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Appeltrath GA, Parreuter J, Lindemann M, Klump H, Karsten CB. An efficient ELISA protocol for measurement of SARS-CoV-2 spike-specific IgG in human plasma and serum samples. MethodsX 2024; 12:102596. [PMID: 38379717 PMCID: PMC10877937 DOI: 10.1016/j.mex.2024.102596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/30/2024] [Indexed: 02/22/2024] Open
Abstract
Here, we describe a protocol for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike-specific immunoglobulin G (IgG) by enzyme-linked immunosorbent assay (ELISA). The protocol was developed with a keen focus on optimizing several key parameters, including antigen coating concentration, antibody and sample dilutions, and assay development time. The final protocol features the following characteristics:•The capability to detect SARS-CoV-2 spike-specific IgG in both plasma and serum samples.•A streamlined procedure that requires only 1 hour and 20 minutes of hands-on time.•Reliable assay performance, with a remarkable sensitivity of 98.1 % and specificity of 99.5 %.
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Affiliation(s)
- Gwenllian A. Appeltrath
- Institute for the Research on HIV and AIDS-associated Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Janine Parreuter
- Institute for the Research on HIV and AIDS-associated Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Hannes Klump
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Institute for Transfusion Medicine and Cell Therapeutics, University Hospital RWTH Aachen, Aachen, Germany
| | - Christina B. Karsten
- Institute for the Research on HIV and AIDS-associated Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Thümmler L, Beckmann N, Sehl C, Soddemann M, Braß P, Bormann M, Brochhagen L, Elsner C, Hoertel N, Cougoule C, Ciesek S, Widera M, Dittmer U, Lindemann M, Horn PA, Witzke O, Kadow S, Kamler M, Gulbins E, Becker KA, Krawczyk A. Fluoxetine and Sertraline Potently Neutralize the Replication of Distinct SARS-CoV-2 Variants. Viruses 2024; 16:545. [PMID: 38675888 DOI: 10.3390/v16040545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
The pandemic caused by SARS-CoV-2 is still a major health problem. Newly emerging variants and long-COVID-19 represent a challenge for the global health system. In particular, individuals in developing countries with insufficient health care need easily accessible, affordable and effective treatments of COVID-19. Previous studies have demonstrated the efficacy of functional inhibitors of acid sphingomyelinase against infections with various viruses, including early variants of SARS-CoV-2. This work investigated whether the acid sphingomyelinase inhibitors fluoxetine and sertraline, usually used as antidepressant molecules in clinical practice, can inhibit the replication of the former and recently emerged SARS-CoV-2 variants in vitro. Fluoxetine and sertraline potently inhibited the infection with pseudotyped virus-like particles and SARS-CoV-2 variants D614G, alpha, delta, omicron BA.1 and omicron BA.5. These results highlight fluoxetine and sertraline as priority candidates for large-scale phase 3 clinical trials at different stages of SARS-CoV-2 infections, either alone or in combination with other medications.
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Affiliation(s)
- Laura Thümmler
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Nadine Beckmann
- Institute of Molecular Biology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Carolin Sehl
- Institute of Molecular Biology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Matthias Soddemann
- Institute of Molecular Biology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Peer Braß
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Maren Bormann
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Leonie Brochhagen
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Carina Elsner
- Institute for Virology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Nicolas Hoertel
- Institute Psychiatry and Neuroscience de Paris, INSERM U1266, Paris Cité University, 75014 Paris, France
- Psychiatry and Addiction Department Corentin-Celton Hospital (AP-HP), 92130 Paris, France
| | - Céline Cougoule
- Institute of Pharmacology and Structural Biology (IPBS), CNRS, University of Toulouse, UPS, 31000 Toulouse, France
| | - Sandra Ciesek
- Institute of Medical Virology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
- Institute of Pharmaceutical Biology, Goethe-University, 60323 Frankfurt am Main, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, 60311 Frankfurt am Main, Germany
| | - Marek Widera
- Institute of Medical Virology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
| | - Ulf Dittmer
- Institute for Virology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Peter A Horn
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Stephanie Kadow
- Institute of Molecular Biology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Markus Kamler
- Department of Thoracic and Cardiovascular Surgery, West German Heart Center, University Hospital Essen, 45147 Essen, Germany
| | - Erich Gulbins
- Institute of Molecular Biology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Katrin Anne Becker
- Institute of Molecular Biology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Adalbert Krawczyk
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
- Institute for Virology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
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Barsegian V, Möckel D, Buehler S, Müller SP, Kreissl MC, Ostheim P, Horn PA, Lindemann M. Lymphocyte Function at Baseline Could Be a New Predictor of Tumor Burden following Six Cycles of Radium-223 Therapy in Patients with Metastasized, Castration-Resistant Prostate Cancer. Cancers (Basel) 2024; 16:886. [PMID: 38473247 DOI: 10.3390/cancers16050886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/09/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
Previous data indicate that one cycle of treatment with radium-223 (223Ra) did not significantly impair lymphocyte function in patients with metastasized, castration-resistant prostate cancer. The aim of the current study was to assess in 21 patients whether six cycles of this therapy had an effect on lymphocyte proliferation and interferon-γ and interleukin (IL)-10 ELISpot results. Lymphocyte proliferation after stimulation with microbial antigens and the production of interferon-γ continuously decreased after six cycles of radionuclide therapy, reaching statistical significance (p < 0.05) at months 1, 2, 4, and/or 6 after therapy. One month after the last cycle of therapy, 67% of patients showed a decrease in tumor burden. The tumor burden correlated negatively with IL-10 secretion at baseline, e.g., after stimulation with tetanus antigen (p < 0.0001, r = -0.82). As determined by receiver operating characteristic (ROC) curve analysis, tetanus-specific IL-10 spots at baseline had the highest predictive value (p = 0.005) for tumor burden at month 6, with an area under the curve (AUC) of 0.90 (sensitivity 100%, specificity 78%). In conclusion, we observed an additive effect of treatment with 223Ra on immune function and found that IL-10 secretion at baseline predicted tumor burden at month 6 after treatment.
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Affiliation(s)
- Vahé Barsegian
- Institute of Nuclear Medicine, Helios Kliniken, 19055 Schwerin, Germany
| | - Daniel Möckel
- Institute of Nuclear Medicine, Helios Kliniken, 19055 Schwerin, Germany
| | - Sebastian Buehler
- Institute of Nuclear Medicine, Helios Kliniken, 19055 Schwerin, Germany
| | - Stefan P Müller
- Department of Nuclear Medicine, University Hospital, 45147 Essen, Germany
| | - Michael C Kreissl
- Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, Otto von Guericke University, 39106 Magdeburg, Germany
| | | | - Peter A Horn
- Institute for Transfusion Medicine, University Hospital, 19055 Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital, 19055 Essen, Germany
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Stefanie S, Koldehoff M, Schenk-Westkamp P, Horn PA, Esser S, Lindemann M. T Cell Responses against Orthopoxviruses in HIV-Positive Patients. Vaccines (Basel) 2024; 12:131. [PMID: 38400115 PMCID: PMC10891540 DOI: 10.3390/vaccines12020131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024] Open
Abstract
A global outbreak of predominantly sexually transmitted mpox infections, outside endemic regions, was reported in May 2022. Thereafter, risk groups were vaccinated against smallpox, a structurally related orthopoxvirus. In the current study, we analyzed T cell responses against peptides derived from orthopoxviruses in 33 HIV-positive patients after two vaccinations against smallpox and in 10 patients after mpox infection. We established an ELISpot assay, detecting either the secretion of the pro-inflammatory cytokine interferon (IFN)-γ or interleukin (IL)-2. After vaccination, 21 out of 33 patients (64%) showed specific IFN-γ secretion and 18 (55%) specific IL-2 secretion, defined as >3-fold higher specific value than negative control and at least 4 spots above the negative control. After mpox infection, all patients showed specific IFN-γ secretion and 7 out of 10 (70%) IL-2 secretion. In vaccinated patients, IFN-γ responses were significantly lower than in patients with mpox infection (median response 4.5 vs. 21.0 spots, p < 0.001). The same trend was observed for IL-2 responses. After mpox infection, IL-2 ELISpot results positively correlated with CD8+ T cells (p < 0.05). Thus, T cell responses were detectable in two thirds of HIV-positive patients after vaccination and were even more abundant and vigorous after mpox infection.
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Affiliation(s)
- Sammet Stefanie
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (S.S.); (P.S.-W.); (S.E.)
| | - Michael Koldehoff
- Zotz Klimas, MVZ Düsseldorf, 40210 Düsseldorf, Germany;
- Department of Hygiene and Environmental Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Pia Schenk-Westkamp
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (S.S.); (P.S.-W.); (S.E.)
| | - Peter A. Horn
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany;
| | - Stefan Esser
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (S.S.); (P.S.-W.); (S.E.)
- Institute for Translational HIV Research, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany;
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Mülling N, van de Sand L, Völk K, Aufderhorst UW, van der Linden M, Horn PA, Kribben A, Wilde B, Krawczyk A, Witzke O, Lindemann M. Antibody responses after sequential vaccination with PCV13 and PPSV23 in kidney transplant recipients. Infection 2023; 51:1703-1716. [PMID: 37243960 PMCID: PMC10665231 DOI: 10.1007/s15010-023-02054-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/16/2023] [Indexed: 05/29/2023]
Abstract
PURPOSE Vaccination against Streptococcus pneumoniae is recommended in transplant recipients to reduce the morbidity and mortality from invasive pneumococcal disease. Previous studies indicate that transplant recipients can produce specific antibodies after vaccination with the 13-valent pneumococcal conjugate vaccine Prevenar 13 (PCV13) or the pneumococcal polysaccharide vaccine Pneumovax 23 (PPSV23). National guidelines recommend sequential vaccination with PCV13 followed by PPSV23 in kidney transplant patients. However, there are currently no data on the serological response in kidney transplant recipients, who received a sequential vaccination with PCV13 and PPSV23. METHODS In the current study, we sequentially vaccinated 46 kidney transplant recipients with PCV13 and PPSV23 and determined global and serotype-specific anti-pneumococcal antibody responses in the year following vaccination. RESULTS Serotype-specific and global anti-pneumococcal antibody concentrations were significantly higher compared to baseline. We observed that serotype-specific antibody responses varied by serotype (between 2.2- and 2.9-fold increase after 12 months). The strongest responses after 12 months were detected against the serotypes 9N (2.9-fold increase) and 14 (2.8-fold increase). Global antibody responses also varied with respect to immunoglobulin class. IgG2 revealed the highest increase (2.7-fold), IgM the lowest (1.7-fold). Sequential vaccination with both vaccines achieved higher antibody levels in comparison with a historical cohort studied at our institute, that was vaccinated with PCV13 alone. During the 12-months follow-up period, none of the patients developed pneumococcal-associated pneumonia or vaccination-related allograft rejection. CONCLUSION In conclusion, we strongly recommend sequential vaccination over single immunization in kidney transplant recipients.
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Affiliation(s)
- Nils Mülling
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Lukas van de Sand
- Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Kim Völk
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | | | - Mark van der Linden
- Department of Medical Microbiology, German National Reference Center for Streptococci, University Hospital Aachen (RWTH), Aachen, Germany
| | - Peter A Horn
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Andreas Kribben
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Benjamin Wilde
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Adalbert Krawczyk
- Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
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Kansy BA, Wehrs TP, Bruderek K, Si Y, Ludwig S, Droege F, Hasskamp P, Henkel U, Dominas N, Hoffmann TK, Horn PA, Schuler M, Gauler TC, Lindemann M, Lang S, Bankfalvi A, Brandau S. HPV-associated head and neck cancer is characterized by distinct profiles of CD8 + T cells and myeloid-derived suppressor cells. Cancer Immunol Immunother 2023; 72:4367-4383. [PMID: 38019346 DOI: 10.1007/s00262-023-03571-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/23/2023] [Indexed: 11/30/2023]
Abstract
Patients with HPV--localized head and neck cancer (HNC) show inferior outcomes after surgery and radiochemotherapy compared to HPV-associated cancers. The underlying mechanisms remain elusive, but differences in immune status and immune activity may be implicated. In this study, we analyzed immune profiles of CD8+ T cells and myeloid-derived suppressor cells (MDSC) in HPV+ versus HPV- disease.The overall frequency of CD8+ T cells was reduced in HNC versus healthy donors but substantially increased after curative therapy (surgery and/or radiochemotherapy). In HPV+ patients, this increase was associated with significant induction of peripheral blood CD8+/CD45RA-/CD62L- effector memory cells. The frequency of HPV-antigen-specific CD8+ cells was low even in patients with virally associated tumors and dropped to background levels after curative therapy. Pre-therapeutic counts of circulating monocytic MDSC, but not PMN-MDSC, were increased in patients with HPV- disease. This increase was accompanied by reduced fractions of terminally differentiated CD8+ effector cells. HPV- tumors showed reduced infiltrates of CD8+ and CD45RO+ immune cells compared with HPV+ tumors. Importantly, frequencies of tumor tissue-infiltrating PMN-MDSC were increased, while percentages of Granzyme B+ and Ki-67+ CD8 T cells were reduced in patients with HPV- disease.We report differences in frequencies and relative ratios of MDSC and effector T cells in HPV- HNC compared with more immunogenic HPV-associated disease. Our data provide new insight into the immunological profiles of these two tumor entities and may be utilized for more tailored immunotherapeutic approaches in the future.
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Affiliation(s)
- Benjamin A Kansy
- Research Division, Department of Otorhinolaryngology, West German Cancer Center, University Duisburg-Essen, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Tim P Wehrs
- Research Division, Department of Otorhinolaryngology, West German Cancer Center, University Duisburg-Essen, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Kirsten Bruderek
- Research Division, Department of Otorhinolaryngology, West German Cancer Center, University Duisburg-Essen, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Yu Si
- Research Division, Department of Otorhinolaryngology, West German Cancer Center, University Duisburg-Essen, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
- Department of Otolaryngology, Head and Neck Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Sonja Ludwig
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Mannheim, Germany
| | - Freya Droege
- Research Division, Department of Otorhinolaryngology, West German Cancer Center, University Duisburg-Essen, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Pia Hasskamp
- Research Division, Department of Otorhinolaryngology, West German Cancer Center, University Duisburg-Essen, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Uta Henkel
- Research Division, Department of Otorhinolaryngology, West German Cancer Center, University Duisburg-Essen, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Nina Dominas
- Research Division, Department of Otorhinolaryngology, West German Cancer Center, University Duisburg-Essen, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Thomas K Hoffmann
- Department of Otorhinolaryngology, University Hospital Ulm, Ulm, Germany
| | - Peter A Horn
- Institute for Transfusion Medicine, University Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Martin Schuler
- Department of Medical Oncology, University Duisburg-Essen, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Thomas C Gauler
- Department of Medical Oncology, University Duisburg-Essen, University Hospital Essen, Essen, Germany
- Department of Radiation Oncology, University Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Stephan Lang
- Research Division, Department of Otorhinolaryngology, West German Cancer Center, University Duisburg-Essen, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Agnes Bankfalvi
- Institute of Pathology, University Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Sven Brandau
- Research Division, Department of Otorhinolaryngology, West German Cancer Center, University Duisburg-Essen, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany.
