Humoral response to SARS-CoV-2 mRNA vaccination in previous non-responder kidney transplant recipients after short-term withdrawal of mycophenolic acid

被引：18

作者：

Benning, Louise ^{[1
]}

Morath, Christian ^{[1
]}

Kuehn, Tessa ^{[1
]}

Bartenschlager, Marie ^{[2
]}

Kim, Heeyoung ^{[2
]}

Beimler, Joerg ^{[1
]}

Buylaert, Mirabel ^{[1
]}

Nusshag, Christian ^{[1
]}

Kaelble, Florian ^{[1
]}

Reineke, Marvin ^{[1
]}

Toellner, Maximilian ^{[1
]}

Schaier, Matthias ^{[1
]}

Klein, Katrin ^{[1
]}

Blank, Antje ^{[3
,4
]}

Schnitzler, Paul ^{[5
]}

Zeier, Martin ^{[1
]}

Suesal, Caner ^{[6
]}

Bartenschlager, Ralf ^{[2
,4
,7
]}

Thuong Hien Tran ^{[8
]}

Speer, Claudius ^{[1
,9
]}

机构：

[1] Heidelberg Univ, Dept Nephrol, Heidelberg, Germany

[2] Heidelberg Univ, Mol Virol, Dept Infect Dis, Heidelberg, Germany

[3] Heidelberg Univ, Dept Clin Pharmacol & Pharmacoepidemiol, Heidelberg, Germany

[4] German Ctr Infect Res, Partner Site Heidelberg, Heidelberg, Germany

[5] Heidelberg Univ, Dept Virol, Heidelberg, Germany

[6] Koc Univ Hosp, Transplant Immunol Res Ctr Excellence, Istanbul, Turkey

[7] German Canc Res Ctr, Div Virus Associated Carcinogenesis, Heidelberg, Germany

[8] Heidelberg Univ, Inst Immunol, Heidelberg, Germany

[9] European Mol Biol Lab, Dept Mol Med Partnership Unit Heidelberg, Heidelberg, Germany

来源：

FRONTIERS IN MEDICINE | 2022年 / 9卷

关键词：

SARS-CoV-2; kidney transplantation; variants of concern; delta variant; omicron variant; vaccination; CELL-FREE DNA; ANTIBODY-RESPONSE; DIALYSIS PATIENTS; COVID-19; VACCINE; REJECTION; BIOMARKER;

D O I：

10.3389/fmed.2022.958293

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Seroconversion rates after COVID-19 vaccination are significantly lower in kidney transplant recipients compared to healthy cohorts. Adaptive immunization strategies are needed to protect these patients from COVID-19. In this prospective observational cohort study, we enrolled 76 kidney transplant recipients with no seroresponse after at least three COVID-19 vaccinations to receive an additional mRNA-1273 vaccination (full dose, 100 mu g). Mycophenolic acid was withdrawn in 43 selected patients 5-7 days prior to vaccination and remained paused for 4 additional weeks after vaccination. SARS-CoV-2-specific antibodies and neutralization of the delta and omicron variants were determined using a live-virus assay 4 weeks after vaccination. In patients with temporary mycophenolic acid withdrawal, donor-specific anti-HLA antibodies and donor-derived cell-free DNA were monitored before withdrawal and at follow-up. SARS-CoV-2 specific antibodies significantly increased in kidney transplant recipients after additional COVID-19 vaccination. The effect was most pronounced in individuals in whom mycophenolic acid was withdrawn during vaccination. Higher SARS-CoV-2 specific antibody titers were associated with better neutralization of SARS-CoV-2 delta and omicron variants. In patients with short-term withdrawal of mycophenolic acid, graft function and donor-derived cell-free DNA remained stable. No acute rejection episode occurred during short-term follow-up. However, resurgence of prior anti-HLA donor-specific antibodies was detected in 7 patients.

引用

页数：12

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