Virology Unit, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.
Medical Statistics, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.
J Med Virol. 2024 Jun;96(6):e29710. doi: 10.1002/jmv.29710.
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.
肾移植受者（KTRs）与其他实体器官移植受者一样，对 mRNA 疫苗的反应不理想，只有约一半的人在接种两剂后产生血清转化。然而，关于加强剂量的有效性，特别是在产生中和抗体（NAbs）方面，仍知之甚少，因为大多数研究主要集中在非中和抗体上。在这里，我们在一年的时间内对 40 名 KTR 进行了 SARS-CoV-2 mRNA 疫苗的纵向评估，检查了加强剂量后大约 5 个月第二次剂量后抗刺突 IgG 和 NAbs 的变化。我们发现，加强剂量后 5 个月的体液免疫反应显著增加，与第二次剂量后观察到的减弱反应形成鲜明对比。值得注意的是，即使在加强剂量后，仍有近四分之一的参与者未达到保护性血浆水平。我们还发现，估计肾小球滤过率（eGFR）越高，接种疫苗后的体液免疫反应越强。总的来说，这些发现强调了加强剂量在增强 KTR 持久体液免疫方面的有效性，正如 65%的患者在加强剂量后 5 个月时发现的 NAbs 达到保护水平所证明的那样，尤其是那些 eGFR 较高的患者。