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany.
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Gross AJ, Süfke C, Schülke H, Lindemann M. [Medical expert opinions]. Z Rheumatol 2023; 82:776-783. [PMID: 37819405 DOI: 10.1007/s00393-023-01443-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
In the physician-patient encounter the annual risk that this will end in a legal dispute is around 0.08%. Nevertheless, the topic is always very present. In such a situation it is important to act professionally and remain objective. An essential part that contributes to this are expert opinions; however, although these are among the basic tasks of a physician, they are not taught in training and further education. This article aims to make a contribution to this.
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Affiliation(s)
- Andreas J Gross
- Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland.
| | - C Süfke
- Konzernbereich Medizinrecht, Versicherungen & Compliance, Asklepios Kliniken, Hamburg, Deutschland
| | - H Schülke
- Konzernbereich Medizinrecht, Versicherungen & Compliance, Asklepios Kliniken, Hamburg, Deutschland
| | - M Lindemann
- Fakultät für Rechtswissenschaft, Bielefeld Center for Healthcare Compliance (BCHC), Universität Bielefeld, Bielefeld, Deutschland
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Gross AJ, Süfke C, Schülke H, Lindemann M. [Medical expert opinions]. HNO 2023; 71:611-618. [PMID: 37540234 DOI: 10.1007/s00106-023-01352-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
In the physician-patient encounter the annual risk that this will end in a legal dispute is around 0.08%. Nevertheless, the topic is always very present. In such a situation it is important to act professionally and remain objective. An essential part that contributes to this are expert opinions; however, although these are among the basic tasks of a physician, they are not taught in training and further education. This article aims to make a contribution to this.
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Affiliation(s)
- Andreas J Gross
- Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland.
| | - C Süfke
- Konzernbereich Medizinrecht, Versicherungen & Compliance, Asklepios Kliniken, Hamburg, Deutschland
| | - H Schülke
- Konzernbereich Medizinrecht, Versicherungen & Compliance, Asklepios Kliniken, Hamburg, Deutschland
| | - M Lindemann
- Fakultät für Rechtswissenschaft, Bielefeld Center for Healthcare Compliance (BCHC), Universität Bielefeld, Bielefeld, Deutschland
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Domouchtsidou A, Beckmann F, Marenbach B, Mueller SP, Best J, Herrmann K, Horn PA, Barsegian V, Lindemann M. In Patients Treated by Selective Internal Radiotherapy, Cellular In Vitro Immune Function Is Predictive of Survival. Cancers (Basel) 2023; 15:4055. [PMID: 37627082 PMCID: PMC10452121 DOI: 10.3390/cancers15164055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/28/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
In patients with liver malignancies, the cellular immune function was impaired in vitro after selective internal radiotherapy (SIRT). Because immunosuppression varied substantially, in the current study, we investigated in 25 SIRT patients followed up for ten years whether the lymphocyte function was correlated with survival. Peripheral blood mononuclear cells were stimulated with four microbial antigens (tuberculin, tetanus toxoid, Candida albicans and CMV) before therapy and at four time points thereafter, and lymphocyte proliferation was determined by H3-thymidine uptake. The median sum of the responses to these four antigens decreased from 39,464 counts per minute (CPM) increment (range 1080-204,512) before therapy to a minimum of 700 CPM increment on day 7 after therapy (0-93,187, p < 0.0001). At all five time points, the median survival in patients with weaker responses was 2- to 3.5-fold shorter (p < 0.05). On day 7, the median survival in patients with responses below and above the cutoff of a 2 CPM increment was 185 and 523 days, respectively (χ2 = 9.4, p = 0.002). In conclusion, lymphocyte function could be a new predictor of treatment outcome after SIRT.
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Affiliation(s)
- Aglaia Domouchtsidou
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Virchowstraße 179, 45147 Essen, Germany; (A.D.); (F.B.); (B.M.); (P.A.H.)
- Department of Microbiology, General Anticancer Oncological Hospital “Agios Savvas”, 115 22 Athens, Greece
| | - Ferdinand Beckmann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Virchowstraße 179, 45147 Essen, Germany; (A.D.); (F.B.); (B.M.); (P.A.H.)
| | - Beate Marenbach
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Virchowstraße 179, 45147 Essen, Germany; (A.D.); (F.B.); (B.M.); (P.A.H.)
| | - Stefan P. Mueller
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (S.P.M.); (K.H.); (V.B.)
| | - Jan Best
- Department of Gastroenterology and Hepatology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany;
- Department of Internal Medicine, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, 44892 Bochum, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (S.P.M.); (K.H.); (V.B.)
| | - Peter A. Horn
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Virchowstraße 179, 45147 Essen, Germany; (A.D.); (F.B.); (B.M.); (P.A.H.)
| | - Vahé Barsegian
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (S.P.M.); (K.H.); (V.B.)
- Institute of Nuclear Medicine, Helios Kliniken, 19049 Schwerin, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Virchowstraße 179, 45147 Essen, Germany; (A.D.); (F.B.); (B.M.); (P.A.H.)
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10
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Bormann M, Brochhagen L, Alt M, Otte M, Thümmler L, van de Sand L, Kraiselburd I, Thomas A, Gosch J, Braß P, Ciesek S, Widera M, Dolff S, Dittmer U, Witzke O, Meyer F, Lindemann M, Schönfeld A, Rohn H, Krawczyk A. Immune responses in COVID-19 patients during breakthrough infection with SARS-CoV-2 variants Delta, Omicron-BA.1 and Omicron-BA.5. Front Immunol 2023; 14:1150667. [PMID: 37520539 PMCID: PMC10372796 DOI: 10.3389/fimmu.2023.1150667] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Background Breakthrough infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants are increasingly observed in vaccinated individuals. Immune responses towards SARS-CoV-2 variants, particularly Omicron-BA.5, are poorly understood. We investigated the humoral and cellular immune responses of hospitalized COVID-19 patients during Delta and Omicron infection waves. Methods The corresponding SARS-CoV-2 variant of the respective patients were identified by whole genome sequencing. Humoral immune responses were analyzed by ELISA and a cell culture-based neutralization assay against SARS-CoV-2 D614G isolate (wildtype), Alpha, Delta (AY.43) and Omicron (BA.1 and BA.5). Cellular immunity was evaluated with an IFN-γ ELISpot assay. Results On a cellular level, patients showed a minor IFN-γ response after stimulating PBMCs with mutated regions of SARS-CoV-2 variants. Neutralizing antibody titers against Omicron-BA.1 and especially BA.5 were strongly reduced. Double-vaccinated patients with Delta breakthrough infection showed a significantly increased neutralizing antibody response against Delta compared to double-vaccinated uninfected controls (median complete neutralization titer (NT100) 640 versus 80, p<0.05). Omicron-BA.1 infection increased neutralization titers against BA.1 in double-vaccinated patients (median NT100 of 160 in patients versus 20 in controls, p=0.07) and patients that received booster vaccination (median NT100 of 50 in patients versus 20 in controls, p=0.68). For boosted patients with BA.5 breakthrough infection, we found no enhancing effect on humoral immunity against SARS-CoV-2 variants. Conclusion Neutralizing antibody titers against Omicron-BA.1 and especially BA.5 were strongly reduced in SARS-CoV-2 breakthrough infections. Delta and Omicron-BA.1 but not Omicron-BA.5 infections boosted the humoral immunity in double-vaccinated patients and patients with booster vaccination. Despite BA.5 breakthrough infection, those patients may still be vulnerable for reinfections with BA.5 or other newly emerging variants of concern.
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Affiliation(s)
- Maren Bormann
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Leonie Brochhagen
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Mira Alt
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Mona Otte
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Laura Thümmler
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lukas van de Sand
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ivana Kraiselburd
- Institute for Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany
| | - Alexander Thomas
- Institute for Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany
| | - Jule Gosch
- Institute for Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany
| | - Peer Braß
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
- Institute of Pharmaceutical Biology, Goethe University Frankfurt, Frankfurt am Main, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, Frankfurt am Main, Germany
| | - Marek Widera
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Sebastian Dolff
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ulf Dittmer
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Folker Meyer
- Institute for Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Andreas Schönfeld
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Hana Rohn
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Adalbert Krawczyk
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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11
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Koldehoff M, Eiz-Vesper B, Maecker-Kolhoff B, Steckel NK, Dittmer U, Horn PA, Lindemann M. Long-Term Follow-Up after Adoptive Transfer of BK-Virus-Specific T Cells in Hematopoietic Stem Cell Transplant Recipients. Vaccines (Basel) 2023; 11:vaccines11040845. [PMID: 37112757 PMCID: PMC10141379 DOI: 10.3390/vaccines11040845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/05/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
The BK virus (BKV) causes severe hemorrhagic cystitis in hematopoietic stem cell transplant (HSCT) recipients. To eliminate reactivated BKV, symptomatic patients can be treated with a reduction of the immunosuppressive therapy, with the antiviral drug cidofovir, or with virus-specific T cells (VSTs). In the current study, we compared the effect of VSTs to other treatment options, following up specific T cells using interferon-gamma ELISpot assay. We observed BKV large T-specific cellular responses in 12 out of 17 HSCT recipients with BKV-related cystitis (71%). In recipients treated with VSTs, 6 out of 7 showed specific T-cell responses, and that number in those without VSTs was 6 out of 10. In comparison, 27 out of 50 healthy controls (54%) responded. In HSCT recipients treated for BKV-related cystitis, absolute CD4+ T-cell numbers and renal function correlated with BKV-specific cellular responses (p = 0.03 and 0.01, respectively). In one patient, BKV-specific cellular immunity could already be detected at baseline, on day 35 after HSCT and prior to VSTs, and remained increased until day 226 after VSTs (78 vs. 7 spots increment). In conclusion, the ELISpot appears to be suitable to sensitively monitor BKV-specific cellular immunity in HSCT recipients, even early after transplantation or in the long term after VSTs.
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Affiliation(s)
- Michael Koldehoff
- Zotz Klimas, MVZ Düsseldorf, 40210 Düsseldorf, Germany
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Britta Eiz-Vesper
- Institute of Transfusion Medicine and Transplant Engineering, Hannover Medical School, 30625 Hannover, Germany
| | - Britta Maecker-Kolhoff
- Department of Pediatric Hematology and Oncology, Hannover Medical School, 30625 Hannover, Germany
| | - Nina K Steckel
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
- Department of Medicine, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, 44892 Bochum, Germany
| | - Ulf Dittmer
- Institute for Virology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Peter A Horn
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
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12
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Offergeld R, Preußel K, Zeiler T, Aurich K, Baumann-Baretti BI, Ciesek S, Corman VM, Dienst V, Drosten C, Görg S, Greinacher A, Grossegesse M, Haller S, Heuft HG, Hofmann N, Horn PA, Houareau C, Gülec I, Jiménez Klingberg CL, Juhl D, Lindemann M, Martin S, Neuhauser HK, Nitsche A, Ohme J, Peine S, Sachs UJ, Schaade L, Schäfer R, Scheiblauer H, Schlaud M, Schmidt M, Umhau M, Vollmer T, Wagner FF, Wieler LH, Wilking H, Ziemann M, Zimmermann M, der Heiden MA. Monitoring the SARS-CoV-2 Pandemic: Prevalence of Antibodies in a Large, Repetitive Cross-Sectional Study of Blood Donors in Germany—Results from the SeBluCo Study 2020–2022. Pathogens 2023; 12:pathogens12040551. [PMID: 37111436 PMCID: PMC10144823 DOI: 10.3390/pathogens12040551] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/17/2023] [Accepted: 03/27/2023] [Indexed: 04/05/2023] Open
Abstract
SARS-CoV-2 serosurveillance is important to adapt infection control measures and estimate the degree of underreporting. Blood donor samples can be used as a proxy for the healthy adult population. In a repeated cross-sectional study from April 2020 to April 2021, September 2021, and April/May 2022, 13 blood establishments collected 134,510 anonymised specimens from blood donors in 28 study regions across Germany. These were tested for antibodies against the SARS-CoV-2 spike protein and nucleocapsid, including neutralising capacity. Seroprevalence was adjusted for test performance and sampling and weighted for demographic differences between the sample and the general population. Seroprevalence estimates were compared to notified COVID-19 cases. The overall adjusted SARS-CoV-2 seroprevalence remained below 2% until December 2020 and increased to 18.1% in April 2021, 89.4% in September 2021, and to 100% in April/May 2022. Neutralising capacity was found in 74% of all positive specimens until April 2021 and in 98% in April/May 2022. Our serosurveillance allowed for repeated estimations of underreporting from the early stage of the pandemic onwards. Underreporting ranged between factors 5.1 and 1.1 in the first two waves of the pandemic and remained well below 2 afterwards, indicating an adequate test strategy and notification system in Germany.
