Impact of Immunosuppression on Recall Immune Responses to Influenza Vaccination in Stable Renal Transplant Recipients

Abstract

Background The recommendation by the American Society of Transplantation for annual trivalent inactivated influenza vaccination greater than 3 to 6 months post-kidney transplantation provides a unique opportunity to test the in vivo impact of immunosuppression on recall T- and B-cell responses to influenza vaccination. Methods This study took advantage of recent breakthroughs in the single-cell quantification of human peripheral blood B-cell responses to prospectively evaluate both B- and T-cell responses to the seasonal (2010 and 2011) influenza vaccine in 23 stable renal transplant recipients and 22 healthy controls. Results and Conclusion The results demonstrate that the early B-cell response to influenza vaccination, quantified by the frequency of influenza-specific antibody-secreting cells (ASC) in peripheral blood, was significantly reduced in stable transplant recipients compared to healthy controls. The magnitude of the seroresponse and the rate of sero-conversion were also blunted. The influenza-specific interferon-gamma (IFNγ) T-cell response was significantly reduced in transplant recipients; however, there was no correlation between the magnitude of the influenza-specific IgG ASC and IFNγ responses. The induction of memory T- and B-cell responses to influenza vaccination supports the recommendation to vaccinate while the blunted responses demonstrate the efficacy of immunosuppression in controlling memory responses individual transplant recipients.

Detection of SARS-CoV-2 antibodies in pediatric kidney transplant patients

“…Although these levels are very high, no one truly knew how these levels translate into protection from the virus. These findings were unexpected, as we already know that compared to the regular population, transplant patients who developed infection have a blunted immune response and a low rate of seroconversion [ 27 ].. The fact that our transplant patients mounted a strong humoral immune response to natural infection makes us believe that they will elicit the same, if not stronger, immune response with future vaccination when it becomes available for this age group.…”

Predicting risk of pulmonary infection in patients with primary membranous nephropathy on immunosuppressive therapy: The AIM‐7C score

“…Consistently, we found that the third month since treatment is the most susceptible period for PI. Under such circumstance, propensity to infection is determined by the rate and magnitude of the immunosuppression and this may explain the exclusion of age as a risk factor. As such, we have identified five bona fide risk factors with the IgG titer as the top one.…”

Memory B Cells in Transplantation

“…Sequencing of the immunoglobulin variable regions isolated from sorted single ASCs producing high affinity influenza-specific antibodies confirmed that the majority of the ASC response arose from memory B cells. Cowan et al (68) built on these observations to quantify the influenza-specific ASC response in stable renal transplant recipients. They observed that the early influenza-specific ASCs response to influenza vaccination was significantly reduced compared to healthy controls.…”