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Role of mTOR inhibitor in the cellular and humoral immune response to a booster dose of SARS-CoV-2 mRNA-1273 vaccine in kidney transplant recipients

BACKGROUND: Immunocompromised patients have an increased risk of developing severe COVID disease, as well as a tendency to suboptimal responses to vaccines. The objective of this study was to evaluate the specific cellular and humoral adaptive immune responses of a cohort of kidney transplant recipi...

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Autores principales: Pérez-Flores, Isabel, Juarez, Ignacio, Aiffil Meneses, Arianne S., Lopez-Gomez, Ana, Romero, Natividad Calvo, Rodriguez-Cubillo, Beatriz, Moreno de la Higuera, María Angeles, Peix-Jiménez, Belen, Gonzalez-Garcia, Raquel, Baos-Muñoz, Elvira, Vilela, Ana Arribi, Gómez Del Moral, Manuel, Martínez-Naves, Eduardo, Sanchez-Fructuoso, Ana Isabel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9931894/
https://www.ncbi.nlm.nih.gov/pubmed/36817489
http://dx.doi.org/10.3389/fimmu.2023.1111569
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author Pérez-Flores, Isabel
Juarez, Ignacio
Aiffil Meneses, Arianne S.
Lopez-Gomez, Ana
Romero, Natividad Calvo
Rodriguez-Cubillo, Beatriz
Moreno de la Higuera, María Angeles
Peix-Jiménez, Belen
Gonzalez-Garcia, Raquel
Baos-Muñoz, Elvira
Vilela, Ana Arribi
Gómez Del Moral, Manuel
Martínez-Naves, Eduardo
Sanchez-Fructuoso, Ana Isabel
author_facet Pérez-Flores, Isabel
Juarez, Ignacio
Aiffil Meneses, Arianne S.
Lopez-Gomez, Ana
Romero, Natividad Calvo
Rodriguez-Cubillo, Beatriz
Moreno de la Higuera, María Angeles
Peix-Jiménez, Belen
Gonzalez-Garcia, Raquel
Baos-Muñoz, Elvira
Vilela, Ana Arribi
Gómez Del Moral, Manuel
Martínez-Naves, Eduardo
Sanchez-Fructuoso, Ana Isabel
author_sort Pérez-Flores, Isabel
collection PubMed
description BACKGROUND: Immunocompromised patients have an increased risk of developing severe COVID disease, as well as a tendency to suboptimal responses to vaccines. The objective of this study was to evaluate the specific cellular and humoral adaptive immune responses of a cohort of kidney transplant recipients (KTR) after 3 doses of mRNA-1273 vaccine and to determinate the main factors involved. METHODS: Prospective observational study in 221 KTR (149 non infected), 55 healthy volunteers (HV) and 23 dialysis patients (DP). We evaluated anti-spike (by quantitative chemiluminescence immunoassay) and anti-nucleocapsid IgG (ELISA), percentage of TCD4(+) and TCD8(+) lymphocytes producing IFNγ against S-protein by intracellular flow cytometry after Spike-specific 15-mer peptide stimulation and serum neutralizing activity (competitive ELISA) at baseline and after vaccination. RESULTS: Among COVID-19 naïve KTR, 54.2% developed cellular and humoral response after the third dose (vs 100% in DP and 91.7% in HV), 18% only showed cell-mediated response, 22.2% exclusively antibody response and 5.6% none. A correlation of neutralizing activity with both the IgG titer (r=0.485, p<0.001) and the percentage of S-protein–specific IFNγ–producing CD8-T cells (r=0.198, p=0.049) was observed. Factors related to the humoral response in naïve KTR were: lymphocytes count pre-vaccination >1000/mm(3) [4.68 (1.72-12.73, p=0.003], eGFR>30 mL/min [7.34(2.72-19.84), p<0.001], mTOR inhibitors [6.40 (1.37-29.86), p=0.018]. Infected KTR developed a stronger serologic response than naïve patients (96.8 vs 75.2%, p<0.001). CONCLUSIONS: KTR presented poor cellular and humoral immune responses following vaccination with mRNA-1273. The immunosuppression degree and kidney function of these patients play an important role, but the only modifiable factor with a high impact on humoral immunogenicity after a booster dose was an immunosuppressive therapy including a mTOR inhibitor. Clinical trials are required to confirm these results.
