Abstract
Background: The ability of transplant (Tx) patients to generate a protective antiviral response under immunosuppression is pivotal in COVID-19 infection. However, analysis of immunity against SARS-CoV-2 is currently lacking.
Methods: Here, we analyzed T cell immunity directed against SARS-CoV-2 spike-, membrane-, and nucleocapsid-protein by flow cytometry and spike-specific neutralizing antibodies in 10 Tx in comparison to 26 nonimmunosuppressed (non-Tx) COVID-19 patients.
Results: Tx patients (7 renal, 1 lung, and 2 combined pancreas-kidney Txs) were recruited in this study during the acute phase of COVID-19 with a median time after SARS-CoV-2-positivity of 3 and 4 d for non-Tx and Tx patients, respectively. Despite immunosuppression, we detected antiviral CD4+ T cell-response in 90% of Tx patients. SARS-CoV-2-reactive CD4+ T cells produced multiple proinflammatory cytokines, indicating their potential protective capacity. Neutralizing antibody titers did not differ between groups. SARS-CoV-2-reactive CD8+ T cells targeting membrane- and spike-protein were lower in Tx patients, albeit without statistical significance. However, frequencies of anti-nucleocapsid-protein-reactive, and anti-SARS-CoV-2 polyfunctional CD8+ T cells, were similar between patient cohorts. Tx patients showed features of a prematurely aged adaptive immune system, but equal frequencies of SARS-CoV-2-reactive memory T cells.
Conclusions: In conclusion, a polyfunctional T cell immunity directed against SARS-CoV-2 proteins as well as neutralizing antibodies can be generated in Tx patients despite immunosuppression. In comparison to nonimmunosuppressed patients, no differences in humoral and cellular antiviral-immunity were found. Our data presenting the ability to generate SARS-CoV-2-specific immunity in immunosuppressed patients have implications for the handling of SARS-CoV-2-infected Tx patients and raise hopes for effective vaccination in this cohort.
【초록키워드】 COVID-19, neutralizing antibody, SARS-CoV-2, vaccination, Cytokines, Immunity, Antiviral, Neutralizing antibodies, T cells, Immunosuppression, lung, CD8+ T cells, anti-SARS-CoV-2, flow cytometry, Cohort, T cell, COVID-19 infection, memory T cells, Patient, Antibody titer, spike-protein, membrane, proinflammatory cytokines, patients, CD8+ T cell, CD4+ T cell, COVID-19 patients, immunosuppressed patients, Protective, SARS-CoV-2 spike, cellular, antiviral response, Frequency, Analysis, SARS-CoV-2 proteins, Immunosuppressed, humoral, frequencies, median time, acute phase, neutralizing antibody titers, statistical significance, no difference, no differences, CD4+, handling, adaptive immune system, renal, SARS-CoV-2 protein, specific neutralizing antibodies, patient cohorts, implication, feature, effective, raise, produced, not differ, analyzed, recruited, generate, groups, presenting, immunosuppressed patient, spike-, Txs, 【제목키워드】 SARS-CoV-2, Population, Transplant,