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Erschienen in: Pediatric Nephrology 7/2023

02.12.2022 | COVID-19 | Original Article

Humoral and cellular immune response to SARS-CoV-2 mRNA BNT162b2 vaccine in pediatric kidney transplant recipients compared with dialysis patients and healthy children

verfasst von: Ruveyda Gulmez, Dogukan Ozbey, Ayse Agbas, Bagdagul Aksu, Nurdan Yildiz, Diana Uckardes, Seha Saygili, Esra Karabag Yilmaz, Zeynep Yuruk Yildirim, Mehmet Tasdemir, Ayca Kiykim, Haluk Cokugras, Nur Canpolat, Ahmet Nayir, Bekir Kocazeybek, Salim Caliskan

Erschienen in: Pediatric Nephrology | Ausgabe 7/2023

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Abstract

Background

Compared with the general population, the immune response to COVID-19 mRNA vaccines is lower in adult kidney transplant recipients (KTRs). However, data is limited for pediatric KTRs. In this study, we aimed to assess humoral and cellular immune responses to the COVID-19 mRNA vaccine in pediatric KTRs.

Methods

This multicenter, prospective, case–control study included 63 KTRs (37 male, aged 12–21 years), 19 dialysis patients, and 19 controls. Humoral (anti-SARS-CoV2 IgG, neutralizing Ab (nAb)) and cellular (interferon-gamma release assay (IGRA)) immune responses were assessed at least one month after two doses of BNT162b2 mRNA vaccine.

Results

Among COVID-19 naïve KTRs (n = 46), 76.1% tested positive for anti-SARS-CoV-2 IgG, 54.3% for nAb, and 63% for IGRA. Serum levels of anti-SARS-CoV-2 IgG and nAb activity were significantly lower in KTRs compared to dialysis and control groups (p < 0.05 for all). Seropositivity in KTRs was independently associated with shorter transplant duration (p = 0.005), and higher eGFR (p = 0.007). IGRA titer was significantly lower than dialysis patients (p = 0.009). Twenty (43.4%) KTRs were positive for all immune parameters. Only four of 11 seronegative KTRs were IGRA-positive. COVID-19 recovered KTRs had significantly higher anti-SARS-CoV-2 IgG and nAb activity levels than COVID-19 naïve KTRs (p = 0.018 and p = 0.007, respectively).

Conclusions

The humoral and cellular immune responses to SARS-CoV-2 mRNA BNT162b2 vaccine are lower in pediatric KTRs compared to dialysis patients. Further prospective studies are required to demonstrate the clinical efficacy of the mRNA vaccine in KTRs.
This prospective study was registered in ClinicalTrials.gov (NCT05465863, registered retrospectively at 20.07.2022).