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Affiliation(s)
- Ruth Offergeld
- Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Karina Preußel
- Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Thomas Zeiler
- German Red Cross Blood Service West, 58097 Hagen, Germany
| | - Konstanze Aurich
- Institute for Immunology and Transfusion Medicine, University Medicine Greifswald, Sauerbruchstrasse, 17475 Greifswald, Germany
| | | | - Sandra Ciesek
- Institute for Medical Virology, German Centre for Infection Research, External Partner Site Frankfurt, University Hospital, Goethe University Frankfurt am Main, 39120 Frankfurt am Main, Germany
| | - Victor M. Corman
- Institute of Virology, German National Reference Laboratory for Coronavirus, Charité—University Medicine Berlin, 10117 Berlin, Germany
| | | | - Christian Drosten
- Institute of Virology, German National Reference Laboratory for Coronavirus, Charité—University Medicine Berlin, 10117 Berlin, Germany
| | - Siegfried Görg
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Andreas Greinacher
- Institute for Immunology and Transfusion Medicine, University Medicine Greifswald, Sauerbruchstrasse, 17475 Greifswald, Germany
| | | | | | - Hans-Gert Heuft
- Institute of Transfusion Medicine and Immunohaematology/Blood Bank, University Hospital Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany
| | | | - Peter A. Horn
- Institute for Transfusion Medicine, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
| | | | - Ilay Gülec
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Transfusion Service Baden-Württemberg—Hessen, Sandhofstraße 1, 60528 Frankfurt am Main, Germany
| | | | - David Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Silke Martin
- Bavarian Red Cross Blood Service, Herzog-Heinrich-Str. 2, 80336 München, Germany
| | | | | | - Julia Ohme
- German Red Cross Blood Service NSTOB, Eldagsener Straße 38, 31832 Springe, Germany
| | - Sven Peine
- Institute of Transfusion Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Ulrich J. Sachs
- Center for Transfusion Medicine and Haemotherapy, University Hospital Giessen and Marburg, Langhansstr. 7, 35392 Giessen, Germany
| | - Lars Schaade
- Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Richard Schäfer
- Institute for Transfusion Medicine and Gene Therapy, Faculty of Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | | | - Martin Schlaud
- Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Michael Schmidt
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Transfusion Service Baden-Württemberg—Hessen, Sandhofstraße 1, 60528 Frankfurt am Main, Germany
| | - Markus Umhau
- Institute for Transfusion Medicine and Gene Therapy, Faculty of Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Tanja Vollmer
- Heart and Diabetes Centre NRW, Institute for Laboratory and Transfusion Medicine, Ruhr-University Bochum, 32545 Bad Oeynhausen, Germany
| | - Franz F. Wagner
- German Red Cross Blood Service NSTOB, Eldagsener Straße 38, 31832 Springe, Germany
| | | | | | - Malte Ziemann
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Ratzeburger Allee 160, 23538 Lübeck, Germany
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13
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Gross AJ, Süfke C, Schülke H, Lindemann M. [Medical expert opinions]. Urologie 2023; 62:305-312. [PMID: 36853508 DOI: 10.1007/s00120-023-02025-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 03/01/2023]
Abstract
In the physician-patient encounter the annual risk that this will end in a legal dispute is around 0.08%. Nevertheless, the topic is always very present. In such a situation it is important to act professionally and remain objective. An essential part that contributes to this are expert opinions; however, although these are among the basic tasks of a physician, they are not taught in training and further education. This article aims to make a contribution to this.
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Affiliation(s)
- Andreas J Gross
- Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland.
| | - C Süfke
- Konzernbereich Medizinrecht, Versicherungen & Compliance, Asklepios Kliniken, Hamburg, Deutschland
| | - H Schülke
- Konzernbereich Medizinrecht, Versicherungen & Compliance, Asklepios Kliniken, Hamburg, Deutschland
| | - M Lindemann
- Fakultät für Rechtswissenschaft, Bielefeld Center for Healthcare Compliance (BCHC), Universität Bielefeld, Bielefeld, Deutschland
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14
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Thümmler L, Lindemann M, Horn PA, Lenz V, Konik M, Gäckler A, Boss K, Theodoropoulos F, Besa V, Taube C, Brenner T, Witzke O, Krawczyk A, Rohn H. Early Treatment with Monoclonal Antibodies or Convalescent Plasma Reduces Mortality in Non-Vaccinated COVID-19 High-Risk Patients. Viruses 2022; 15:119. [PMID: 36680159 PMCID: PMC9861454 DOI: 10.3390/v15010119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/11/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
Vulnerable patients such as immunosuppressed or elderly patients are at high risk for a severe course of COVID-19 upon SARS-CoV-2 infection. Immunotherapy with SARS-CoV-2 specific monoclonal antibodies (mAb) or convalescent plasma represents a considerable treatment option to protect these patients from a severe or lethal course of infection. However, monoclonal antibodies are not always available or less effective against emerging SARS-CoV-2 variants. Convalescent plasma is more commonly available and may represent a good treatment alternative in low-income countries. We retrospectively evaluated outcomes in individuals treated with mAbs or convalescent plasma and compared the 30-day overall survival with a patient cohort that received supportive care due to a lack of SARS-CoV-2 specific therapies between March 2020 and April 2021. Our data demonstrate that mAb treatment is highly effective in preventing severe courses of SARS-CoV-2 infection. All patients treated with mAb survived. Treatment with convalescent plasma improved overall survival to 82% compared with 61% in patients without SARS-CoV-2 targeted therapy. Our data indicate that early convalescent plasma treatment may be an option to improve the overall survival of high-risk COVID-19 patients. This is especially true when other antiviral drugs are not available or their efficacy is significantly reduced, which may be the case with emerging SARS-CoV-2 variants.
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Affiliation(s)
- Laura Thümmler
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
- Institute for Transfusion Medicine, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Peter A. Horn
- Institute for Transfusion Medicine, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Veronika Lenz
- Institute for Transfusion Medicine, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Margarethe Konik
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Anja Gäckler
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Kristina Boss
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Fotis Theodoropoulos
- Department of Pneumology, University Medicine Essen—Ruhrlandklinik, University Duisburg-Essen, 45147 Essen, Germany
| | - Vasiliki Besa
- Department of Pneumology, University Medicine Essen—Ruhrlandklinik, University Duisburg-Essen, 45147 Essen, Germany
| | - Christian Taube
- Department of Pneumology, University Medicine Essen—Ruhrlandklinik, University Duisburg-Essen, 45147 Essen, Germany
| | - Thorsten Brenner
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Adalbert Krawczyk
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
- Institute for Virology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Hana Rohn
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
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15
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Thümmler L, Konik M, Lindemann M, Fisenkci N, Koldehoff M, Gäckler A, Horn PA, Theodoropoulos F, Taube C, Zettler M, Anastasiou OE, Braß P, Jansen S, Witzke O, Rohn H, Krawczyk A. Long-term cellular immune response in immunocompromised unvaccinated COVID-19 patients undergoing monoclonal antibody treatment. Front Immunol 2022; 13:980698. [PMID: 36311723 PMCID: PMC9606643 DOI: 10.3389/fimmu.2022.980698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022] Open
Abstract
Immunocompromised patients are at increased risk for a severe course of COVID-19. Treatment of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with anti-SARS-CoV-2 monoclonal antibodies (mAbs) has become widely accepted. However, the effects of mAb treatment on the long-term primary cellular response to SARS-CoV-2 are unknown. In the following study, we investigated the long-term cellular immune responses to SARS-CoV-2 Spike S1, Membrane (M) and Nucleocapsid (N) antigens using the ELISpot assay in unvaccinated, mAb-treated immunocompromised high-risk patients. Anti-SARS-CoV-2 mAb untreated though vaccinated COVID-19 immunocompromised patients, vaccinated SARS-CoV-2 immunocompromised patients without COVID-19 and vaccinated healthy control subjects served as control groups. The cellular immune response was determined at a median of 5 months after SARS-CoV-2 infection. Our data suggest that immunocompromised patients develop an endogenous long-term cellular immune response after COVID-19, although at low levels. A better understanding of the cellular immune response will help guide clinical decision making for these vulnerable patient cohorts.
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Affiliation(s)
- Laura Thümmler
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Institute for Transfusion Medicine, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Margarethe Konik
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Neslinur Fisenkci
- Institute for Transfusion Medicine, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Michael Koldehoff
- Department of Hematology and Stem Cell Transplantation, University Medicine Essen, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Hygiene and Environmental Medicine, University Medicine Essen, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anja Gäckler
- Department of Nephrology, University Medicine Essen, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Peter A. Horn
- Institute for Transfusion Medicine, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Fotis Theodoropoulos
- Department of Pneumology, University Medicine Essen-Ruhrlandklinik, University Duisburg- Essen, Essen, Germany
| | - Christian Taube
- Department of Pneumology, University Medicine Essen-Ruhrlandklinik, University Duisburg- Essen, Essen, Germany
| | - Markus Zettler
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Olympia Evdoxia Anastasiou
- Institute for Virology, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Peer Braß
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Sarah Jansen
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Hana Rohn
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- *Correspondence: Adalbert Krawczyk, ; Hana Rohn,
| | - Adalbert Krawczyk
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Institute for Virology, University Medicine Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- *Correspondence: Adalbert Krawczyk, ; Hana Rohn,
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16
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Heinemann FM, Lindemann M, Keles D, Witzke O, Kribben A, Baba HA, Becker JU, Heinold A, Horn PA, Eisenberger U. Cumulative mean fluorescent intensities of
HLA
specific antibodies predict antibody mediated rejections after kidney transplantation. HLA 2022; 100:553-562. [DOI: 10.1111/tan.14790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Falko Markus Heinemann
- Institute for Transfusion Medicine University Duisburg‐Essen, University Hospital Essen Essen Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine University Duisburg‐Essen, University Hospital Essen Essen Germany
| | - Deniz Keles
- Institute for Transfusion Medicine University Duisburg‐Essen, University Hospital Essen Essen Germany
- Department of Nephrology University Duisburg‐Essen, University Hospital Essen Essen Germany
| | - Oliver Witzke
- Department of Infectious Diseases, West German Centre for Infectious Diseases University Duisburg‐Essen, University Hospital Essen Essen Germany
| | - Andreas Kribben
- Department of Nephrology University Duisburg‐Essen, University Hospital Essen Essen Germany
| | - Hideo Andreas Baba
- Institute of Pathology University Duisburg‐Essen, University Hospital Essen Essen Germany
| | | | - Andreas Heinold
- Institute for Transfusion Medicine University Duisburg‐Essen, University Hospital Essen Essen Germany
| | - Peter Alexander Horn
- Institute for Transfusion Medicine University Duisburg‐Essen, University Hospital Essen Essen Germany
| | - Ute Eisenberger
- Department of Nephrology University Duisburg‐Essen, University Hospital Essen Essen Germany
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Čiučiulkaitė I, Möhlendick B, Thümmler L, Fisenkci N, Elsner C, Dittmer U, Siffert W, Lindemann M. GNB3 c.825c>T polymorphism influences T-cell but not antibody response following vaccination with the mRNA-1273 vaccine. Front Genet 2022; 13:932043. [PMID: 36105097 PMCID: PMC9465595 DOI: 10.3389/fgene.2022.932043] [Citation(s) in RCA: 108] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Immune responses following vaccination against COVID-19 with different vaccines and the waning of immunity vary within the population. Genetic host factors are likely to contribute to this variability. However, to the best of our knowledge, no study on G protein polymorphisms and vaccination responses against COVID-19 has been published so far. Methods: Antibodies against the SARS-CoV-2 spike protein and T-cell responses against a peptide pool of SARS-CoV-2 S1 proteins were measured 1 and 6 months after the second vaccination with mRNA-1273 in the main study group of 204 participants. Additionally, antibodies against the SARS-CoV-2 spike protein were measured in a group of 597 participants 1 month after the second vaccination with mRNA-1273. Genotypes of GNB3 c.825C>T were determined in all participants. Results: The median antibody titer against the SARS-CoV-2 spike protein and median values of spots increment in the SARS-CoV-2 IFN-γ ELISpot assay against the S1-peptide pool were significantly decreased from months 1 to 6 (p < 0.0001). Genotypes of GNB3 c.825C>T had no influence on the humoral immune response. At month 1, CC genotype carriers had significantly increased T-cell responses compared to CT (p = 0.005) or TT (p = 0.02) genotypes. CC genotype carriers had an almost 6-fold increased probability compared to TT genotype carriers and an almost 3-fold increased probability compared to T-allele carriers to mount a SARS-CoV-2-specific T-cell response above the median value. Conclusion: CC genotype carriers of the GNB3 c.825C>T polymorphism have an increased T-cell immune response to SARS-CoV-2, which may indicate better T-cell-mediated protection against COVID-19 after vaccination with mRNA-1273.
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Affiliation(s)
- Ieva Čiučiulkaitė
- Institute of Pharmacogenetics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- *Correspondence: Ieva Čiučiulkaitė,
| | - Birte Möhlendick
- Institute of Pharmacogenetics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Laura Thümmler
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Neslinur Fisenkci
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Carina Elsner
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ulf Dittmer
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Winfried Siffert
- Institute of Pharmacogenetics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Möhlendick B, Schönfelder K, Zacher C, Elsner C, Rohn H, Konik MJ, Thümmler L, Rebmann V, Lindemann M, Jöckel KH, Siffert W. The GNB3 c.825C>T (rs5443) polymorphism and protection against fatal outcome of corona virus disease 2019 (COVID-19). Front Genet 2022; 13:960731. [PMID: 36017493 PMCID: PMC9395599 DOI: 10.3389/fgene.2022.960731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background and aims: Albeit several factors which influence the outcome of corona virus disease (COVID-19) are already known, genetic markers which may predict the outcome of the disease in hospitalized patients are still very sparse. Thus, in this study, we aimed to analyze whether the single-nucleotide polymorphism (SNP) rs5443 in the gene GNB3, which was associated with higher T cell responses in previous studies, might be a suitable biomarker to predict T cell responses and the outcome of COVID-19 in a comprehensive German cohort.Methods: We analyzed the influence of demographics, pre-existing disorders, laboratory parameters at the time of hospitalization, and GNB3 rs5443 genotype in a comprehensive cohort (N = 1570) on the outcome of COVID-19. In a sub cohort, we analyzed SARS-CoV-2-specific T cell responses and associated GNB3 rs5443 genotypes. We investigated the influence of all factors on COVID-19 fatality in multivariable analysis.Results: We found a younger patient age, normotension or absence of diabetes mellitus or cardiovascular diseases, normal blood cell counts, and low inflammatory markers at hospital admission were protective factors against fatal course of disease. In addition, the rs5443 TT genotype was significantly associated with protection against COVID-19 fatality (OR: 0.60, 95% CI: 0.40–0.92, p = 0.02). We also observed significantly increased SARS-CoV-2-specific T cell responses in rs5443 TT genotype carriers (p = 0.01). Although we observed a significant association of the factors described previously in univariate analysis, only a younger age of the patients, normal blood cell counts, and the GNB3 rs5443 TT genotype remained independent predictors against COVID-19 fatality in multivariable analysis.Conclusion: Immutable predictors for COVID-19 fatality are relatively rare. In this study we could show that the TT genotype of the SNP rs5443 in the gene GNB3 is associated with protection against COVID-19 fatality. It was as well correlated to higher SARS-CoV-2-specific T cell responses, which could result in a milder course of disease in those patients. Based on those observations we hereby provide a further prognostic biomarker, which might be used in routine diagnostics as a predictive factor for COVID-19 mortality already upon hospitalization.
