Abravanel Florence, Marion Olivier, Del Bello Arnaud, Beunon Thomas, Romieu-Mourez Raphaelle, Couat Chloé, Pucelle Mélanie, Staes Laetitia, Guitard Joelle, Esposito Laure, Faguer Stanislas, Kamar Nassim, Izopet Jacques
Laboratory of Virology, Toulouse Purpan University Hospital, 31073 Toulouse, France.
INFINITY-Inserm U1291-CNRS U5051, 31073 Toulouse, France.
Vaccines (Basel). 2022 Feb 24;10(3):354. doi: 10.3390/vaccines10030354.
Two doses of anti-SARS-CoV-2 mRNA-based vaccines are poorly immunogenic in solid organ transplant recipients (SOT).
In total, 68 belatacept-treated SOT recipients followed at the Toulouse University Hospital were investigated. They were given three injections of the BNT162b2 mRNA COVID-19 vaccine. Their humoral response was assessed by determining anti-spike antibodies and neutralizing antibodies. The T-cell responses were assessed using an enzyme-linked immunospot assay that measured the interferon-γ produced by specific SARS-CoV-2 T-cells in a subgroup of 17 patients.
Only 23.5% of these patients developed a detectable anti-spike response. Moreover, the cellular and the humoral responses were well correlated. Patients with no humoral response were also without a detectable cellular response. Those belatacept-treated patients who developed an Anti-SARS-CoV-2 humoral response were younger, had been transplanted for longer, and had a higher lymphocyte count and a better glomerular filtration rate than those with no response. Finally, patients on tacrolimus plus belatacept produced a lower immune response.
Belatacept-treated SOT recipients have a reduced immune response to anti-SARS-CoV-2 mRNA vaccination. The vaccine should be given quite separately from the belatacept infusion to improve immunogenicity. Studies to assess whether switching to another immunosuppressive regimen can improve the post-vaccination immune response would be useful.
两剂基于抗严重急性呼吸综合征冠状病毒2（SARS-CoV-2）信使核糖核酸（mRNA）的疫苗在实体器官移植受者（SOT）中的免疫原性较差。
对图卢兹大学医院随访的68例接受贝拉西普治疗的SOT受者进行了研究。他们接受了三针BNT162b2 mRNA新冠疫苗注射。通过测定抗刺突抗体和中和抗体来评估他们的体液反应。使用酶联免疫斑点试验评估17例患者亚组中特异性SARS-CoV-2 T细胞产生的干扰素-γ，以此评估T细胞反应。
这些患者中只有23.5%产生了可检测到的抗刺突反应。此外，细胞反应和体液反应密切相关。无体液反应的患者也没有可检测到的细胞反应。那些产生抗SARS-CoV-2体液反应的接受贝拉西普治疗的患者比无反应者更年轻、移植时间更长、淋巴细胞计数更高且肾小球滤过率更好。最后，接受他克莫司加贝拉西普治疗的患者产生的免疫反应较低。
接受贝拉西普治疗的SOT受者对抗SARS-CoV-2 mRNA疫苗的免疫反应降低。疫苗应与贝拉西普输注分开给药以提高免疫原性。评估改用另一种免疫抑制方案是否能改善疫苗接种后的免疫反应的研究将是有用的。