Graphical abstract

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Literatur
2.
Zurück zum Zitat Jager KJ, Kramer A, Chesnaye NC, Couchoud C, Sanchez-Alvarez JE, Garneata L, Collart F, Hemmelder MH, Ambuhl P, Kerschbaum J, Legeai C, Del Pino YPMD, Mircescu G, Mazzoleni L, Hoekstra T, Winzeler R, Mayer G, Stel VS, Wanner C, Zoccali C, Massy ZA (2020) Results from the ERA-EDTA Registry indicate a high mortality due to COVID-19 in dialysis patients and kidney transplant recipients across Europe. Kidney Int 98:1540–1548. https://doi.org/10.1016/j.kint.2020.09.006CrossRefPubMedPubMedCentral Jager KJ, Kramer A, Chesnaye NC, Couchoud C, Sanchez-Alvarez JE, Garneata L, Collart F, Hemmelder MH, Ambuhl P, Kerschbaum J, Legeai C, Del Pino YPMD, Mircescu G, Mazzoleni L, Hoekstra T, Winzeler R, Mayer G, Stel VS, Wanner C, Zoccali C, Massy ZA (2020) Results from the ERA-EDTA Registry indicate a high mortality due to COVID-19 in dialysis patients and kidney transplant recipients across Europe. Kidney Int 98:1540–1548. https://​doi.​org/​10.​1016/​j.​kint.​2020.​09.​006CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Canpolat N, Yildirim ZY, Yildiz N, Tasdemir M, Goknar N, Evrengul H, Gulmez R, Aksu B, Dursun H, Ozcelik G, Yavascan O, Cicek RY, Tulpar S, Hacihamdioglu DO, Nayir A, Alpay H (2022) COVID-19 in pediatric patients undergoing chronic dialysis and kidney transplantation. Eur J Pediatr 181:117–123. https://doi.org/10.1007/s00431-021-04191-zCrossRefPubMed Canpolat N, Yildirim ZY, Yildiz N, Tasdemir M, Goknar N, Evrengul H, Gulmez R, Aksu B, Dursun H, Ozcelik G, Yavascan O, Cicek RY, Tulpar S, Hacihamdioglu DO, Nayir A, Alpay H (2022) COVID-19 in pediatric patients undergoing chronic dialysis and kidney transplantation. Eur J Pediatr 181:117–123. https://​doi.​org/​10.​1007/​s00431-021-04191-zCrossRefPubMed
13.
Zurück zum Zitat Stumpf J, Siepmann T, Lindner T, Karger C, Schwobel J, Anders L, Faulhaber-Walter R, Schewe J, Martin H, Schirutschke H, Barnett K, Huther J, Muller P, Langer T, Pluntke T, Anding-Rost K, Meistring F, Stehr T, Pietzonka A, Escher K, Cerny S, Rothe H, Pistrosch F, Seidel H, Paliege A, Beige J, Bast I, Steglich A, Gembardt F, Kessel F, Kroger H, Arndt P, Sradnick J, Frank K, Klimova A, Mauer R, Grahlert X, Anft M, Blazquez-Navarro A, Westhoff TH, Stervbo U, Tonn T, Babel N, Hugo C (2021) Humoral and cellular immunity to SARS-CoV-2 vaccination in renal transplant versus dialysis patients: a prospective, multicenter observational study using mRNA-1273 or BNT162b2 mRNA vaccine. Lancet Reg Health Eur 9:100178. https://doi.org/10.1016/j.lanepe.2021.100178CrossRefPubMedPubMedCentral Stumpf J, Siepmann T, Lindner T, Karger C, Schwobel J, Anders L, Faulhaber-Walter R, Schewe J, Martin H, Schirutschke H, Barnett K, Huther J, Muller P, Langer T, Pluntke T, Anding-Rost K, Meistring F, Stehr T, Pietzonka A, Escher K, Cerny S, Rothe H, Pistrosch F, Seidel H, Paliege A, Beige J, Bast I, Steglich A, Gembardt F, Kessel F, Kroger H, Arndt P, Sradnick J, Frank K, Klimova A, Mauer R, Grahlert X, Anft M, Blazquez-Navarro A, Westhoff TH, Stervbo U, Tonn T, Babel N, Hugo C (2021) Humoral and cellular immunity to SARS-CoV-2 vaccination in renal transplant versus dialysis patients: a prospective, multicenter observational study using mRNA-1273 or BNT162b2 mRNA vaccine. Lancet Reg Health Eur 9:100178. https://​doi.​org/​10.​1016/​j.​lanepe.​2021.