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Affiliation(s)
- Birte Möhlendick
- Institute of Pharmacogenetics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- *Correspondence: Birte Möhlendick,
| | - Kristina Schönfelder
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Christoph Zacher
- Institute of Pharmacogenetics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Carina Elsner
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Hana Rohn
- Department of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Margarethe J. Konik
- Department of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Laura Thümmler
- Department of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Vera Rebmann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Karl-Heinz Jöckel
- Institute of Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Winfried Siffert
- Institute of Pharmacogenetics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Lindemann M, Baumann C, Wilde B, Gäckler A, Meller L, Horn PA, Krawczyk A, Witzke O. Prospective, Longitudinal Study on Specific Cellular Immune Responses after Vaccination with an Adjuvanted, Recombinant Zoster Vaccine in Kidney Transplant Recipients. Vaccines (Basel) 2022; 10:vaccines10060844. [PMID: 35746452 PMCID: PMC9227383 DOI: 10.3390/vaccines10060844] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 02/05/2023] Open
Abstract
Solid organ transplant recipients have an up to ninefold higher risk of varicella-zoster virus (VZV) reactivation than the general population. Due to lifelong immunosuppressive therapy, vaccination against VZV may be less effective in kidney transplant (KTX) recipients. In the current study, twelve female and 17 male KTX recipients were vaccinated twice with the adjuvanted, recombinant zoster vaccine Shingrix™, which contains the VZV glycoprotein E (gE). Cellular immunity against various VZV antigens was analyzed with interferon-gamma ELISpot. We observed the strongest vaccination-induced changes after stimulation with a gE peptide pool. One month after the second vaccination, median responses were 8.0-fold higher than the responses prior to vaccination (p = 0.0006) and 4.8-fold higher than responses after the first vaccination (p = 0.0007). After the second vaccination, we observed an at least twofold increase in ELISpot responses towards gE peptides in 22 out of 29 patients (76%). Male sex, good kidney function, early time point after transplantation, and treatment with tacrolimus or mycophenolate were correlated significantly with higher VZV-specific cellular immunity, whereas diabetes mellitus was correlated with impaired responses. Thus, our data indicate that vaccination with Shingrix™ significantly augmented cellular, VZV gE-specific immunity in KTX recipients, which was dependent on several covariates.
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Affiliation(s)
- Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (C.B.); (P.A.H.)
- Correspondence: ; Tel.: +49-201-723-4217
| | - Charleen Baumann
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (C.B.); (P.A.H.)
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University Essen-Duisburg, 45147 Essen, Germany; (L.M.); (A.K.); (O.W.)
| | - Benjamin Wilde
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (B.W.); (A.G.)
| | - Anja Gäckler
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (B.W.); (A.G.)
| | - Lara Meller
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University Essen-Duisburg, 45147 Essen, Germany; (L.M.); (A.K.); (O.W.)
| | - Peter A. Horn
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (C.B.); (P.A.H.)
| | - Adalbert Krawczyk
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University Essen-Duisburg, 45147 Essen, Germany; (L.M.); (A.K.); (O.W.)
| | - Oliver Witzke
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University Essen-Duisburg, 45147 Essen, Germany; (L.M.); (A.K.); (O.W.)
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20
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Koldehoff M, Horn PA, Lindemann M. Cellular Immune Response after Vaccination with an Adjuvanted, Recombinant Zoster Vaccine in Allogeneic Hematopoietic Stem Cell Transplant Recipients. Vaccines (Basel) 2022; 10:809. [PMID: 35632565 PMCID: PMC9143460 DOI: 10.3390/vaccines10050809] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 12/15/2022] Open
Abstract
Hematopoietic stem cell transplant (HSCT) recipients have a high risk of developing primary varicella-zoster virus (VZV) infection and reactivation. VZV vaccination may prevent infection and reactivation. In the current study, recipients of allogeneic HSCT (34 females, 45 males) were vaccinated with adjuvanted, recombinant zoster vaccine Shingrix™, which contains the VZV glycoprotein E. Cellular immunity against various VZV antigens was analyzed by interferon-gamma ELISpot. Peripheral blood mononuclear cells (PBMC) of recipients with versus without prior shingles (n = 36 and n = 43, respectively) showed approximately twofold higher VZV-specific responses prior to and post vaccination. After the first and second vaccination, ELISpot responses towards the glycoprotein E were significantly higher in males versus females (median of spots increment 18 versus 1 and 17 versus 4, respectively, p ≤ 0.02 each). Multivariate analysis showed that shingles and sex both impacts significantly on VZV immunity. Whereas vaccination-induced changes could hardly be detected after stimulation with a whole VZV antigen, there was a significant increase in responses towards glycoprotein E after vaccination (p < 0.005). These data indicate that vaccination with Shingrix™ augmented cellular, VZV-specific immunity in HSCT recipients. Shingles and male sex could both be identified as factors leading to increased immunity.
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Affiliation(s)
- Michael Koldehoff
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany;
- Department of Hygiene and Environmental Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Peter A. Horn
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany;
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany;
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Wünsch K, Anastasiou OE, Alt M, Brochhagen L, Cherneha M, Thümmler L, van Baal L, Madel RJ, Lindemann M, Taube C, Witzke O, Rohn H, Krawczyk A, Jansen S. COVID-19 in Elderly, Immunocompromised or Diabetic Patients—From Immune Monitoring to Clinical Management in the Hospital. Viruses 2022; 14:v14040746. [PMID: 35458476 PMCID: PMC9024512 DOI: 10.3390/v14040746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/19/2022] [Accepted: 03/21/2022] [Indexed: 01/01/2023] Open
Abstract
The novel, highly transmissible severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has triggered a pandemic of acute respiratory illness worldwide and remains a huge threat to the healthcare system’s capacity to respond to COVID-19. Elderly and immunocompromised patients are at increased risk for a severe course of COVID-19. These high-risk groups have been identified as developing diminished humoral and cellular immune responses. Notably, SARS-CoV-2 RNA remains detectable in nasopharyngeal swabs of these patients for a prolonged period of time. These factors complicate the clinical management of these vulnerable patient groups. To date, there are no well-defined guidelines for an appropriate duration of isolation for elderly and immunocompromised patients, especially in hospitals or nursing homes. The aim of the present study was to characterize at-risk patient cohorts capable of producing a replication-competent virus over an extended period after symptomatic COVID-19, and to investigate the humoral and cellular immune responses and infectivity to provide a better basis for future clinical management. In our cohort, the rate of positive viral cultures and the sensitivity of SARS-CoV-2 antigen tests correlated with higher viral loads. Elderly patients and patients with diabetes mellitus had adequate cellular and humoral immune responses to SARS-CoV-2 infection, while immunocompromised patients had reduced humoral and cellular immune responses. Our patient cohort was hospitalized for longer compared with previously published cohorts. Longer hospitalization was associated with a high number of nosocomial infections, representing a potential hazard for additional complications to patients. Most importantly, regardless of positive SARS-CoV-2 RNA detection, no virus was culturable beyond a cycle threshold (ct) value of 33 in the majority of samples. Our data clearly indicate that elderly and diabetic patients develop a robust immune response to SARS-CoV-2 and may be safely de-isolated at a ct value of more than 35.
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Affiliation(s)
- Korbinian Wünsch
- West German Centre of Infectious Diseases, Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (K.W.); (M.A.); (L.B.); (M.C.); (L.T.); (R.J.M.); (O.W.); (A.K.)
| | - Olympia E. Anastasiou
- Institute for Virology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany;
| | - Mira Alt
- West German Centre of Infectious Diseases, Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (K.W.); (M.A.); (L.B.); (M.C.); (L.T.); (R.J.M.); (O.W.); (A.K.)
| | - Leonie Brochhagen
- West German Centre of Infectious Diseases, Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (K.W.); (M.A.); (L.B.); (M.C.); (L.T.); (R.J.M.); (O.W.); (A.K.)
| | - Maxim Cherneha
- West German Centre of Infectious Diseases, Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (K.W.); (M.A.); (L.B.); (M.C.); (L.T.); (R.J.M.); (O.W.); (A.K.)
| | - Laura Thümmler
- West German Centre of Infectious Diseases, Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (K.W.); (M.A.); (L.B.); (M.C.); (L.T.); (R.J.M.); (O.W.); (A.K.)
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany;
| | - Lukas van Baal
- Department of Endocrinology, Diabetes and Metabolism and Division of Laboratory Research, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany;
| | - Rabea J. Madel
- West German Centre of Infectious Diseases, Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (K.W.); (M.A.); (L.B.); (M.C.); (L.T.); (R.J.M.); (O.W.); (A.K.)
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany;
| | - Christian Taube
- Department of Pneumology, University Medicine Essen—Ruhrlandklinik, University Duisburg-Essen, 45147 Essen, Germany;
| | - Oliver Witzke
- West German Centre of Infectious Diseases, Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (K.W.); (M.A.); (L.B.); (M.C.); (L.T.); (R.J.M.); (O.W.); (A.K.)
| | - Hana Rohn
- West German Centre of Infectious Diseases, Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (K.W.); (M.A.); (L.B.); (M.C.); (L.T.); (R.J.M.); (O.W.); (A.K.)
- Correspondence: (H.R.); (S.J.)
| | - Adalbert Krawczyk
- West German Centre of Infectious Diseases, Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (K.W.); (M.A.); (L.B.); (M.C.); (L.T.); (R.J.M.); (O.W.); (A.K.)
| | - Sarah Jansen
- West German Centre of Infectious Diseases, Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (K.W.); (M.A.); (L.B.); (M.C.); (L.T.); (R.J.M.); (O.W.); (A.K.)
- Correspondence: (H.R.); (S.J.)
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Ma X, Dai Y, Witzke O, Xu S, Lindemann M, Kribben A, Dolff S, Wilde B. Chloroquine Suppresses Effector B-Cell Functions and Has Differential Impact on Regulatory B-Cell Subsets. Front Immunol 2022; 13:818704. [PMID: 35211119 PMCID: PMC8860819 DOI: 10.3389/fimmu.2022.818704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/12/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Chloroquine (CQ) is approved for treatment of B-cell mediated diseases such as rheumatoid arthritis and systemic lupus erythematosus. However, the exact mode of action in these diseases has not been studied and it remains unclear which effect CQ has on B-cells. Thus, it was the aim of this study to investigate to which extent CQ affects functionality of effector and regulatory B-cell. Methods For this purpose, B-cells were isolated from peripheral blood of healthy controls and renal transplant patients. B-cells were stimulated in presence or absence of CQ and Interleukin-10 (IL-10) and Granzyme B (GrB) secretion were assessed. In addition, effector functions such as plasma cell formation, and Immunoglobulin G (IgG) secretion were studied. Results CQ suppressed Toll-Like-Receptor (TLR)-9 induced B-cell proliferation in a dose-dependent manner. IL-10pos regulatory B-cells were suppressed by CQ already at low concentrations whereas anti-IgG/IgM-induced GrB secreting regulatory B-cells were less susceptible. Plasma blast formation and IgG secretion was potently suppressed by CQ. Moreover, purified B-cells from renal transplant patients were also susceptible to CQ-induced suppression of effector B-cell functions as observed by diminished IgG secretion. Conclusion In conclusion, CQ had a suppressive effect on IL-10 regulatory B-cells whereas GrB secreting regulatory B-cells were less affected. Effector functions of B-cells such as plasma blast formation and IgG secretion were also inhibited by CQ. Effector B-cells derived from renal transplant patients already under immunosuppression could be suppressed by CQ. These findings may partly explain the clinical efficacy of CQ in B-cell mediated autoimmune diseases. The application of CQ in other disease contexts where suppression of effector B-cells could offer a benefit, such as renal transplantation, may hypothetically be advantageous.
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Affiliation(s)
- Xin Ma
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Department of Nephrology, First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Yang Dai
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Shilei Xu
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Andreas Kribben
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sebastian Dolff
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Benjamin Wilde
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Pompsch M, Fisenkci N, Horn PA, Kraemer M, Lindemann M. Evidence of extensive cellular immune response after SARS-CoV-2 vaccination in ocrelizumab-treated patients with multiple sclerosis. Neurol Res Pract 2021; 3:60. [PMID: 34802469 PMCID: PMC8606235 DOI: 10.1186/s42466-021-00158-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 10/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients with multiple sclerosis receiving ocrelizumab-treatment are in desperate need of a protection against SARS-CoV-2 infection. METHODS In this study, Euroimmun semi-quantitative Anti-SARS-CoV-2 IgG for detection of humoral response and ELISpot assays for detection of SARS-CoV-2-specific T-cell-response were used in 10 ocrelizumab-treated patients with multiple sclerosis twice vaccinated with Comirnaty® mRNA vaccine. This data was compared with a control group of 20 age- and sex-matched healthy volunteers, who had all previously received a full SARS-CoV-2 mRNA vaccination with Comirnaty® or Spikevax®. RESULTS While all subjects in the control group had high humoral response to the vaccination, in B-cell-depleted individuals a significantly reduced antibody response to vaccination against SARS-CoV-2 was observed. SARS-CoV-2 specific T-cell-response, however, did not differ significantly between both cohorts. CONCLUSIONS T-cell-mediated response to Comirnaty® vaccination is observable despite attenuated humoral response in B-cell-depleted patients. This might enable partial protection against COVID-19. Trial registration Retrospectively registered.
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Affiliation(s)
- Mosche Pompsch
- Department of Neurology, Alfried Krupp Hospital, Alfried-Krupp-Straße 21, 45130, Essen, Germany
| | - Neslinur Fisenkci
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Peter A Horn
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Markus Kraemer
- Department of Neurology, Alfried Krupp Hospital, Alfried-Krupp-Straße 21, 45130, Essen, Germany. .,Department of Neurology, Medical Faculty of Heinrich-Heine-University, Düsseldorf, Germany.
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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24
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Kibler A, Budeus B, Homp E, Bronischewski K, Berg V, Sellmann L, Murke F, Heinold A, Heinemann FM, Lindemann M, Bekeredjian-Ding I, Horn PA, Kirschning CJ, Küppers R, Seifert M. Systematic memory B cell archiving and random display shape the human splenic marginal zone throughout life. J Exp Med 2021; 218:211756. [PMID: 33538775 PMCID: PMC7868796 DOI: 10.1084/jem.20201952] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/02/2020] [Accepted: 12/21/2020] [Indexed: 12/19/2022] Open
Abstract
Human memory B cells (MBCs) are generated and diversified in secondary lymphoid tissues throughout the organism. A paired immunoglobulin (Ig)-gene repertoire analysis of peripheral blood (PB) and splenic MBCs from infant, adult, and elderly humans revealed that throughout life, circulating MBCs are comprehensively archived in the spleen. Archive MBC clones are systematically preserved and uncoupled from class-switching. Clonality in the spleen increases steadily, but boosts at midlife, thereby outcompeting small clones. The splenic marginal zone (sMZ) represents a primed MBC compartment, generated from a stochastic exchange within the archive memory pool. This is supported by functional assays, showing that PB and splenic CD21+ MBCs acquire transient CD21high expression upon NOTCH2-stimulation. Our study provides insight that the human MBC system in PB and spleen is composed of three interwoven compartments: the dynamic relationship of circulating, archive, and its subset of primed (sMZ) memory changes with age, thereby contributing to immune aging.
