Risk Factors for Weak Antibody Response of SARS-CoV-2 Vaccine in Adult Solid Organ Transplant Recipients: A Systemic Review and Meta-Analysis

Zong, Kezhen; Peng, Dadi; Huang, Zuotian; Luo, Yunhai; Wang, Yihua; Xiang, Shiming; Li, Tingting; Mou, Tong; Wu, Zhongjun J.

doi:10.3389/fimmu.2022.888385

Cited by 16 publications

(20 citation statements)

References 48 publications

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“…Although speculative, the less intensive immunosuppressive regimen with lower trough levels of cyclosporine and tacrolimus late after heart transplantation may account for this observation. Moreover, the presence of higher tacrolimus trough levels in those with weak response points in this direction and corroborates previous observations, indicating an association between therapy with tacrolimus and weak humoral response after SARS-CoV-2 vaccine in solid organ transplant recipients [ 17 ].…”

Section: Discussionsupporting

confidence: 90%

“…The mechanism responsible for this impaired immunologic response remains undetermined. In solid organ transplant recipients’ older age, the presence of diabetes mellitus, the use of MPA or mycophenolate, high-dose corticosteroids, and triple immunosuppression therapy [ 17 ] have been associated with a negative antibody response.…”

Section: Discussionmentioning

confidence: 99%

“…Poor anti-spike antibody and T cell responses in heart transplant recipients after the first and second doses of SARS-CoV-2 mRNA vaccines suggest that these patients may remain at a higher risk for COVID-19. Given the preliminary results of this study, either the administration of an additive booster vaccine or lowering or temporarily discontinuing antiproliferative immunosuppression, as a strategy to increase response to SARS-CoV-2 vaccines, similar to what has been tested in kidney transplant recipients [ 17 , 18 ], might be promising and deserves to be explored in future research.…”

Section: Discussionmentioning

confidence: 99%

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T Cell and Antibody Response Following Double Dose of BNT162b2 mRNA Vaccine in SARS-CoV-2 Naïve Heart Transplant Recipients

et al. 2022

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Introduction: Preliminary studies have suggested a low post-vaccination antibody response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in heart transplant(HTx)recipients. Although many studies have focused on the role of antibodies in vaccine-induced protection against SARS-CoV-2, the role of T cell immunity is less well characterized. To date, data regarding seroconversion and T cell response after mRNA SARS-CoV-2 vaccination in patients undergoing HTx are scarce. Therefore, the present study aimed to assess the specific memory humoral and cellular responses after two doses of the BNT162b2 vaccine in HTx recipients. Methods: Blood was drawn from heart transplant (HTx) recipients at two pre-specified time points after the first and second vaccine doses to measure both the anti-SARS-CoV-2 antibody response against the spike protein and the SARS-CoV-2-reactive T cell response. Results: Our study included 34 SARS-CoV-2 naïve HTx recipients (mean age, 61 ± 11 years). The mean time from transplantation to the first vaccine dose is 10 ± 10 years. Subgroup analysis (n = 21) demonstrated that after the first vaccine dose, only 14% had antibodies and 19% had a SARS-CoV-2-reactive T-cell response, which increased to 41% and 53%, respectively, after the second dose. Interestingly, 20% of patients with no antibodies after the second dose still had a positive SARS-CoV-2-reactive T cell response. The percentage of patients with positive S-IgG antibody titers was significantly higher 5 years after transplantation (18% 0–5 years post-TX vs. 65% 5 years post-TX, p = 0.013). Similarly, 5 years after heart transplantation, the percentage of patients with a T cell response was significantly higher (35% 0–5 years post-TX vs. 71% 5 years post-TX, p = 0.030). Conclusions: In SARS-CoV-2 naïve HTx recipients, post-vaccination antibody titers but also SARS-CoV-2 specific T cell response are low. Therefore, the protection from SARS-CoV-2 that is generally attributed to vaccination should be regarded with caution in HTx recipients.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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T Cell and Antibody Response Following Double Dose of BNT162b2 mRNA Vaccine in SARS-CoV-2 Naïve Heart Transplant Recipients

et al. 2022

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“…We showed that the female sex was associated with a lower likelihood of anti-RBD IgG response but not associated with anti-RBD IgA and T-cell responses. The association between sex and antibody response to SARS-CoV-2 vaccination has been reported in a number of previous publications, and data is conflicting (12,(62)(63)(64)(65). In a recent meta-analysis including 26 studies on SOT recipients, the male gender was associated with a higher likelihood of antibody response after two doses of SARS-CoV-2 mRNA vaccines (12).…”

