Vaccination Against SARS-CoV-2 in Lung Transplant Recipients: Immunogenicity, Efficacy and Safety

Abstract

Lung transplant (LuTx) recipients are considered to be at higher risk of developing serious illness from COVID-19. COVID-19 vaccines were shown in randomized clinical trials to substantially reduce the severity of COVID-19, however, patients receiving immunosuppressants were excluded from these trials. Observational studies report a proportion of solid organ transplant (SOT) recipients being able to mount sufficient titers of SARS-CoV-2 specific IgG antibodies, however, other studies demonstrate that more than 90% of the SOT recipients elicit neither humoral nor cellular immune response after vaccination. Currently, the third booster dose of the COVID-19 vaccines was shown to elicit strong immune responses and may, thus, represent a potent tool in the prevention of severe COVID-19 infection in SOT recipients, including patients after lung transplantation. To address the main challenges of SARS-CoV-2 vaccination in LuTx recipients in the era of COVID-19, we have closely collected all available data on the immunogenicity, efficacy and safety of COVID-19 vaccines in LuTx recipients.

Outcomes of SARS‐CoV‐2 infection among lung transplant recipients: A single center retrospective study

“…An important observation is that a positive humoral response to adequate vaccination (44%) was higher than previously reported among LTRs (12%–27%) 23,24 . However, despite this higher seroconversion rate, we were not able to demonstrate an association between vaccination and better outcome.…”

Fine-tuning of mononuclear phagocytes for improved inflammatory responses: role of soybean-derived immunomodulatory compounds

“…Simultaneously, M2 subsets promote the remodeling of damaged tissues by producing ornithine, a substrate of polyamine synthesis. Nowadays, anti-inflammatory M2 macrophages can be categorized into at least four subsets (M2a, M2b, M2c, and M2d) based on the expression of transcription factors (26). Given that M2 macrophages play a role in repairing M1 macrophage-mediated tissue damages, their appearance in damaged tissues is likely attributable to be either the reprogramming from M1 to M2 subsets or the replenishment of M2 subsets during the recovery process.…”

Human tissue-resident peritoneal macrophages reveal resistance towards oxidative cell stress induced by non-invasive physical plasma

“…Differently from SPMs, LPMs stem from yolk-sac progenitors and have self-renewal potential with GATA-binding protein 6 (GATA-6), a transcription factor, responsible for their differentiation and survival (11). Owing to their high plasticity, tissue-resident macrophages can initiate an immune response, regulate wound repair and modulate tumor expansion (12). "Classically" activated (M1) macrophages exert cytotoxic effects, express CD86, a co-stimulatory molecule required for the activation of T cells, and release proinflammatory cytokines (e.g., IL-6, IL-17) (13)(14)(15).…”