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Affiliation(s)
- Artur Kibler
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Essen, Germany
| | - Bettina Budeus
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Essen, Germany
| | - Ekaterina Homp
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Essen, Germany
| | - Kevin Bronischewski
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Essen, Germany
| | - Victoria Berg
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Essen, Germany
| | - Ludger Sellmann
- Department of Haematology, University Hospital Essen, Essen, Germany
| | - Florian Murke
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Andreas Heinold
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Falko M Heinemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | | | - Peter A Horn
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | | | - Ralf Küppers
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Essen, Germany
| | - Marc Seifert
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Essen, Germany
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25
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Lindemann M, Klisanin V, Thümmler L, Fisenkci N, Tsachakis-Mück N, Ditschkowski M, Schwarzkopf S, Klump H, Reinhardt HC, Horn PA, Koldehoff M. Humoral and Cellular Vaccination Responses against SARS-CoV-2 in Hematopoietic Stem Cell Transplant Recipients. Vaccines (Basel) 2021; 9:1075. [PMID: 34696183 PMCID: PMC8537291 DOI: 10.3390/vaccines9101075] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 01/14/2023] Open
Abstract
The cellular response to SARS-CoV-2 vaccination and infection in allogeneic hematopoietic stem cell transplant (HSCT) recipients is not yet clear. In the current study, HSCT recipients prior to and post vaccination were tested for SARS-CoV-2-specific humoral and cellular immunity. Antibodies against spike (S) 1 were assessed by Anti-SARS-CoV-2 IgG ELISA (Euroimmun). Cellular immunity was analyzed by an in house interferon-gamma ELISpot and T-SPOT.COVID (Oxford Immunotec), using altogether seven SARS-CoV-2-specific antigens. In 117 HSCT patients vaccinated twice, SARS-CoV-2 IgG antibodies were significantly higher than in HSCT controls pre vaccination (p < 0.0001). After the second vaccination, we observed a median antibody ratio of 4.7 and 68% positive results, whereas 35 healthy controls reached a median ratio of 9.0 and 100% positivity. ELISpot responses in patients were significantly (p < 0.001) reduced to ≤33% of the controls. After the second vaccination, female HSCT patients and female healthy controls showed significantly higher antibody responses than males (6.0 vs. 2.1 and 9.2 vs. 8.2, respectively; p < 0.05). Cellular immunity was diminished in patients irrespective of sex. In conclusion, especially male HSCT recipients showed impaired antibody responses after SARS-CoV-2 vaccination. Changing the vaccine schedule or composition could help increase vaccine responses.
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Affiliation(s)
- Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (L.T.); (N.F.); (S.S.); (H.K.); (P.A.H.)
| | - Vesna Klisanin
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (V.K.); (N.T.-M.); (M.D.); (H.C.R.); (M.K.)
| | - Laura Thümmler
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (L.T.); (N.F.); (S.S.); (H.K.); (P.A.H.)
| | - Neslinur Fisenkci
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (L.T.); (N.F.); (S.S.); (H.K.); (P.A.H.)
| | - Nikolaos Tsachakis-Mück
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (V.K.); (N.T.-M.); (M.D.); (H.C.R.); (M.K.)
| | - Markus Ditschkowski
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (V.K.); (N.T.-M.); (M.D.); (H.C.R.); (M.K.)
| | - Sina Schwarzkopf
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (L.T.); (N.F.); (S.S.); (H.K.); (P.A.H.)
| | - Hannes Klump
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (L.T.); (N.F.); (S.S.); (H.K.); (P.A.H.)
| | - Hans Christian Reinhardt
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (V.K.); (N.T.-M.); (M.D.); (H.C.R.); (M.K.)
| | - Peter A. Horn
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (L.T.); (N.F.); (S.S.); (H.K.); (P.A.H.)
| | - Michael Koldehoff
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (V.K.); (N.T.-M.); (M.D.); (H.C.R.); (M.K.)
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26
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Lindemann M, Wilde B, Friebus-Kardash J, Gäckler A, Witzke O, Dittmer U, Horn PA, Kribben A, Mülling N, Eisenberger U. Comparison of Humoral and Cellular CMV Immunity in Patients Awaiting Kidney Transplantation. Diagnostics (Basel) 2021; 11:diagnostics11091688. [PMID: 34574029 PMCID: PMC8467335 DOI: 10.3390/diagnostics11091688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/26/2021] [Accepted: 09/13/2021] [Indexed: 01/05/2023] Open
Abstract
Chronic kidney disease may alter antiviral T cell immunity. In the current study, we assessed in 63 patients prior to kidney transplantation how humoral and cellular immunity against cytomegalovirus (CMV) correlated using an interferon (IFN)-γ ELISpot (T-Track® CMV, Mikrogen, Neuried, Germany). The cohort comprised 24 patients with negative and 39 with positive CMV IgG. Whereas none of the patients with negative CMV IgG showed detectable responses to the T-Track® CMV, 26 out of 39 patients with positive CMV IgG had positive ELISpot responses. The median response to CMV pp65 in the CMV seronegative group was 0 spot forming units (SFU) per 200,000 PBMC (range 0–1) and in the seropositive group 43 SFU (range 0–750). Thus, 13 out of 39 patients with positive CMV serostatus (33%) had undetectable T cell immunity and may be at an increased risk of CMV reactivation. CMV pp65-specific ELISpot responses were 29.3-fold higher in seropositive patients with vs. without dialysis and 5.6-fold higher in patients with vs. without immunosuppressive therapy, but patients with dialysis and immunosuppressive therapy showed, as expected, lower responses to phytohemagglutinin, the positive control. This finding may be caused by (subclinical) CMV-DNAemia and a “booster” of CMV-specific T cells.
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Affiliation(s)
- Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany;
- Correspondence: ; Tel.: +49-201-723-4217
| | - Benjamin Wilde
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (B.W.); (J.F.-K.); (A.G.); (A.K.); (N.M.); (U.E.)
| | - Justa Friebus-Kardash
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (B.W.); (J.F.-K.); (A.G.); (A.K.); (N.M.); (U.E.)
| | - Anja Gäckler
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (B.W.); (J.F.-K.); (A.G.); (A.K.); (N.M.); (U.E.)
| | - Oliver Witzke
- West German Centre of Infectious Diseases, Department of Infectious Diseases, University Hospital Essen, University Essen-Duisburg, 45147 Essen, Germany;
| | - Ulf Dittmer
- Institute for Virology, University Hospital Essen, University Essen-Duisburg, 45147 Essen, Germany;
| | - Peter A. Horn
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany;
| | - Andreas Kribben
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (B.W.); (J.F.-K.); (A.G.); (A.K.); (N.M.); (U.E.)
| | - Nils Mülling
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (B.W.); (J.F.-K.); (A.G.); (A.K.); (N.M.); (U.E.)
| | - Ute Eisenberger
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (B.W.); (J.F.-K.); (A.G.); (A.K.); (N.M.); (U.E.)
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27
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Thümmler L, Schwarzkopf S, Knop D, Ross JA, Berg V, Horn PA, Lindemann M. Comparison of SARS-CoV-2- and HCoV-Specific T Cell Response Using IFN-γ ELISpot. Diagnostics (Basel) 2021; 11:diagnostics11081439. [PMID: 34441374 PMCID: PMC8394367 DOI: 10.3390/diagnostics11081439] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/29/2021] [Accepted: 08/09/2021] [Indexed: 12/23/2022] Open
Abstract
Herd immunity is essential to control severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), especially in immunocompromised patients. Convalescent individuals should be vaccinated later due to vaccine shortage, as studies show that neutralizing antibodies generated during infection are stable for at least 6 months. Cellular immunity is also detectable for months. However, there is evidence of cross-reactivity of T cells with human endemic coronaviruses (HCoVs). Here, we show that cross-reactivity—which may prevent the specific detection of SARS-CoV-2-specific T cell responses—can be avoided if cells are stimulated with the N-terminus of the spike protein in IFN-γ ELISpot. In contrast to previous studies, we examined T-cell responses against all four known HCoVs using IFN-γ ELISpot in 19 convalescent volunteers and 10 fully vaccinated volunteers. In addition, we performed Spearman analyses to detect cross-reactivity of T cells. We observed no correlation between T-cell responses against SARS-CoV-2 and human endemic coronaviruses, either in the whole cohort or in the individual groups. The use of the respective stimuli could lead to a more accurate assessment of cellular immunity in recovered individuals. This testing procedure could help to define the best time point at which convalescents should receive SARS-CoV-2 vaccination.
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Affiliation(s)
- Laura Thümmler
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (L.T.); (S.S.); (D.K.); (P.A.H.)
| | - Sina Schwarzkopf
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (L.T.); (S.S.); (D.K.); (P.A.H.)
| | - Dietmar Knop
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (L.T.); (S.S.); (D.K.); (P.A.H.)
| | - J. Alexander Ross
- Institute of Cell Biology (Cancer Research), University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (J.A.R.); (V.B.)
| | - Victoria Berg
- Institute of Cell Biology (Cancer Research), University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (J.A.R.); (V.B.)
| | - Peter A. Horn
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (L.T.); (S.S.); (D.K.); (P.A.H.)
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (L.T.); (S.S.); (D.K.); (P.A.H.)
- Correspondence: ; Tel.: +49-201-723-4217
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28
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Steindor M, Stehling F, Olivier M, Kehrmann J, Diricks M, Maurer FP, Horn PA, Straßburg S, Welsner M, Sutharsan S, Lindemann M. Species-Specific Interferon-Gamma Release Assay for the Diagnosis of Mycobacterium abscessus Complex Infection. Front Microbiol 2021; 12:692395. [PMID: 34322105 PMCID: PMC8312262 DOI: 10.3389/fmicb.2021.692395] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/14/2021] [Indexed: 11/13/2022] Open
Abstract
Mycobacterium abscessus complex (MABC) infection has a devastating impact on the course of cystic fibrosis (CF) and non-CF lung disease. Diagnosis of MABC pulmonary disease is challenging, and current diagnostic approaches lack accuracy, especially in CF. In this study, we aimed to establish an MABC-specific interferon-γ release assay to detect host immune responses to MABC and improve diagnostics of MABC infection by the detection of antigen-specific T cells. Four species-specific proteins of MABC were overexpressed in an Escherichia coli expression system. Purified proteins were used to stimulate peripheral blood mononuclear cells of study subjects in an ELISpot assay. Interferon-γ response of 12 subjects with established diagnosis of MABC infection (10 CF and two non-CF) was compared with 35 controls (22 CF and 13 non-CF) distributed to three control groups, 17 CF subjects without NTM infection, nine subjects with NTM infection other than MABC, and nine subjects with tuberculosis. Cellular in vitro responses in the MABC group were stronger than in the control groups, especially toward the protein MAB_0405c (39 vs. 4 spots per 300,000 PBMC, p = 0.004; data represent mean values) in all patients and also in the subgroup of CF subjects (39 spots vs. 1 spot, p = 0.003). Receiver operating characteristic curve analysis indicated that spot numbers of at least 20 were highly predictive of MABC infection (all patients: area under curve 0.773, sensitivity 58%, and specificity 94%; CF patients: area under curve 0.818, sensitivity 60%, and specificity 100%). In conclusion, we identified MAB_0405c as a protein that may stimulate MABC-specific interferon-γ secretion and may add to the diagnosis of MABC infection in affected patients.
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Affiliation(s)
- Mathis Steindor
- Pediatric Pulmonology and Sleep Medicine, Children's University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Florian Stehling
- Pediatric Pulmonology and Sleep Medicine, Children's University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Margarete Olivier
- Pediatric Pulmonology and Sleep Medicine, Children's University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jan Kehrmann
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Margo Diricks
- Molecular and Experimental Mycobacteriology, Research Center Borstel - Leibniz Lung Center, Borstel, Germany.,National and WHO Supranational Reference Center for Mycobacteria, Research Center Borstel, Borstel, Germany
| | - Florian P Maurer
- National and WHO Supranational Reference Center for Mycobacteria, Research Center Borstel, Borstel, Germany.,Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter A Horn
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Svenja Straßburg
- Department of Pulmonary Medicine, Adult Cystic Fibrosis Center, University Hospital Essen - Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany
| | - Matthias Welsner
- Department of Pulmonary Medicine, Adult Cystic Fibrosis Center, University Hospital Essen - Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany
| | - Sivagurunathan Sutharsan
- Department of Pulmonary Medicine, Adult Cystic Fibrosis Center, University Hospital Essen - Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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29
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Budeus B, Kibler A, Brauser M, Homp E, Bronischewski K, Ross JA, Görgens A, Weniger MA, Dunst J, Kreslavsky T, Vitoriano da Conceição Castro S, Murke F, Oakes CC, Rusch P, Andrikos D, Kern P, Köninger A, Lindemann M, Johansson P, Hansen W, Lundell AC, Rudin A, Dürig J, Giebel B, Hoffmann D, Küppers R, Seifert M. Human Cord Blood B Cells Differ from the Adult Counterpart by Conserved Ig Repertoires and Accelerated Response Dynamics. J Immunol 2021; 206:2839-2851. [PMID: 34117106 DOI: 10.4049/jimmunol.2100113] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/14/2021] [Indexed: 11/19/2022]
Abstract
Neonatal and infant immune responses are characterized by a limited capability to generate protective Ab titers and memory B cells as seen in adults. Multiple studies support an immature or even impaired character of umbilical cord blood (UCB) B cells themselves. In this study, we provide a comprehensive molecular and functional comparison of B cell subsets from UCB and adult peripheral blood. Most UCB B cells have a mature, naive B cell phenotype as seen in adults. The UCB Ig repertoire is highly variable but interindividually conserved, as BCR clonotypes are frequently shared between neonates. Furthermore, UCB B cells show a distinct transcriptional program that confers accelerated responsiveness to stimulation and facilitated IgA class switching. Stimulation drives extensive differentiation into Ab-secreting cells, presumably limiting memory B cell formation. Humanized mice suggest that the distinctness of UCB versus adult B cells is already reflected by the developmental program of hematopoietic precursors, arguing for a layered B-1/B-2 lineage system as in mice, albeit our findings suggest only partial comparability to murine B-1 cells. Our study shows that UCB B cells are not immature or impaired but differ from their adult mature counterpart in a conserved BCR repertoire, efficient IgA class switching, and accelerated, likely transient response dynamics.
