Abstract
Background: An impaired humoral response to full dose of BNT162b2 vaccine was observed in renal transplant recipients (RTR). Methods: To reveal predictors for humoral response to third vaccine, patients were stratified to positive (N = 85) and negative (N = 14) response groups based on receptor-binding domain (RBD) IgG ≥1.1 and neutralizing antibodies (NA) ≥ 16 dilution versus RBD IgG <1.1 or NA < 16, respectively. NA were detected using a SARS-CoV-2 pseudo-virus. Results: Response rate increased from 32.3% (32/99) before the third dose to 85.9% (85/99) post-third vaccine with a significant rise in geometric mean titers (GMTs) for RBD IgG and NA [0.79 (95% CI 0.65-0.96) vs. 3.08 (95% CI 2.76-3.45), p < 0.001 and 17.46 (95% CI 12.38-24.62) vs. 362.2 (95% CI 220.7-594.6), p < 0.001 respective. 80.6% (54/67) seroconverted and 96.9% (31/32) remained positive following the vaccine with a significant increase in GMTs for RBD IgG and NA. Age, ESRD secondary to diabetic nephropathy (DN) and renal allograft function were independent predictors for antibody response in RTR. Mycophenolic acid (MPA) use and dose had no impact on humoral response following the third booster. AEs were recorded for 70.1% of RTR population. Systemic AEs were more common in recipients with a positive humoral response as opposed to non-responders (45.2% versus 15.4% respectively, p = 0.04). Conclusion: 85.9% of RTR develop NA to BNT162b2 third vaccine, found effective in both negative and positive responders prior to the vaccine. Antigenic re-exposure overcame the suppressive effect of MPA on antibody response in RTR.
Keywords: COVID-19 vaccine; antibody response; humoral response; immunosuppression; renal transplantation.
【저자키워드】 COVID-19 vaccine, Antibody Response, Immunosuppression, Humoral response, Renal transplantation, 【초록키워드】 COVID-19, neutralizing antibody, SARS-CoV-2, IgG, Vaccine, BNT162b2 vaccine, COVID-19 vaccine, Neutralizing antibodies, antibody, Antibody Response, Immunosuppression, BNT162b2, Receptor-binding domain, Humoral response, RBD, non-responders, Patient, diabetic nephropathy, predictor, Renal transplantation, Responder, group, booster, ESRD, dose, independent predictors, Allograft, humoral, systemic, Dilution, response rate, secondary to, mycophenolic acid, geometric mean, Diabetic, 95% CI, recipients, significant increase, domain, geometric mean titers, GMTs, RBD IgG, responders, renal, positive, geometric mean titer, recipient, systemic AEs, non-responder, effective, pseudo-virus, nephropathy, develop, remained, seroconverted, had no, the vaccine, stratified, were recorded, GMT, independent predictor, negative and positive, of BNT162b2, 【제목키워드】 Transplant, response, recipient, increase,