Abstract
Background: Patients with chronic renal insufficiency on maintenance haemodialysis face an increased risk of COVID-19 induced mortality and impaired vaccine responses. To date, only a few studies have addressed SARS-CoV-2 vaccine elicited immunity in this immunocompromised population.
Methods: We assessed immunogenicity of the mRNA vaccine BNT162b2 in at-risk dialysis patients and characterised systemic cellular and humoral immune responses in serum and saliva using interferon γ release assay and multiplex-based cytokine and immunoglobulin measurements. We further compared binding capacity and neutralization efficacy of vaccination-induced immunoglobulins against emerging SARS-CoV-2 variants Alpha, Beta, Epsilon and Cluster 5 by ACE2-RBD competition assay.
Findings: Patients on maintenance haemodialysis exhibit detectable but variable cellular and humoral immune responses against SARS-CoV-2 and variants of concern after a two-dose regimen of BNT162b2. Although vaccination-induced immunoglobulins were detectable in saliva and plasma, both anti-SARS-CoV-2 IgG and neutralization efficacy was reduced compared to a vaccinated non-dialysed control population. Similarly, T-cell mediated interferon γ release after stimulation with SARS-CoV-2 spike peptides was significantly diminished.
Interpretation: Quantifiable humoral and cellular immune responses after BNT162b2 vaccination in individuals on maintenance haemodialysis are encouraging, but urge for longitudinal follow-up to assess longevity of immunity. Diminished virus neutralization and interferon γ responses in the face of emerging variants of concern may favour this at-risk population for re-vaccination using modified vaccines at the earliest opportunity.
Funding: Initiative and Networking Fund of the Helmholtz Association of German Research Centres, EU Horizon 2020 research and innovation program, State Ministry of Baden-Württemberg for Economic Affairs, Labour and Tourism.
Keywords: Dialysis; Immunocompromised; Protective immunity; SARS-CoV-2; Variants of concern; mRNA vaccination.
【저자키워드】 SARS-CoV-2, mRNA vaccination, variants of concern, dialysis, protective immunity, Immunocompromised, 【초록키워드】 COVID-19, mRNA vaccination, Saliva, Efficacy, Vaccine, vaccination, immunogenicity, Mortality, Immunity, mRNA vaccine, Cellular immune response, neutralization, immunoglobulins, SARS-CoV-2 variant, interferon, cytokine, variants, SARS-CoV-2 vaccine, dialysis, BNT162b2, serum, Immunoglobulin, protective immunity, anti-SARS-CoV-2 IgG, Epsilon, immune responses, response, Research, Patient, Virus neutralization, peptides, Immunocompromised, Haemodialysis, Cluster, Alpha, plasma, Beta, Follow-up, humoral immune response, T-cell, multiplex, Longevity, humoral immune responses, binding, Humoral and cellular immune responses, Stimulation, cellular, Tourism, humoral, vaccine responses, renal insufficiency, networking, interferon γ, increased risk, individual, cellular immune responses, Horizon, renal, ACE2-RBD, diminished, two-dose regimen, initiative, state, significantly, detectable, elicited, addressed, was reduced, of BNT162b2, SARS-CoV-2 spike peptide, 【제목키워드】 Patient, Haemodialysis, humoral immunogenicity,