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spelling pubmed-99318942023-02-17 Role of mTOR inhibitor in the cellular and humoral immune response to a booster dose of SARS-CoV-2 mRNA-1273 vaccine in kidney transplant recipients Pérez-Flores, Isabel Juarez, Ignacio Aiffil Meneses, Arianne S. Lopez-Gomez, Ana Romero, Natividad Calvo Rodriguez-Cubillo, Beatriz Moreno de la Higuera, María Angeles Peix-Jiménez, Belen Gonzalez-Garcia, Raquel Baos-Muñoz, Elvira Vilela, Ana Arribi Gómez Del Moral, Manuel Martínez-Naves, Eduardo Sanchez-Fructuoso, Ana Isabel Front Immunol Immunology BACKGROUND: Immunocompromised patients have an increased risk of developing severe COVID disease, as well as a tendency to suboptimal responses to vaccines. The objective of this study was to evaluate the specific cellular and humoral adaptive immune responses of a cohort of kidney transplant recipients (KTR) after 3 doses of mRNA-1273 vaccine and to determinate the main factors involved. METHODS: Prospective observational study in 221 KTR (149 non infected), 55 healthy volunteers (HV) and 23 dialysis patients (DP). We evaluated anti-spike (by quantitative chemiluminescence immunoassay) and anti-nucleocapsid IgG (ELISA), percentage of TCD4(+) and TCD8(+) lymphocytes producing IFNγ against S-protein by intracellular flow cytometry after Spike-specific 15-mer peptide stimulation and serum neutralizing activity (competitive ELISA) at baseline and after vaccination. RESULTS: Among COVID-19 naïve KTR, 54.2% developed cellular and humoral response after the third dose (vs 100% in DP and 91.7% in HV), 18% only showed cell-mediated response, 22.2% exclusively antibody response and 5.6% none. A correlation of neutralizing activity with both the IgG titer (r=0.485, p<0.001) and the percentage of S-protein–specific IFNγ–producing CD8-T cells (r=0.198, p=0.049) was observed. Factors related to the humoral response in naïve KTR were: lymphocytes count pre-vaccination >1000/mm(3) [4.68 (1.72-12.73, p=0.003], eGFR>30 mL/min [7.34(2.72-19.84), p<0.001], mTOR inhibitors [6.40 (1.37-29.86), p=0.018]. Infected KTR developed a stronger serologic response than naïve patients (96.8 vs 75.2%, p<0.001). CONCLUSIONS: KTR presented poor cellular and humoral immune responses following vaccination with mRNA-1273. The immunosuppression degree and kidney function of these patients play an important role, but the only modifiable factor with a high impact on humoral immunogenicity after a booster dose was an immunosuppressive therapy including a mTOR inhibitor. Clinical trials are required to confirm these results. Frontiers Media S.A. 2023-02-02 /pmc/articles/PMC9931894/ /pubmed/36817489 http://dx.doi.org/10.3389/fimmu.2023.1111569 Text en Copyright © 2023 Pérez-Flores, Juarez, Aiffil Meneses, Lopez-Gomez, Romero, Rodriguez-Cubillo, Moreno de la Higuera, Peix-Jiménez, Gonzalez-Garcia, Baos-Muñoz, Vilela, Gómez Del Moral, Martínez-Naves and Sanchez-Fructuoso https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Pérez-Flores, Isabel
Juarez, Ignacio
Aiffil Meneses, Arianne S.
Lopez-Gomez, Ana
Romero, Natividad Calvo
Rodriguez-Cubillo, Beatriz
Moreno de la Higuera, María Angeles
Peix-Jiménez, Belen
Gonzalez-Garcia, Raquel
Baos-Muñoz, Elvira
Vilela, Ana Arribi
Gómez Del Moral, Manuel
Martínez-Naves, Eduardo
Sanchez-Fructuoso, Ana Isabel
Role of mTOR inhibitor in the cellular and humoral immune response to a booster dose of SARS-CoV-2 mRNA-1273 vaccine in kidney transplant recipients
title Role of mTOR inhibitor in the cellular and humoral immune response to a booster dose of SARS-CoV-2 mRNA-1273 vaccine in kidney transplant recipients
title_full Role of mTOR inhibitor in the cellular and humoral immune response to a booster dose of SARS-CoV-2 mRNA-1273 vaccine in kidney transplant recipients
title_fullStr Role of mTOR inhibitor in the cellular and humoral immune response to a booster dose of SARS-CoV-2 mRNA-1273 vaccine in kidney transplant recipients
title_full_unstemmed Role of mTOR inhibitor in the cellular and humoral immune response to a booster dose of SARS-CoV-2 mRNA-1273 vaccine in kidney transplant recipients
title_short Role of mTOR inhibitor in the cellular and humoral immune response to a booster dose of SARS-CoV-2 mRNA-1273 vaccine in kidney transplant recipients
title_sort role of mtor inhibitor in the cellular and humoral immune response to a booster dose of sars-cov-2 mrna-1273 vaccine in kidney transplant recipients
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9931894/
https://www.ncbi.nlm.nih.gov/pubmed/36817489
http://dx.doi.org/10.3389/fimmu.2023.1111569
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