Cellular and Humoral Responses in Dialysis Patients after Vaccination with the BNT162b2 or mRNA-1273 Vaccines

SIMPLE SUMMARY: Patients with end-stage renal disease (ESRD) requiring hemodialysis (HD) constitute a high-risk group in terms of susceptibility to and severity of infection. High mortality rates have been observed in this population group with SARS-CoV-2 infection, and thus strategies to halt viral...

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Detalles Bibliográficos
Autores principales: Mavrovouniotis, Ilias, Fylaktou, Asimina, Stagou, Maria, Ouranos, Konstantinos, Lioulios, Georgios, Evgenikaki, Efthimia, Exindari, Maria, Gioula, Georgia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967689/
https://www.ncbi.nlm.nih.gov/pubmed/36836831
http://dx.doi.org/10.3390/life13020474
Descripción
Sumario:SIMPLE SUMMARY: Patients with end-stage renal disease (ESRD) requiring hemodialysis (HD) constitute a high-risk group in terms of susceptibility to and severity of infection. High mortality rates have been observed in this population group with SARS-CoV-2 infection, and thus strategies to halt viral transmission are deemed crucial. Vaccination with an mRNA-based vaccine has been shown to decrease the risk of severe disease and substantially reduce mortality, both in healthy individuals and ESRD patients. The cellular and humoral immune responses elicited in HD patients, however, are diminished when compared to healthy controls, with the waning immunity that ensues placing them at high risk for reinfection. Several variables have been found to be associated with this suboptimal response to vaccination, with immunosuppression, older age, and underlying comorbidities playing a central role. Lately, the effects of booster dose administration have been studied in HD patients, with results indicating an enhanced immune response capable of inducing a protective immune profile in this group. ABSTRACT: The outbreak of SARS-CoV-2 has raised considerable concern about the detrimental effects it can induce in public health, with the interest of the scientific community being focused on the development of preventive and therapeutic approaches. Patients with end-stage renal disease (ESRD) are amongst vulnerable populations for critical illness owing to the presence of other comorbidities, their defective immune system, and their inability of self-isolation. To date, vaccination constitutes the most promising method to manage viral dispersion. Therefore, it is particularly important to investigate the effectiveness of available vaccines against SARS-CoV-2 in this risk group. Here, we summarize initial experience regarding the humoral and cellular immune responses elicited in dialysis patients after completion of the recommended vaccination regimen, as well as after booster dose administration, with one of the two mRNA vaccines, namely, BNT162b2 and mRNA-1273. In conclusion, a significantly diminished and delayed immune pattern was observed in ESRD patients compared to healthy population, with a peak in antibody titers occurring 3–5 weeks after the second dose. A booster dose significantly augmented the immune response in dialysis patients with either mRNA-based vaccine. Variables adversely correlating with the weak immunogenicity observed in dialysis patients include immunosuppressive therapy, older age, comorbidities, longer time in hemodialysis treatment, and higher body mass index. On the contrary, previous COVID-19 infection and administration of the mRNA-1273 vaccine are deemed to induce a more favorable immune response. Further investigation is needed to thoroughly understand the efficacy of mRNA-based vaccines in hemodialysis patients and define predictive factors that can influence it.