Frontiers in Immunology (Mar 2023)

Comparable cellular and humoral immunity upon homologous and heterologous COVID-19 vaccination regimens in kidney transplant recipients

  • Nina Körber,
  • Christopher Holzmann-Littig,
  • Christopher Holzmann-Littig,
  • Gesa Wilkens,
  • Bo-Hung Liao,
  • Maia L. Werz,
  • Louise Platen,
  • Cho-Chin Cheng,
  • Myriam Tellenbach,
  • Verena Kappler,
  • Viktor Lehner,
  • Hrvoje Mijočević,
  • Catharina Christa,
  • Volker Assfalg,
  • Uwe Heemann,
  • Christoph Schmaderer,
  • Ulrike Protzer,
  • Ulrike Protzer,
  • Ulrike Protzer,
  • Matthias C. Braunisch,
  • Tanja Bauer,
  • Tanja Bauer,
  • Lutz Renders,
  • Lutz Renders

DOI
https://doi.org/10.3389/fimmu.2023.1172477
Journal volume & issue
Vol. 14

Abstract

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BackgroundKidney transplant recipients (KTRs) are at high risk for a severe course of coronavirus disease 2019 (COVID-19); thus, effective vaccination is critical. However, the achievement of protective immunogenicity is hampered by immunosuppressive therapies. We assessed cellular and humoral immunity and breakthrough infection rates in KTRs vaccinated with homologous and heterologous COVID-19 vaccination regimens.MethodWe performed a comparative in-depth analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–specific T-cell responses using multiplex Fluorospot assays and SARS-CoV-2-specific neutralizing antibodies (NAbs) between three-times homologously (n = 18) and heterologously (n = 8) vaccinated KTRs.ResultsWe detected SARS-CoV-2-reactive T cells in 100% of KTRs upon third vaccination, with comparable frequencies, T-cell expression profiles, and relative interferon γ and interleukin 2 production per single cell between homologously and heterologously vaccinated KTRs. SARS-CoV-2-specific NAb positivity rates were significantly higher in heterologously (87.5%) compared to homologously vaccinated (50.0%) KTRs (P < 0.0001), whereas the magnitudes of NAb titers were comparable between both subcohorts after third vaccination. SARS-CoV-2 breakthrough infections occurred in equal numbers in homologously (38.9%) and heterologously (37.5%) vaccinated KTRs with mild-to-moderate courses of COVID-19.ConclusionOur data support a more comprehensive assessment of not only humoral but also cellular SARS-CoV-2-specific immunity in KTRs to provide an in-depth understanding about the COVID-19 vaccine–induced immune response in a transplant setting.

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