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Affiliation(s)
- Bettina Budeus
- Institute of Cell Biology (Cancer Research), Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Artur Kibler
- Institute of Cell Biology (Cancer Research), Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Martina Brauser
- Institute of Cell Biology (Cancer Research), Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Ekaterina Homp
- Institute of Cell Biology (Cancer Research), Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Kevin Bronischewski
- Institute of Cell Biology (Cancer Research), Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - J Alexander Ross
- Institute of Cell Biology (Cancer Research), Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Andre Görgens
- Institute for Transfusion Medicine, Medical Faculty, University of Duisburg-Essen, Essen, Germany.,Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Marc A Weniger
- Institute of Cell Biology (Cancer Research), Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Josefine Dunst
- Division of Immunology and Allergy, Department of Medicine, Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Taras Kreslavsky
- Division of Immunology and Allergy, Department of Medicine, Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Symone Vitoriano da Conceição Castro
- Institute for Transfusion Medicine, Medical Faculty, University of Duisburg-Essen, Essen, Germany.,CAPES Foundation, Ministry of Education of Brazil, Brasília, Brazil
| | - Florian Murke
- Institute for Transfusion Medicine, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Christopher C Oakes
- Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH.,Department of Biomedical Informatics, The Ohio State University, Columbus, OH
| | - Peter Rusch
- Department of Gynecology, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Dimitrios Andrikos
- Department of Gynecology, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Peter Kern
- Department of Gynecology, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Angela Köninger
- Department of Gynecology, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Patricia Johansson
- Department of Hematology, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Wiebke Hansen
- Institute of Medical Microbiology, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Anna-Carin Lundell
- Department of Rheumatology and Inflammation Research, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; and
| | - Anna Rudin
- Department of Rheumatology and Inflammation Research, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; and
| | - Jan Dürig
- Department of Hematology, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Bernd Giebel
- Institute for Transfusion Medicine, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Daniel Hoffmann
- Department of Bioinformatics and Computational Biophysics, Faculty of Biology, University of Duisburg-Essen, Essen, Germany
| | - Ralf Küppers
- Institute of Cell Biology (Cancer Research), Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Marc Seifert
- Institute of Cell Biology (Cancer Research), Medical Faculty, University of Duisburg-Essen, Essen, Germany;
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30
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Korth J, Wilde B, Dolff S, Frisch J, Jahn M, Krawczyk A, Trilling M, Schipper L, Cordes S, Ross B, Lindemann M, Kribben A, Dittmer U, Witzke O, Herrmann A, Anastasiou OE. SARS-CoV-2 Seroprevalence in Healthcare Workers in Germany: A Follow-Up Study. Int J Environ Res Public Health 2021; 18:4540. [PMID: 33922895 PMCID: PMC8123190 DOI: 10.3390/ijerph18094540] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/14/2021] [Accepted: 04/21/2021] [Indexed: 12/19/2022]
Abstract
SARS-CoV-2 is a worldwide challenge for the medical sector. Healthcare workers (HCW) are a cohort vulnerable to SARS-CoV-2 infection due to frequent and close contact with COVID-19 patients. However, they are also well trained and equipped with protective gear. The SARS-CoV-2 IgG antibody status was assessed at three different time points in 450 HCW of the University Hospital Essen in Germany. HCW were stratified according to contact frequencies with COVID-19 patients in (I) a high-risk group with daily contacts with known COVID-19 patients (n = 338), (II) an intermediate-risk group with daily contacts with non-COVID-19 patients (n = 78), and (III) a low-risk group without patient contacts (n = 34). The overall seroprevalence increased from 2.2% in March-May to 4.0% in June-July to 5.1% in October-December. The SARS-CoV-2 IgG detection rate was not significantly different between the high-risk group (1.8%; 3.8%; 5.5%), the intermediate-risk group (5.1%; 6.3%; 6.1%), and the low-risk group (0%, 0%, 0%). The overall SARS-CoV-2 seroprevalence remained low in HCW in western Germany one year after the outbreak of COVID-19 in Germany, and hygiene standards seemed to be effective in preventing patient-to-staff virus transmission.
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Affiliation(s)
- Johannes Korth
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany; (B.W.); (M.J.); (A.K.)
| | - Benjamin Wilde
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany; (B.W.); (M.J.); (A.K.)
| | - Sebastian Dolff
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany; (S.D.); (J.F.); (A.K.); (L.S.); (O.W.)
| | - Jasmin Frisch
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany; (S.D.); (J.F.); (A.K.); (L.S.); (O.W.)
| | - Michael Jahn
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany; (B.W.); (M.J.); (A.K.)
| | - Adalbert Krawczyk
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany; (S.D.); (J.F.); (A.K.); (L.S.); (O.W.)
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Virchowstr. 179, 45147 Essen, Germany; (M.T.); (U.D.); (A.H.); (O.E.A.)
| | - Mirko Trilling
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Virchowstr. 179, 45147 Essen, Germany; (M.T.); (U.D.); (A.H.); (O.E.A.)
| | - Leonie Schipper
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany; (S.D.); (J.F.); (A.K.); (L.S.); (O.W.)
| | - Sebastian Cordes
- Department of Pneumology, University Hospital Essen, University of Duisburg-Essen, Tüschener Weg 40, 45239 Essen, Germany;
| | - Birgit Ross
- Hospital Hygiene, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany;
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany;
| | - Andreas Kribben
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany; (B.W.); (M.J.); (A.K.)
| | - Ulf Dittmer
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Virchowstr. 179, 45147 Essen, Germany; (M.T.); (U.D.); (A.H.); (O.E.A.)
| | - Oliver Witzke
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany; (S.D.); (J.F.); (A.K.); (L.S.); (O.W.)
| | - Anke Herrmann
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Virchowstr. 179, 45147 Essen, Germany; (M.T.); (U.D.); (A.H.); (O.E.A.)
| | - Olympia Evdoxia Anastasiou
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Virchowstr. 179, 45147 Essen, Germany; (M.T.); (U.D.); (A.H.); (O.E.A.)
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31
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Lindemann M, Lenz V, Knop D, Klump H, Alt M, Aufderhorst UW, Schipper L, Schwarzkopf S, Meller L, Steckel N, Koldehoff M, Heinold A, Heinemann FM, Fischer J, Hutschenreuter G, Knabbe C, Dolff S, Brenner T, Dittmer U, Witzke O, Herbstreit F, Horn PA, Krawczyk A. Convalescent plasma treatment of critically ill intensive care COVID-19 patients. Transfusion 2021; 61:1394-1403. [PMID: 33784412 PMCID: PMC8251157 DOI: 10.1111/trf.16392] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/08/2020] [Accepted: 12/08/2020] [Indexed: 01/08/2023]
Abstract
Background Infection with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) may be life‐threatening, and specific antiviral drugs are currently not available. However, first studies indicated that convalescent plasma treatment might improve the clinical outcome of coronavirus disease 2019 (COVID‐19) patients. Study Design and Methods In the current study, we investigated the efficacy of convalescent plasma treatment in eight COVID‐19 patients. All the patients were critically ill, and seven of them were SARS‐CoV‐2 RNA–positive when starting treatment. SARS‐CoV‐2–specific antibodies were determined by an enzyme‐linked immunosorbent assay detecting immunoglobulin G (IgG) antibodies against the S1 protein (Euroimmun), and the neutralizing titers were determined with a cell‐culture‐based neutralization assay. Plasma treatment started between 4 and 23 days after the onset of symptoms. The patients were usually treated by three plasma units, each containing 200–280 ml, which was applied at day 1, 3, and 5. Results Donor sera had on average lower IgG antibody ratios and neutralizing titers than the COVID‐19 patients before the onset of treatment (median ratio of 5.8 and neutralizing titer of 1:320 vs. 7.5 and 1:640, respectively). Nevertheless, we observed an increase of antibody ratios in seven and of neutralizing titers in five patients after treatment; which did, however, not correlate with patient survival. Plasma treatment was effective in three patients, but five deceased despite treatment. Patients who deceased had a later treatment onset than survivors and finally died from multiple organ failure. Conclusion Our data indicate that the efficacy of convalescent plasma treatment of critically ill COVID‐19 patients who already had developed strong antiviral immune responses and organ complications is limited.
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Affiliation(s)
- Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Veronika Lenz
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Dietmar Knop
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Hannes Klump
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Mira Alt
- Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitätsmedizin Essen, University Duisburg-Essen, Essen, Germany
| | - Ulrich W Aufderhorst
- Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitätsmedizin Essen, University Duisburg-Essen, Essen, Germany.,Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Leonie Schipper
- Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitätsmedizin Essen, University Duisburg-Essen, Essen, Germany
| | - Sina Schwarzkopf
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Lara Meller
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany.,Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitätsmedizin Essen, University Duisburg-Essen, Essen, Germany
| | - Nina Steckel
- Department of Bone Marrow Transplantation, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Michael Koldehoff
- Department of Bone Marrow Transplantation, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Andreas Heinold
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Falko M Heinemann
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Johannes Fischer
- Institute for Transplant Diagnostics and Cell Therapeutics, Heinrich Heine University, Düsseldorf, Germany
| | | | - Cornelius Knabbe
- Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center NRW, Ruhr University Bochum, Bochum, Germany
| | - Sebastian Dolff
- Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitätsmedizin Essen, University Duisburg-Essen, Essen, Germany
| | - Thorsten Brenner
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, Essen, Germany
| | - Ulf Dittmer
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitätsmedizin Essen, University Duisburg-Essen, Essen, Germany
| | - Frank Herbstreit
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, Essen, Germany
| | - Peter A Horn
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Adalbert Krawczyk
- Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitätsmedizin Essen, University Duisburg-Essen, Essen, Germany.,Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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32
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Subburayalu J, Dolff S, Xu S, Sun M, Lindemann M, Heinold A, Heinemann FM, Tervaert JWC, Eisenberger U, Korth J, Brinkhoff A, Kribben A, Witzke O, Wilde B. Characterization of follicular T helper cells and donor-specific T helper cells in renal transplant patients with de novo donor-specific HLA-antibodies. Clin Immunol 2021; 226:108698. [PMID: 33639275 DOI: 10.1016/j.clim.2021.108698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 02/19/2021] [Accepted: 02/20/2021] [Indexed: 12/21/2022]
Abstract
T follicular helper (TFH) cells are a heterogeneous subset of immunocompetent T helper (TH) cells capable of augmenting B cell responses in lymphoid tissues. In transplantation, exposure to allogeneic tissue activates TFH cells increasing the risk of the emergence of de novo donor-specific HLA-antibodies (dnDSA). These can cause antibody-mediated rejection (AMR) and allograft loss. Follicular regulatory T (TFR) cells counteract TFH cell activity. Here, we investigated the implications of TFH and TFR cells on dnDSA formation after renal transplantation (RTX). Considering TFH cells to be CXCR5+ and IL-21+, we found by flow cytometry that patients with dnDSA produced IL-21 more abundantly compared to healthy volunteers. In in vitro alloreactivity assays, patients with dnDSA featured an enhanced alloreactive TH cell pool in response to donor-specific HLA antigens. Besides, longitudinal investigations suggested enhanced alloreactivity shortly after transplantation increasing the risk of dnDSA development. Taken together, in spite of continuous immunosuppression we report a strong IL-21 response in TFH cells and an expanded reservoir of donor-specific memory TH cells in patients with dnDSA. This warrants further investigations if aberrant TFH cell activation may precede the formation of dnDSA promoting AMR.
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Affiliation(s)
- Julien Subburayalu
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen 45147, Germany
| | - Sebastian Dolff
- Department of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen 45147, Germany
| | - Shilei Xu
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen 45147, Germany; Department of General Surgery, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510530, China
| | - Ming Sun
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen 45147, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen 45147, Germany
| | - Andreas Heinold
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen 45147, Germany
| | - Falko M Heinemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen 45147, Germany
| | - Jan Willem Cohen Tervaert
- Division of Rheumatology, Department of Medicine, University of Alberta, Edmonton, AB T6G 2G3, Canada
| | - Ute Eisenberger
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen 45147, Germany
| | - Johannes Korth
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen 45147, Germany
| | - Alexandra Brinkhoff
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen 45147, Germany
| | - Andreas Kribben
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen 45147, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen 45147, Germany
| | - Benjamin Wilde
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen 45147, Germany.
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33
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Wagner-Drouet E, Teschner D, Wolschke C, Schäfer-Eckart K, Gärtner J, Mielke S, Schreder M, Kobbe G, Hilgendorf I, Klein S, Verbeek M, Ditschkowski M, Koch M, Lindemann M, Schmidt T, Rascle A, Barabas S, Deml L, Wagner R, Wolff D. Comparison of Cytomegalovirus-Specific Immune Cell Response to Proteins versus Peptides Using an IFN-γ ELISpot Assay after Hematopoietic Stem Cell Transplantation. Diagnostics (Basel) 2021; 11:diagnostics11020312. [PMID: 33671952 PMCID: PMC7919014 DOI: 10.3390/diagnostics11020312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 12/12/2022] Open
Abstract
Cytomegalovirus (CMV) infection is a major cause of morbidity and mortality following hematopoietic stem cell transplantation (HSCT). Measuring CMV-specific cellular immunity may improve the risk stratification and management of patients. IFN-γ ELISpot assays, based on the stimulation of peripheral blood mononuclear cells with CMV pp65 and IE-1 proteins or peptides, have been validated in clinical settings. However, it remains unclear to which extend the T-cell response to synthetic peptides reflect that mediated by full-length proteins processed by antigen-presenting cells. We compared the stimulating ability of pp65 and IE-1 proteins and corresponding overlapping peptides in 16 HSCT recipients using a standardized IFN-γ ELISpot assay. Paired qualitative test results showed an overall 74.4% concordance. Discordant results were mainly due to low-response tests, with one exception. One patient with early CMV reactivation and graft-versus-host disease, sustained CMV DNAemia and high CD8+ counts showed successive negative protein-based ELISpot results but a high and sustained response to IE-1 peptides. Our results suggest that the response to exogenous proteins, which involves their uptake and processing by antigen-presenting cells, more closely reflects the physiological response to CMV infection, while the response to exogenous peptides may lead to artificial in vitro T-cell responses, especially in strongly immunosuppressed patients.
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Affiliation(s)
- Eva Wagner-Drouet
- Department of Hematology, Medical Oncology, and Pneumology, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (E.W.-D.); (D.T.)
| | - Daniel Teschner
- Department of Hematology, Medical Oncology, and Pneumology, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (E.W.-D.); (D.T.)
| | - Christine Wolschke
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, 20246 Eppendorf, Hamburg, Germany;
| | - Kerstin Schäfer-Eckart
- Medizinische Klinik 5, Klinikum Nürnberg Nord, Paracelsus Medizinische Privatuniversität, 90419 Nürnberg, Germany; (K.S.-E.); (J.G.)
| | - Johannes Gärtner
- Medizinische Klinik 5, Klinikum Nürnberg Nord, Paracelsus Medizinische Privatuniversität, 90419 Nürnberg, Germany; (K.S.-E.); (J.G.)
| | - Stephan Mielke
- Department of Medicine II, University Medical Center Würzburg, 97080 Würzburg, Germany; (S.M.); (M.S.)
