PDF(Pubmed)
Abstract：
The immunological imprint after two doses of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) mRNA vaccination for patients after kidney transplantation (KTx) remain unclear. This study included KTx recipients and volunteer healthy controls (HCs) who received two doses of SARS-CoV-2 mRNA vaccine (Pfizer BioNTech) from January 2021 to December 2021. We analyzed safety within 21 days after each vaccination dose and compared the immune response in peripheral blood mononuclear cells (PBMCs) between the two groups. No graft rejection was observed throughout this study. Adverse events were generally observed within 5 days. The KTx group exhibited a significantly lower degree of symptoms between doses 1 and 2 (P < 0.001). Increases in activated subsets of T and B cells expressing human leukocyte antigen (HLA)-DR and/or CD38 were observed in the HC group after dose 2 (both P < 0.001), with the greatest increases in HLA-DR+CD8+ T cells and CD38+CD19+ B cells (P = 0.042 and P = 0.031, respectively). In addition, PD1+CD8+ T cells-but not PD1+CD4+ T cells-increased significantly in the HC group (P = 0.027). In the KTx group, however, activated HLA-DR+, CD38+, and PD1+ cells remained at baseline levels. Immunoglobulin (Ig)G against SARS-CoV-2 was detected in only four KTx recipients (13.3%) after dose 2 (P < 0.001). Multivariate logistic regression analyses revealed that ΔHLA-DR+CD8+ T cells and ΔCD38+CD19+ B cells were significantly associated with IgG formation (both P = 0.02). SARS-CoV-2 mRNA vaccine generates impaired cellular and humoral immunity for KTx recipients. Results indicate the need for modified vaccination strategies in immunocompromised KTx recipients.
摘要：
对肾移植（KTx）后的患者进行两剂严重急性呼吸综合征-冠状病毒2（SARS-CoV-2）mRNA疫苗接种后的免疫学印记仍不清楚。这项研究包括KTx接受者和志愿者健康对照（HCs），他们从2021年1月至2021年12月接受了两剂SARS-CoV-2mRNA疫苗（PfizerBioNTech）。我们分析了每次疫苗接种后21天内的安全性，并比较了两组之间外周血单核细胞（PBMC）的免疫反应。在整个研究中没有观察到移植物排斥。一般在5天内观察到不良事件。KTx组在剂量1和2之间表现出显著较低的症状程度(P<0.001)。在剂量2后，HC组中观察到表达人类白细胞抗原（HLA）-DR和/或CD38的T和B细胞的活化亚群增加（均P<0.001），HLA-DR+CD8+T细胞和CD38+CD19+B细胞的增加最大（分别为P=0.042和P=0.031）。此外,在HC组中，PD1CD8T细胞而不是PD1CD4T细胞显着增加（P=0.027）。在KTx组中，然而,激活的HLA-DR+，CD38+,和PD1+细胞保持在基线水平。剂量2后，仅在四名KTx接受者（13.3％）中检测到针对SARS-CoV-2的免疫球蛋白（Ig）G（P<0.001）。多变量逻辑回归分析显示，ΔHLA-DRCD8T细胞和ΔCD38CD19B细胞与IgG形成显着相关（均P=0.02）。SARS-CoV-2mRNA疫苗对KTx受体产生受损的细胞和体液免疫。结果表明，在免疫受损的KTx接受者中需要改进的疫苗接种策略。