​100178CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Crespo M, Barrilado-Jackson A, Padilla E, Eguia J, Echeverria-Esnal D, Cao H, Faura A, Folgueiras M, Sola-Porta E, Pascual S, Barbosa F, Hurtado S, Ribera L, Rio-No L, Perez-Saez MJ, Redondo-Pachon D, Pascual J (2022) Negative immune responses to two-dose mRNA COVID-19 vaccines in renal allograft recipients assessed with simple antibody and interferon gamma release assay cellular monitoring. Am J Transplant 22:786–800. https://doi.org/10.1111/ajt.16854CrossRefPubMedPubMedCentral Crespo M, Barrilado-Jackson A, Padilla E, Eguia J, Echeverria-Esnal D, Cao H, Faura A, Folgueiras M, Sola-Porta E, Pascual S, Barbosa F, Hurtado S, Ribera L, Rio-No L, Perez-Saez MJ, Redondo-Pachon D, Pascual J (2022) Negative immune responses to two-dose mRNA COVID-19 vaccines in renal allograft recipients assessed with simple antibody and interferon gamma release assay cellular monitoring. Am J Transplant 22:786–800. https://​doi.​org/​10.​1111/​ajt.​16854CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Sanders JF, Bemelman FJ, Messchendorp AL, Baan CC, van Baarle D, van Binnendijk R, Diavatopoulos DA, Frolke SC, Geers D, GeurtsvanKessel CH, den Hartog G, van der Heiden M, Imhof C, Kho MML, Koopmans MPG, Malahe SRK, Mattheussens WB, van der Molen R, van Mourik D, Remmerswaal EBM, Rots N, Vart P, de Vries RD, Gansevoort RT, Hilbrands LB, Reinders MEJ, RECOVAC Collaborators (2022) The RECOVAC immune-response study: the immunogenicity, tolerability, and safety of COVID-19 vaccination in patients with chronic kidney disease, on dialysis, or living with a kidney transplant. Transplantation 106:821–834. https://doi.org/10.1097/TP.0000000000003983CrossRefPubMed Sanders JF, Bemelman FJ, Messchendorp AL, Baan CC, van Baarle D, van Binnendijk R, Diavatopoulos DA, Frolke SC, Geers D, GeurtsvanKessel CH, den Hartog G, van der Heiden M, Imhof C, Kho MML, Koopmans MPG, Malahe SRK, Mattheussens WB, van der Molen R, van Mourik D, Remmerswaal EBM, Rots N, Vart P, de Vries RD, Gansevoort RT, Hilbrands LB, Reinders MEJ, RECOVAC Collaborators (2022) The RECOVAC immune-response study: the immunogenicity, tolerability, and safety of COVID-19 vaccination in patients with chronic kidney disease, on dialysis, or living with a kidney transplant. Transplantation 106:821–834. https://​doi.​org/​10.​1097/​TP.​0000000000003983​CrossRefPubMed
24.
Zurück zum Zitat Boedecker-Lips SC, Lautem A, Runkel S, Klimpke P, Kraus D, Keil P, Holtz S, Tomalla V, Marczynski P, Boedecker CB, Galle PR, Koch M, Weinmann-Menke J (2022) Six-month follow-up after vaccination with BNT162b2: SARS-CoV-2 antigen-specific cellular and humoral immune responses in hemodialysis patients and kidney transplant recipients. Pathogens 11:67. https://doi.org/10.3390/pathogens11010067CrossRefPubMedPubMedCentral Boedecker-Lips SC, Lautem A, Runkel S, Klimpke P, Kraus D, Keil P, Holtz S, Tomalla V, Marczynski P, Boedecker CB, Galle PR, Koch M, Weinmann-Menke J (2022) Six-month follow-up after vaccination with BNT162b2: SARS-CoV-2 antigen-specific cellular and humoral immune responses in hemodialysis patients and kidney transplant recipients. Pathogens 11:67. https://​doi.​org/​10.​3390/​pathogens1101006​7CrossRefPubMedPubMedCentral
Metadaten
Titel
Humoral and cellular immune response to SARS-CoV-2 mRNA BNT162b2 vaccine in pediatric kidney transplant recipients compared with dialysis patients and healthy children
verfasst von
Ruveyda Gulmez
Dogukan Ozbey
Ayse Agbas
Bagdagul Aksu
Nurdan Yildiz
Diana Uckardes
Seha Saygili
Esra Karabag Yilmaz
Zeynep Yuruk Yildirim
Mehmet Tasdemir
Ayca Kiykim
Haluk Cokugras
Nur Canpolat
Ahmet Nayir
Bekir Kocazeybek
Salim Caliskan
Publikationsdatum
02.12.2022
Verlag
Springer Berlin Heidelberg
Schlagwort
COVID-19
Erschienen in
Pediatric Nephrology / Ausgabe 7/2023
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-022-05813-w

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