- Department of Laboratory Medicine, CAST, Karolinska Institutet and University Hospital, 17177 Stockholm, Sweden
| | - Martin Schreder
- Department of Medicine II, University Medical Center Würzburg, 97080 Würzburg, Germany; (S.M.); (M.S.)
| | - Guido Kobbe
- Department of Hematology, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, 40225 Düsseldorf, Germany;
| | - Inken Hilgendorf
- Klinik für Innere Medizin II, Abteilung für Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, 07747 Jena, Germany;
| | - Stefan Klein
- Department of Hematology and Oncology, UMM University Medical Center Mannheim, University of Heidelberg, 68167 Mannheim, Germany;
| | - Mareike Verbeek
- Medical Department, Hematology and Oncology, Klinikum rechts der Isar, Technical University Munich, 81675 Munich, Germany;
| | - Markus Ditschkowski
- Innere Klinik, Tumorforschung, University Hospital Essen, 45147 Essen, Germany;
| | - Martina Koch
- Department of Hepatobiliary Surgery and Transplantation, University Medical Center Hamburg-Eppendorf, 20246 Eppendorf, Hamburg, Germany;
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, 45147 Essen, Germany;
| | - Traudel Schmidt
- Lophius Biosciences, 93053 Regensburg, Germany; (T.S.); (A.R.); (S.B.); (L.D.)
| | - Anne Rascle
- Lophius Biosciences, 93053 Regensburg, Germany; (T.S.); (A.R.); (S.B.); (L.D.)
| | - Sascha Barabas
- Lophius Biosciences, 93053 Regensburg, Germany; (T.S.); (A.R.); (S.B.); (L.D.)
| | - Ludwig Deml
- Lophius Biosciences, 93053 Regensburg, Germany; (T.S.); (A.R.); (S.B.); (L.D.)
| | - Ralf Wagner
- Lophius Biosciences, 93053 Regensburg, Germany; (T.S.); (A.R.); (S.B.); (L.D.)
- Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, 93053 Regensburg, Germany
- Correspondence: (R.W.); (D.W.); Tel.: +49-941-944-6452 (R.W.); +49-941-944-5542 (D.W.)
| | - Daniel Wolff
- Department of Internal Medicine III, Hematology and Oncology, University Medical Center Regensburg, 93053 Regensburg, Germany
- Correspondence: (R.W.); (D.W.); Tel.: +49-941-944-6452 (R.W.); +49-941-944-5542 (D.W.)
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34
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Lindemann M, Krawczyk A, Dolff S, Konik M, Rohn H, Platte M, Thümmler L, Schwarzkopf S, Schipper L, Bormann M, van de Sand L, Breyer M, Klump H, Knop D, Lenz V, Temme C, Dittmer U, Horn PA, Witzke O. SARS-CoV-2-specific humoral and cellular immunity in two renal transplants and two hemodialysis patients treated with convalescent plasma. J Med Virol 2021; 93:3047-3054. [PMID: 33527424 PMCID: PMC8014298 DOI: 10.1002/jmv.26840] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/22/2021] [Accepted: 01/29/2021] [Indexed: 12/24/2022]
Abstract
When patients with chronic kidney disease are infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) they can face two specific problems: virus-specific immune responses may be impaired and remdesivir, an antiviral drug described to shorten recovery, is contraindicated. Antiviral treatment with convalescent plasma (CP) could be an alternative treatment option. In this case report, we present two kidney transplant recipients and two hemodialysis patients who were infected with SARS-CoV-2 and received CP. Antibodies against the receptor-binding domain in the S1 subunit of the SARS-CoV-2 spike protein were determined sequentially by immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) and neutralization assay and specific cellular responses by interferon-gamma ELISpot. Before treatment, in both kidney transplant recipients and one hemodialysis patient antibodies were undetectable by ELISA (ratio < 1.1), corresponding to low neutralizing antibody titers (≤1:40). ELISpot responses in the four patients were either weak or absent. After CP treatment, we observed an increase of SARS-CoV-2-specific antibodies (IgG ratio and neutralization titer) and of specific cellular responses. After intermittent clinical improvement, one kidney transplant recipient again developed typical symptoms on Day 12 after treatment and received a second cycle of CP treatment. Altogether, three patients clinically improved and could be discharged from the hospital. However, one 83-year-old multimorbid patient deceased. Our data suggest that the success of CP therapy may only be temporary in patients with chronic kidney disease; which requires close monitoring of viral load and antiviral immunity and possibly an adaptation of the treatment regimen.
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Affiliation(s)
- Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Adalbert Krawczyk
- Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitätsmedizin Essen, University of Duisburg-Essen, Essen, Germany.,Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sebastian Dolff
- Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitätsmedizin Essen, University of Duisburg-Essen, Essen, Germany
| | - Margarethe Konik
- Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitätsmedizin Essen, University of Duisburg-Essen, Essen, Germany
| | - Hana Rohn
- Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitätsmedizin Essen, University of Duisburg-Essen, Essen, Germany
| | - Maximillian Platte
- Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitätsmedizin Essen, University of Duisburg-Essen, Essen, Germany
| | - Laura Thümmler
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sina Schwarzkopf
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Leonie Schipper
- Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitätsmedizin Essen, University of Duisburg-Essen, Essen, Germany
| | - Maren Bormann
- Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitätsmedizin Essen, University of Duisburg-Essen, Essen, Germany
| | - Lukas van de Sand
- Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitätsmedizin Essen, University of Duisburg-Essen, Essen, Germany
| | - Marianne Breyer
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Hannes Klump
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Dietmar Knop
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Veronika Lenz
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Christian Temme
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ulf Dittmer
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Peter A Horn
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitätsmedizin Essen, University of Duisburg-Essen, Essen, Germany
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35
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Wagner-Drouet E, Teschner D, Wolschke C, Janson D, Schäfer-Eckart K, Gärtner J, Mielke S, Schreder M, Kobbe G, Kondakci M, Hilgendorf I, von Lilienfeld-Toal M, Klein S, Heidenreich D, Kreil S, Verbeek M, Grass S, Ditschkowski M, Gromke T, Koch M, Lindemann M, Hünig T, Schmidt T, Rascle A, Guldan H, Barabas S, Deml L, Wagner R, Wolff D. Standardized monitoring of cytomegalovirus-specific immunity can improve risk stratification of recurrent cytomegalovirus reactivation after hematopoietic stem cell transplantation. Haematologica 2021; 106:363-374. [PMID: 31879324 PMCID: PMC7849569 DOI: 10.3324/haematol.2019.229252] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 12/18/2019] [Indexed: 12/22/2022] Open
Abstract
Recurrence of cytomegalovirus reactivation remains a major cause of morbidity and mortality following allogeneic hematopoietic stem cell transplantation. Monitoring cytomegalovirus-specific cellular immunity using a standardized assay might improve the risk stratification of patients. A prospective multicenter study was conducted in 175 intermediate- and high-risk allogeneic hematopoietic stem cell transplant recipients under preemptive antiviral therapy. Cytomegalovirus-specific cellular immunity was measured using a standardized IFN-γ ELISpot assay (T-Track® CMV). Primary aim was to evaluate the suitability of measuring cytomegalovirus-specific immunity after end of treatment for a first cytomegalovirus reactivation to predict recurrent reactivation. 40/101 (39.6%) patients with a first cytomegalovirus reactivation experienced recurrent reactivations, mainly in the high-risk group (cytomegalovirus-seronegative donor/cytomegalovirus-seropositive recipient). The positive predictive value of T-Track® CMV (patients with a negative test after the first reactivation experienced at least one recurrent reactivation) was 84.2% in high-risk patients. Kaplan-Meier analysis revealed a higher probability of recurrent cytomegalovirus reactivation in high-risk patients with a negative test after the first reactivation (hazard ratio 2.73; p=0.007). Interestingly, a post-hoc analysis considering T-Track® CMV measurements at day 100 post-transplantation, a time point highly relevant for outpatient care, showed a positive predictive value of 90.0% in high-risk patients. Our results indicate that standardized cytomegalovirus-specific cellular immunity monitoring may allow improved risk stratification and management of recurrent cytomegalovirus reactivation after hematopoietic stem cell transplantation. This study was registered at www.clinicaltrials.gov as #NCT02156479.
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Affiliation(s)
- Eva Wagner-Drouet
- Dpt of Hematology, Medical Oncology, and Pneumology, University Medical Center, Mainz, Germany
| | - Daniel Teschner
- Dpt of Hematology, Medical Oncology, and Pneumology, University Medical Center, Mainz, Germany
| | - Christine Wolschke
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Germany
| | - Dietlinde Janson
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Germany
| | - Kerstin Schäfer-Eckart
- Oncology, Hematology and Bone Marrow Transplantation Unit, Klinikum Nord, Nürnberg, Germany
| | - Johannes Gärtner
- Oncology, Hematology and Bone Marrow Transplantation Unit, Klinikum Nord, Nürnberg, Germany
| | - Stephan Mielke
- Department of Laboratory Medicine, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - Martin Schreder
- First Department of Medicine, Center for Oncology and Hematology, Wilhelminenspital, Vienna, Austria
| | - Guido Kobbe
- Department of Hematology, University Hospital, Heinrich Heine University Düsseldorf, Germany
| | - Mustafa Kondakci
- Department of Hematology, University Hospital, Heinrich Heine University Düsseldorf, Germany
| | - Inken Hilgendorf
- Klinik f. Innere Medizin II, Abt. Haematol. und Internist. Onkologie, Univ.-Klinikum Jena, Germany
| | | | - Stefan Klein
- Dpt of Hematology and Oncology, Univ. Medical Center Mannheim, Univ. of Heidelberg, Mannheim,Germany
| | - Daniela Heidenreich
- Dpt of Hematology and Oncology, Univ. Medical Center Mannheim, Univ. of Heidelberg, Mannheim,Germany
| | - Sebastian Kreil
- Dpt of Hematology and Oncology, Univ. Medical Center Mannheim, Univ. of Heidelberg, Mannheim,Germany
| | - Mareike Verbeek
- III. Medical Department, Hematology and Oncology, Klinikum rechts der Isar, TUM, Munich, Germany
| | - Sandra Grass
- III. Medical Department, Hematology and Oncology, Klinikum rechts der Isar, TUM, Munich, Germany
| | | | - Tanja Gromke
- Innere Klinik, Tumorforschung, University Hospital Essen, Germany
| | - Martina Koch
- Dpt of Transplantation Surgery, University Medical Center of the JGU, Mainz, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, Germany
| | - Thomas Hünig
- Institute of Virology and Immunobiology, University Medical Center Würzburg, Germany
| | | | | | | | | | | | - Ralf Wagner
- Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Germany
| | - Daniel Wolff
- Dpt of Internal Medicine III, Hematology and Oncology, University Medical Center Regensburg, Germany
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36
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Gliga S, Fiedler M, Dornieden T, Achterfeld A, Paul A, Horn PA, Herzer K, Lindemann M. Comparison of Three Cellular Assays to Predict the Course of CMV Infection in Liver Transplant Recipients. Vaccines (Basel) 2021; 9:vaccines9020088. [PMID: 33504093 PMCID: PMC7911226 DOI: 10.3390/vaccines9020088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/15/2021] [Accepted: 01/22/2021] [Indexed: 12/15/2022] Open
Abstract
To estimate protection from cytomegalovirus (CMV) replication after solid organ transplantation, CMV serology has been considered insufficient and thus CMV immunity is increasingly assessed by cellular in vitro methods. We compared two commercially available IFN-γ ELISpot assays (T-Track CMV and T-SPOT.CMV) and an IFN-γ ELISA (QuantiFERON-CMV). Currently, there is no study comparing these three assays. The assays were performed in 56 liver transplant recipients at the end of antiviral prophylaxis and one month thereafter. In CMV high- or intermediate-risk patients the two ELISpot assays showed significant correlation (p < 0.0001, r > 0.6) but the correlation of the ELISpot assays with QuantiFERON-CMV was weaker. Results of both ELISpot assays were similarly predictive of protection from CMV-DNAemia ≥500 copies/mL [CMV pp65 T-SPOT.CMV at the end of prophylaxis: area under curve (AUC) = 0.744, cut-off 142 spot forming units (SFU), sensitivity set to 100%, specificity 46%; CMV IE-1 T-Track CMV at month 1: AUC = 0.762, cut-off 3.5 SFU, sensitivity set to 100%, specificity 59%]. The QuantiFERON-CMV assay was inferior, reaching a specificity of 23% when setting the sensitivity to 100%. In conclusion, both CMV-specific ELISpot assays appear suitable to assess protection from CMV infection/reactivation in liver transplant recipients.
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Affiliation(s)
- Smaranda Gliga
- Institute for Transfusion Medicine, University Hospital Essen, Virchowstraße 179, 45147 Essen, Germany; (S.G.); (T.D.); (P.A.H.)
- Institute for Virology, University Hospital Essen, University Essen-Duisburg, 45147 Essen, Germany;
| | - Melanie Fiedler
- Institute for Virology, University Hospital Essen, University Essen-Duisburg, 45147 Essen, Germany;
| | - Theresa Dornieden
- Institute for Transfusion Medicine, University Hospital Essen, Virchowstraße 179, 45147 Essen, Germany; (S.G.); (T.D.); (P.A.H.)
| | - Anne Achterfeld
- Department of Gastroenterology and Hepatology, University Hospital Essen, University Essen-Duisburg, 45147 Essen, Germany; (A.A.); (K.H.)
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University Essen-Duisburg, 45147 Essen, Germany;
| | - Andreas Paul
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University Essen-Duisburg, 45147 Essen, Germany;
| | - Peter A. Horn
- Institute for Transfusion Medicine, University Hospital Essen, Virchowstraße 179, 45147 Essen, Germany; (S.G.); (T.D.); (P.A.H.)
| | - Kerstin Herzer
- Department of Gastroenterology and Hepatology, University Hospital Essen, University Essen-Duisburg, 45147 Essen, Germany; (A.A.); (K.H.)
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University Essen-Duisburg, 45147 Essen, Germany;
- Knappschaftsklinik Bad Neuenahr, 53474 Bad Neuenahr-Ahrweiler, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, Virchowstraße 179, 45147 Essen, Germany; (S.G.); (T.D.); (P.A.H.)
- Correspondence: ; Tel.: +49-201-723-4217
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Schwarzkopf S, Krawczyk A, Knop D, Klump H, Heinold A, Heinemann FM, Thümmler L, Temme C, Breyer M, Witzke O, Dittmer U, Lenz V, Horn PA, Lindemann M. Cellular Immunity in COVID-19 Convalescents with PCR-Confirmed Infection but with Undetectable SARS-CoV-2-Specific IgG. Emerg Infect Dis 2020; 27. [PMID: 33058753 DOI: 10.3201/2701.203772] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
We investigated immune responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among a group of convalescent, potential blood donors in Germany who had PCR-confirmed SARS-CoV-2 infection. Sixty days after onset of symptoms, 13/78 (17%) study participants had borderline or negative results to an ELISA detecting IgG against the S1 protein of SARS-CoV-2. We analyzed participants with PCR-confirmed infection who had strong antibody responses (ratio >3) as positive controls and participants without symptoms of SARS-CoV-2 infection and without household contact with infected patients as negative controls. Using interferon-γ ELISpot, we observed that 78% of PCR-positive volunteers with undetectable antibodies showed T cell immunity against SARS-CoV-2. We observed a similar frequency (80%) of T-cell immunity in convalescent donors with strong antibody responses but did not detect immunity in negative controls. We concluded that, in convalescent patients with undetectable SARS-CoV-2 IgG, immunity may be mediated through T cells.
