Abstract：
Kidney transplant recipients (KTRs), like other solid organ transplant recipients display a suboptimal response to mRNA vaccines, with only about half achieving seroconversion after two doses. However, the effectiveness of a booster dose, particularly in generating neutralizing antibodies (NAbs), remains poorly understood, as most studies have mainly focused on non-neutralizing antibodies. Here, we have longitudinally assessed the humoral response to the SARS-CoV-2 mRNA vaccine in 40 KTRs over a year, examining changes in both anti-spike IgG and NAbs following a booster dose administered about 5 months post-second dose. We found a significant humoral response increase 5 months post-booster, a stark contrast to the attenuated response observed after the second dose. Of note, nearly a quarter of participants did not achieve protective plasma levels even after the booster dose. We also found that the higher estimated glomerular filtration rate (eGFR) correlated with a more robust humoral response postvaccination. Altogether, these findings underscore the effectiveness of the booster dose in enhancing durable humoral immunity in KTRs, as evidenced by the protective level of NAbs found in 65% of the patients 5 months post- booster, especially those with higher eGFR rates.
摘要：
肾移植受者（KTRs），像其他实体器官移植受者一样，对mRNA疫苗表现出次优的反应，只有大约一半在两次剂量后实现血清转化。然而,加强剂量的有效性，特别是在产生中和抗体（NAb），仍然知之甚少，因为大多数研究主要集中在非中和抗体上。这里,我们纵向评估了一年中40个KTRs对SARS-CoV-2mRNA疫苗的体液反应，在第二次给药后约5个月给予加强剂量后，检查抗尖峰IgG和NAb的变化。我们发现加强后5个月体液反应显著增加，与第二剂量后观察到的减弱反应形成鲜明对比。值得注意的是，近四分之一的参与者即使在加强剂量后仍未达到保护性血浆水平.我们还发现，较高的估计肾小球滤过率（eGFR）与疫苗接种后更强大的体液反应相关。总之,这些发现强调了加强剂量在增强KTRs持久体液免疫中的有效性，如在升压后5个月的患者中发现的NAb的保护水平所证明的那样，尤其是那些具有较高的eGFR率。
