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Takai S, Nishida H, Ito H, Fukuhara H, Nawano T, Narisawa T, Kanno H, Yagi M, Yamagishi A, Sakurai T, Naito S, Kato T, Morikane K, Tsuchiya N. Humoral and cellular immune response and the safety of third SARS-CoV-2 mRNA vaccine with longer interval after the second vaccination in kidney transplant recipients. Front Immunol 2022; 13:1050211. [PMID: 36532067 PMCID: PMC9747938 DOI: 10.3389/fimmu.2022.1050211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/16/2022] [Indexed: 12/02/2022] Open
Abstract
We evaluated the humoral and cellular immune responses and safety of the third severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine with a longer interval after the second vaccination in kidney transplant recipients (KTRs). We enrolled 54 kidney transplant recipients without a history of coronavirus disease 2019 (COVID-19), who received a third dose of the vaccine. We assessed anti-SARS-CoV-2 spike antibody and antigen-specific T cells using enzyme-linked immunospot (ELISpot) against the spike protein at baseline, after the second vaccination, and after the third vaccination. We also evaluated the adverse events related to each dose of the vaccine. The duration between the second and third vaccinations was 7 ± 1 month. All 17 (100%) KTRs with anti-SARS-CoV-2 antibody positivity after the second vaccination and 27 of 37 (73%) KTRs without anti-SARS-CoV-2 antibody positivity after the second vaccination were positive for anti-SARS-CoV-2 antibodies (p=0.022). Anti-SARS-CoV-2 antibody titers were significantly higher than those after the second vaccination (p<0.001). Age ≥ 60 years and lymphocyte count < 1150/mm3 were confirmed as risk factors for anti-SARS-CoV-2 antibody negativity after the third vaccination in multivariate regression analysis. ELISpot cytokine activities were positive after the third vaccination in 26 of 29 (90%) KTRs with ELISpot cytokine activity positivity after the second vaccination and 12 of 24 (50%) KTRs without ELISpot cytokine activity after the second vaccination. The rate of change in cytokine activity after the third vaccination was significantly higher than that after the second vaccination (p<0.001). Only lymphocyte counts less than 1150/mm3 were confirmed as risk factors for ELISpot cytokine activity negativity in the multivariate regression analysis. Systemic adverse events classified as greater than moderate did not differ for each vaccine dose. None of the patients showed clinical symptoms of acute rejection. The third SARS-CoV-2 mRNA vaccine administration, with a longer interval after the second vaccination, improved humoral and cellular immune responses to SARS-CoV-2 mRNA vaccines without severe adverse effects in the KTRs.
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Affiliation(s)
- Satoshi Takai
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Hayato Nishida
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan,*Correspondence: Hayato Nishida,
| | - Hiromi Ito
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Hiroki Fukuhara
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Takaaki Nawano
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Takafumi Narisawa
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Hidenori Kanno
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Mayu Yagi
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Atsushi Yamagishi
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Toshihiko Sakurai
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Sei Naito
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Tomoyuki Kato
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Keita Morikane
- Division of Clinical Laboratory and Infection Control, Yamagata University Hospital, Yamagata, Japan
| | - Norihiko Tsuchiya
- Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan
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Takai S, Nishida H, Ito H, Fukuhara H, Nawano T, Narisawa T, Kanno H, Yagi M, Yamagishi A, Sakurai T, Naito S, Kato T, Morikane K, Tsuchiya N. Immunogenicity and safety of two doses of SARS-CoV-2 mRNA vaccine in kidney transplant recipients with low-dose rituximab. Int J Urol 2022; 29:1279-1286. [PMID: 35863901 PMCID: PMC9349512 DOI: 10.1111/iju.14978] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/22/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We evaluated whether the treatment history of low-dose rituximab affected safety profiles, and humoral and cellular responses induced by severe acute respiratory syndrome coronavirus 2 messenger ribonucleic acid vaccine in healthy controls and kidney transplant recipients. METHODS We enrolled 10 healthcare workers as controls, 22 kidney transplant recipients with rituximab, and 36 kidney transplant recipients without rituximab without history of coronavirus disease 2019 who received two doses of vaccine. We assessed anti-severe acute respiratory syndrome coronavirus 2 spike antibody and the antigen-specific T cells using enzyme-linked immunospot against spike protein at baseline and after two doses of vaccine. RESULTS All controls showed anti-severe acute respiratory syndrome coronavirus 2 antibody seroconversion and enzyme-linked immunospot positivity. Only 19/58 (33%) kidney transplant recipients experienced anti-severe acute respiratory syndrome coronavirus 2 antibody seroconversion and 31/58 (53%) kidney transplant recipients developed enzyme-linked immunospot assay positivity after vaccination. The anti-severe acute respiratory syndrome coronavirus 2 antibody seroconversion rate and enzyme-linked immunospot assay positivity rate after vaccination were not significantly different between kidney transplant recipients with or without rituximab. Multivariate regression analysis demonstrated rituximab was not associated with a lack of humoral and cellular responses to the vaccine. CONCLUSIONS Low-dose rituximab in kidney transplant recipients did not affect humoral or cellular responses to the severe acute respiratory syndrome coronavirus 2 messenger ribonucleic acid vaccine without severe systemic adverse events including the deterioration of kidney function.
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Affiliation(s)
- Satoshi Takai
- Department of UrologyYamagata University Faculty of MedicineYamagataJapan
| | - Hayato Nishida
- Department of UrologyYamagata University Faculty of MedicineYamagataJapan
| | - Hiromi Ito
- Department of UrologyYamagata University Faculty of MedicineYamagataJapan
| | - Hiroki Fukuhara
- Department of UrologyYamagata University Faculty of MedicineYamagataJapan
| | - Takaaki Nawano
- Department of Cardiology, Pulmonology, and NephrologyYamagata University Faculty of MedicineYamagataJapan
| | - Takafumi Narisawa
- Department of UrologyYamagata University Faculty of MedicineYamagataJapan
| | - Hidenori Kanno
- Department of UrologyYamagata University Faculty of MedicineYamagataJapan
| | - Mayu Yagi
- Department of UrologyYamagata University Faculty of MedicineYamagataJapan
| | - Atsushi Yamagishi
- Department of UrologyYamagata University Faculty of MedicineYamagataJapan
| | - Toshihiko Sakurai
- Department of UrologyYamagata University Faculty of MedicineYamagataJapan
| | - Sei Naito
- Department of UrologyYamagata University Faculty of MedicineYamagataJapan
| | - Tomoyuki Kato
- Department of UrologyYamagata University Faculty of MedicineYamagataJapan
| | - Keita Morikane
- Division of Clinical Laboratory and Infection ControlYamagata University HospitalYamagataJapan
| | - Norihiko Tsuchiya
- Department of UrologyYamagata University Faculty of MedicineYamagataJapan
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