Section: Discussionmentioning

confidence: 99%

Humoral and T-cell response 12 months after the first BNT162b2 vaccination in solid organ transplant recipients and controls: Kinetics, associated factors, and role of SARS-CoV-2 infection

et al. 2023

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IntroductionWe investigated humoral and T-cell responses within 12 months after first BNT162b2 vaccine in solid organ transplant (SOT) recipients and controls who had received at least three vaccine doses. Furthermore, we compared the immune response in participants with and without previous SARS-CoV-2 infection.MethodsWe included adult liver, lung, and kidney transplant recipients, and controls were selected from a parallel cohort of healthcare workers.ResultsAt 12th-month, the IgG geometric mean concentrations (GMCs) (P<0.001), IgA GMCs (P=0.003), and median IFN-γ (P<0.001) were lower in SOT recipients than in controls. However, in SOT recipients and controls with previous infection, the neutralizing index was 99%, and the IgG, and IgA responses were comparable. After adjustment, female-sex (aOR: 3.6, P<0.009), kidney (aOR: 7.0, P= 0.008) or lung transplantation (aOR: 7.5, P= 0.014), and use of mycophenolate (aOR: 5.2, P=0.03) were associated with low IgG non response. Age (OR:1.4, P=0.038), time from transplantation to first vaccine (OR: 0.45, P<0.035), and previous SARS-CoV-2 infection (OR: 0.14, P<0.001), were associated with low IgA non response. Diabetes (OR:2.4, P=0.044) was associated with T-cell non response.ConclusionIn conclusion, humoral and T-cell responses were inferior in SOT recipients without previous SARS-CoV-2 infection but comparable to controls in SOT recipients with previous infection.

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“…The predominantly used immunosuppressive anti-metabolite, MMF/MPA, impairs both seroconversion rate and IgG and RBD-IgG titers in organ transplant recipients 2 months after SARS-CoV-2 mRNA vaccination ( 10 , 12 , 28 ). A recent meta-analysis showed that MPA/MMF weakened antibody response to the SARS-CoV-2 vaccine in adult solid organ transplant recipients ( 29 ). MMF/MPA may delay humoral response with significant antibody decline in kidney transplant recipients after SARS-CoV-2 mRNA vaccination ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

Immunogenicity profiling and distinct immune response in liver transplant recipients vaccinated with SARS-CoV-2 inactivated vaccines

et al. 2022

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SARS-CoV-2 vaccination has been recommended for liver transplant (LT) recipients. However, our understanding of inactivated vaccine stimulation of the immune system in regulating humoral and cellular immunity among LT recipients is inadequate. Forty-six LT recipients who received two-dose inactivated vaccines according to the national vaccination schedule were enrolled. The clinical characteristics, antibody responses, single-cell peripheral immune profiling, and plasma cytokine/chemokine/growth factor levels were recorded. Sixteen (34.78%) LT recipients with positive neutralizing antibody (nAb) were present in the Type 1 group. Fourteen and 16 LT recipients with undetected nAb were present in the Type 2 and Type 3 groups, respectively. Time from transplant and lymphocyte count were different among the three groups. The levels of anti-RBD and anti-S1S2 decreased with decreasing neutralizing inhibition rates. Compared to the Type 2 and Type 3 groups, the Type 1 group had an enhanced innate immune response. The proportions of B, DNT, and CD3+CD19+ cells were increased in the Type 1 group, whereas monocytes and CD4+ T cells were decreased. High CD19, high CD8+CD45RA+ cells, and low effector memory CD4+/naïve CD4+ cells of the T-cell populations were present in the Type 1 group. The Type 1 group had higher concentrations of plasma CXCL10, MIP-1 beta, and TNF-alpha. No severe adverse events were reported in all LT recipients. We identified the immune responses induced by inactivated vaccines among LT recipients and provided insights into the identification of immunotypes associated with the responders.

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Risk Factors for Weak Antibody Response of SARS-CoV-2 Vaccine in Adult Solid Organ Transplant Recipients: A Systemic Review and Meta-Analysis

Cited by 16 publications

References 48 publications

T Cell and Antibody Response Following Double Dose of BNT162b2 mRNA Vaccine in SARS-CoV-2 Naïve Heart Transplant Recipients

T Cell and Antibody Response Following Double Dose of BNT162b2 mRNA Vaccine in SARS-CoV-2 Naïve Heart Transplant Recipients

Humoral and T-cell response 12 months after the first BNT162b2 vaccination in solid organ transplant recipients and controls: Kinetics, associated factors, and role of SARS-CoV-2 infection

Immunogenicity profiling and distinct immune response in liver transplant recipients vaccinated with SARS-CoV-2 inactivated vaccines

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