, BSc Frederike J. Bemelman, MD, PhD Luuk B. Hilbrands, MD, PhD Marlies E. J. Reinders, MD, PhD Ron T. Gansevoort, MD, PhD Jan-Stephan Sanders, MD, PhD Debbie van Baarle, PhD on behalf of RECOVAC Consortium SARS-CoV-2 Spike-specific IFN-γ T-cell Response After COVID-19 Vaccination in Patients With Chronic Kidney Disease, on Dialysis, or Living With a Kidney Transplant Transplantation Direct |
| title | SARS-CoV-2 Spike-specific IFN-γ T-cell Response After COVID-19 Vaccination in Patients With Chronic Kidney Disease, on Dialysis, or Living With a Kidney Transplant |
| title_full | SARS-CoV-2 Spike-specific IFN-γ T-cell Response After COVID-19 Vaccination in Patients With Chronic Kidney Disease, on Dialysis, or Living With a Kidney Transplant |
| title_fullStr | SARS-CoV-2 Spike-specific IFN-γ T-cell Response After COVID-19 Vaccination in Patients With Chronic Kidney Disease, on Dialysis, or Living With a Kidney Transplant |
| title_full_unstemmed | SARS-CoV-2 Spike-specific IFN-γ T-cell Response After COVID-19 Vaccination in Patients With Chronic Kidney Disease, on Dialysis, or Living With a Kidney Transplant |
| title_short | SARS-CoV-2 Spike-specific IFN-γ T-cell Response After COVID-19 Vaccination in Patients With Chronic Kidney Disease, on Dialysis, or Living With a Kidney Transplant |
| title_sort | sars cov 2 spike specific ifn γ t cell response after covid 19 vaccination in patients with chronic kidney disease on dialysis or living with a kidney transplant |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001387 |
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