Humoral and cellular response to SARS-CoV-2 mRNA vaccine in paediatric heart transplant recipients
Amanda Bermejo-Gómez,
Laura Tarancon-Diez,
Beatriz Lazaro-Martin,
Begoña Santiago-Garcia,
Nuria Gil Villanueva,
Roberto Alonso,
Mª Ángeles Muñoz-Fernández,
Manuela Camino López,
Alicia Hernanz-Lobo,
María Luisa Navarro Gómez
Affiliations
Amanda Bermejo-Gómez
Pediatric Infectious Diseases Unit, Department of Pediatrics, Gregorio Marañón University Hospital, Madrid, Spain; Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain
Laura Tarancon-Diez
Pediatric Infectious Diseases Unit, Department of Pediatrics, Gregorio Marañón University Hospital, Madrid, Spain; Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain; Biomedical Research Centre Network for Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
Beatriz Lazaro-Martin
Pediatric Infectious Diseases Unit, Department of Pediatrics, Gregorio Marañón University Hospital, Madrid, Spain; Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain; Biomedical Research Centre Network for Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
Begoña Santiago-Garcia
Pediatric Infectious Diseases Unit, Department of Pediatrics, Gregorio Marañón University Hospital, Madrid, Spain; Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain; Biomedical Research Centre Network for Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain; Clinical Microbiology and Infectious Diseases Department, Gregorio Marañón University Hospital, Madrid, Spain; Complutense University, Madrid, Spain
Mª Ángeles Muñoz-Fernández
Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain; Molecular Immunology Laboratory, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
Pediatric Infectious Diseases Unit, Department of Pediatrics, Gregorio Marañón University Hospital, Madrid, Spain; Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain; Biomedical Research Centre Network for Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
María Luisa Navarro Gómez
Pediatric Infectious Diseases Unit, Department of Pediatrics, Gregorio Marañón University Hospital, Madrid, Spain; Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain; Biomedical Research Centre Network for Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain; Complutense University, Madrid, Spain; Corresponding author. Pediatric Infectious Diseases Unit, Department of Pediatrics, Gregorio Marañón University Hospital, Madrid, Spain.
Objective: The aim of this prospective cohort study is to analyse the humoral and cellular vaccine responses in paediatric heart transplant recipients (HTR, n = 12), and compare it with the response in healthy controls (HC, n = 14). All participants were 5–18 years old and vaccinated with mRNA vaccine against SARS-CoV-2 between December 2021 and May 2022. Methods: The humoral response was measured by quantifying antibody titers against SARS-CoV-2 spike protein (anti-S). The T-lymphocyte phenotype and SARS-CoV2-specific CD4+ and CD8+ T-cell response was studied by multiparametric flow cytometry through peripheral blood mononuclear cells by the quantification of degranulation markers (CD107a) and intracellular cytokines (IFN-γ, TNF-α and IL-2) after in vitro stimulation with SARS-CoV-2 peptides from structural proteins (S, M, N, E) and non-structural viral proteins. Results: After vaccination, humoral response was found in all HTR, although they showed lower levels of anti-S IgG compared to HC (p = 0.003). However, in terms of cellular response, no significant differences were obtained in the prevalence of responders and magnitude of responses between groups. In addition, anti-S IgG levels directly correlated with a higher SARS-CoV-2 specific T-cell response (rho = 0.43; p = 0.027 and rho = 0.45; p = 0.02 for IFN-γ+ and TNF-α+ production of CD8+ T-cells, respectively). Activated T-cell phenotype in HTR was associated with a lower humoral response to SARS-CoV-2 vaccine. Conclusion: HTR had humoral response after vaccination, although they showed lower levels of specific anti-S antibodies compared to HC. There were no significant differences in the SARS-CoV2-specific cellular response between the two groups. Obtaining satisfactory data on this type of response could potentially challenge the current vaccine guideline recommendations.