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Korth J, Wilde B, Dolff S, Anastasiou OE, Krawczyk A, Jahn M, Cordes S, Ross B, Esser S, Lindemann M, Kribben A, Dittmer U, Witzke O, Herrmann A. SARS-CoV-2-specific antibody detection in healthcare workers in Germany with direct contact to COVID-19 patients. J Clin Virol 2020; 128:104437. [PMID: 32434708 PMCID: PMC7219425 DOI: 10.1016/j.jcv.2020.104437] [Citation(s) in RCA: 234] [Impact Index Per Article: 58.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/10/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The novel coronavirus SARS-CoV-2 is associated with a severe respiratory manifestation, COVID-19, and presents a challenge for healthcare systems worldwide. Healthcare workers are a vulnerable cohort for SARS-CoV-2 infection due to frequent and close contact to patients with COVID-19. STUDY DESIGN Serum samples from 316 healthcare workers of the University Hospital Essen, Germany were tested for SARS-CoV-2-IgG antibodies. A questionnaire was used to collect demographic and clinical data. Healthcare workers were grouped depending on the frequency of contact to COVID-19 patients in high-risk-group (n = 244) with daily contact to known or suspected SARS-CoV-2 positive patients, intermediated-risk-group (n = 37) with daily contact to patients without known or suspected SARS-CoV-2 infection at admission and low-risk-group (n = 35) without patient contact. RESULTS In 5 of 316 (1.6 %) healthcare workers SARS-CoV-2-IgG antibodies could be detected. The seroprevalence was higher in the intermediate-risk-group vs. high-risk-group (2/37 (5.4 %) vs. 3/244 (1.2 %), p = 0.13). Four of the five subject were tested negative for SARS-CoV-2 via PCR. One (20 %) subject was not tested via PCR since he was asymptomatic. CONCLUSION The overall seroprevalence of SARS-CoV-2 in healthcare workers of a tertiary hospital in Germany is low (1.6 %). The data indicate that the local hygiene standard might be effective.
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Affiliation(s)
- Johannes Korth
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany.
| | - Benjamin Wilde
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Sebastian Dolff
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Olympia E Anastasiou
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Virchowstr. 179, 45147 Essen, Germany
| | - Adalbert Krawczyk
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Michael Jahn
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Sebastian Cordes
- Department of Pneumology, University Hospital Essen, University Hospital Essen, Tüschener Weg 40, 45239 Essen, Germany
| | - Birgit Ross
- Hospital Hygiene, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Stefan Esser
- Clinic of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Andreas Kribben
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Ulf Dittmer
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Virchowstr. 179, 45147 Essen, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Anke Herrmann
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Virchowstr. 179, 45147 Essen, Germany
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Creagh AP, Simillion C, Scotland A, Lipsmeier F, Bernasconi C, Belachew S, van Beek J, Baker M, Gossens C, Lindemann M, De Vos M. Smartphone-based remote assessment of upper extremity function for multiple sclerosis using the Draw a Shape Test. Physiol Meas 2020; 41:054002. [DOI: 10.1088/1361-6579/ab8771] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Grutza R, Moskorz W, Senff T, Bäcker E, Lindemann M, Zimmermann A, Uhrberg M, Lang PA, Timm J, Cosmovici C. NKG2C pos NK Cells Regulate the Expansion of Cytomegalovirus-Specific CD8 T Cells. J Immunol 2020; 204:2910-2917. [PMID: 32284334 DOI: 10.4049/jimmunol.1901281] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 03/31/2020] [Indexed: 12/17/2023]
Abstract
Infection with the human CMV associates with phenotypic alterations in lymphocyte subsets. A highly reproducible finding in CMV-seropositive individuals is an expansion of NKG2Cpos NK cells. In this study, we analyzed if the altered NK cell compartment in CMV-seropositive human donors may affect CMV-specific CD8 T cells. Resting CMV-specific CD8 T cells were terminally differentiated and expressed high levels of the NKG2C ligand HLA-E. Activation of CMV-specific CD8 T cells with the cognate Ag further increased HLA-E expression. In line with a negative regulatory effect of NKG2Cpos NK cells on HLA-Ehigh CD8 T cells, depletion of NKG2Cpos NK cells enhanced Ag-specific expansion of CMV-specific CD8 T cells in vitro. In turn, the activation of NK cells in coculture with CMV-specific CD8 T cells promoted a selective loss of HLA-Ehigh CD8 T cells. To test if NKG2Cpos NK cells can target HLA-Ehigh CD8 T cells, Jurkat T cells with and without stabilized HLA-E on the surface were used. NKG2Cpos NK cells stimulated with HLA-Ehigh Jurkat cells released higher levels of Granzyme B compared with NKG2Cneg NK cells and NKG2Cpos NK cells stimulated with HLA-Elow Jurkat cells. Moreover, intracellular levels of caspase 3/7 were increased in HLA-Ehigh Jurkat cells compared with HLA-Elow Jurkat cells, consistent with higher rates of apoptosis in HLA-Ehigh T cells in the presence of NKG2Cpos NK cells. Our data show that NKG2Cpos NK cells interact with HLA-Ehigh CD8 T cells, which may negatively regulate the expansion of CMV-specific CD8 T cells upon activation.
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Affiliation(s)
- Ralf Grutza
- Institute of Virology, University Hospital Düsseldorf, Heinrich Heine University, Medical Faculty, 40225 Düsseldorf, Germany
| | - Wiebke Moskorz
- Institute of Virology, University Hospital Düsseldorf, Heinrich Heine University, Medical Faculty, 40225 Düsseldorf, Germany
| | - Tina Senff
- Institute of Virology, University Hospital Düsseldorf, Heinrich Heine University, Medical Faculty, 40225 Düsseldorf, Germany
| | - Eugen Bäcker
- Institute of Virology, University Hospital Düsseldorf, Heinrich Heine University, Medical Faculty, 40225 Düsseldorf, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Albert Zimmermann
- Institute of Virology, University Hospital Düsseldorf, Heinrich Heine University, Medical Faculty, 40225 Düsseldorf, Germany
| | - Markus Uhrberg
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Düsseldorf, Heinrich Heine University, 40225 Düsseldorf, Germany; and
| | - Philipp A Lang
- Department of Molecular Medicine II, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University, 40225 Düsseldorf, Germany
| | - Jörg Timm
- Institute of Virology, University Hospital Düsseldorf, Heinrich Heine University, Medical Faculty, 40225 Düsseldorf, Germany
| | - Christine Cosmovici
- Institute of Virology, University Hospital Düsseldorf, Heinrich Heine University, Medical Faculty, 40225 Düsseldorf, Germany;
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Oesterreich S, Lindemann M, Goldblatt D, Horn PA, Wilde B, Witzke O. Humoral response to a 13-valent pneumococcal conjugate vaccine in kidney transplant recipients. Vaccine 2020; 38:3339-3350. [PMID: 32178906 DOI: 10.1016/j.vaccine.2020.02.088] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/30/2019] [Accepted: 02/29/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Vaccination against S. pneumoniae is recommended by national guidelines. Moderate immunogenicity of the 13-valent pneumococcal conjugate vaccine (PCV13) has been reported in adult kidney transplant recipients (KTR). This study further defines the immunogenicity of PCV13 in this cohort. METHODS 49 KTR were immunized with PCV13. A validated opsonophagocytic killing assay (OPA), a global anti-pneumococcal capsular polysaccharide (anti-PCP) IgG, IgG2, IgM and IgA ELISA, and - for selected patients - a serotype specific anti-PCP WHO reference ELISA were performed pre-vaccination and at month 1 and 12 post-vaccination. RESULTS Geometric mean OPA titers increased significantly for 13/13 serotypes at month 1 and for 10/13 serotypes at month 12 post-vaccination. Vaccine response defined as an OPA titer ≥1:8 was reached in 9/13 serotypes (median). 53% reached the vaccine response criteria at month 1 and 45% at month 12. At month 1 after vaccination, the median OPA titer in an age-group matched healthy reference population was 5- to 10-fold higher than in KTR. OPA titers correlated strongly with results to the global and serotype specific anti-PCP IgG ELISA. Lower OPA titers significantly (p < 0.05) correlated with albuminuria, an interval between vaccination and transplantation <12 months, age and treatment with mycophenolate mofetil. Global IgG, IgG2, IgM and IgA, as well as serotype specific anti-PCP antibody concentrations (12/13 serotypes) increased significantly at month 1 and 12 post-vaccination. CONCLUSIONS Kidney transplant recipients show a significant humoral response after vaccination with PCV13. Functional antibody response exists, but is not as vigorous as in healthy adults.
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Affiliation(s)
- Simon Oesterreich
- Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
| | - David Goldblatt
- University College London, Institute of Child Health, London, United Kingdom; World Health Organisation, Pneumococcal Serology Reference Laboratory, London, United Kingdom
| | - Peter A Horn
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Benjamin Wilde
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
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Kordelas L, Schwich E, Lindemann M, Heinemann FM, Buttkereit U, Horn PA, Beelen DW, Rebmann V. Decreased Soluble Human Leukocyte Antigen E Levels in Patients After Allogeneic Hematopoietic Stem Cell Transplantation Are Associated With Severe Acute and Extended Chronic Graft-versus-Host Disease and Inferior Overall Survival. Front Immunol 2020; 10:3027. [PMID: 31998310 PMCID: PMC6966962 DOI: 10.3389/fimmu.2019.03027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/10/2019] [Indexed: 12/13/2022] Open
Abstract
HLA-E is a member of the non-classical HLA molecules and by interaction with activating or inhibitory receptors of NK and T cells, HLA-E can lead to immune activation or suppression context-dependently. Recently, the non-classical HLA molecules gain more attention in the setting of allogeneic hematopoietic stem cell transplantation (HSCT). Most studies so far have focused on the two most frequent genotypes (HLA-E*01:01 and HLA-E*01:03) and investigated their potential association with clinical endpoints of HSCT, like graft-versus-host disease (GvHD), relapse, and overall survival (OS). However, these studies have produced inconsistent results regarding the role of HLA-E and the clinical endpoints after HSCT. We therefore here investigate the amount of soluble HLA-E (sHLA-E) in patients following HSCT and relate this to the clinical endpoints after HSCT. In univariate analysis, we observe a significant association of reduced levels of sHLA-E with severe acute GvHD, extended chronic GvHD and with inferior OS. Using receiver operating characteristic analyses specific thresholds obtained 1, 2, or 3 month(s) after HSCT were identified being indicative for severe acute GvHD, extended chronic GvHD, or inferior OS. In sub-group analyses, this effect can be confirmed in patients not treated with ATG, but is derogated in ATG-treated patients. Notably, we could not detect any association of the course of sHLA-E levels post-HSCT with the three most frequent HLA-E genotypes (HLA-E*01:03/*01:03, HLA-E*01:01/*01:01, HLA-E*01:01/*01:03). However, with regard to 5-year-OS there was an association of HLA-E*01:03 homozygosity with inferior OS. Taking ATG-treatment, recipient and donor HLA-E genotypes into consideration among other well-known risk factors, the sHLA-E status was found as an independent predictor for the development of extended cGvHD and inferior OS following HSCT irrespective of the sHLA-E thresholds. These findings shed some light on the possible impact of reduced sHLA-E levels after HSCT on GvHD and OS. Thus, sHLA-E appears to be a novel promising candidate for the prediction of clinical HSCT outcome with regards to extended cGvHD and OS.
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Affiliation(s)
- Lambros Kordelas
- Department of Bone Marrow Transplantation, University Hospital Essen, Essen, Germany
| | - Esther Schwich
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Falko M. Heinemann
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Ulrike Buttkereit
- Department of Bone Marrow Transplantation, University Hospital Essen, Essen, Germany
| | - Peter A. Horn
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Dietrich W. Beelen
- Department of Bone Marrow Transplantation, University Hospital Essen, Essen, Germany
| | - Vera Rebmann
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
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Kelley M, Rentfrow G, Lindemann M, Wang D. Effect of Different Fat Sources and Vitamin E Isoforms/Levels on Carcass Characteristics and Meat Quality of Pigs Grown to 150 Kg. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb.10813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
ObjectivesThe objective was to evaluate the effect of supplementing α- and γ-tocopherol vitamin E isoforms with corn oil and tallow on carcass characteristics and meat quality of pigs grown to heavier weights (>150 kg).Materials and MethodsIndividually fed pigs (n = 72; 36 barrows, 36 gilts; 28.55 ± 1.16 kg) were randomly assigned to 12 dietary treatments in a 2 × 6 factorial arrangement. Fat treatments were tallow and corn oil (5?). The vitamin E treatments included four levels of α-tocopheryl-acetate (ATA; 11, 40, 100, and 200 ppm) and two levels of mixed tocopherols (primarily γ-tocopherol; 40 and 100 ppm). Pigs were humanely slaughtered at approximately 150 kg. 45 min pH was taken at the 10th rib. After 24 h chill (4°C), carcass measurements were taken (carcass length, backfat depth at first rib, last rib, 10th rib and last lumbar, loin muscle area, and 24 h pH at the 10th rib). In addition, wholesale weights from the Boston butt (IMPS #406), shoulder picnic (IMPS #405), loin (IMPS #412), and belly (IMPS #408) and spareribs were recorded. Furthermore, bellies were divided into eight sections and the average depth was taken at each section and the vertical and lateral belly flex was measured. Drip loss was determined by suspending a 1.3cm chop at 4°C for 48 h and purge loss was determined from approximately 2kg vacuum packaged loin muscle sections at 0, 7, 14, and 30d. Objective (Hunter Lab Colorimeter XE Plus) and subjective (NPPC color, marbling and firmness scores) measurements were taken at the 10th rib. Data analysis were performed in SAS by least squares analysis of variance using the generalized linear model as a randomized complete block design. The individual pig served as the experimental unit and results were reported as least square means.ResultsThere were no differences in dressing percentage, 24 h pH, backfat depth, loin muscle area, primal cuts, purge loss, and drip loss between the two vitamin E isoforms. Fat treatments did not affect dressing percentage, 45 min and 24 h pH, backfat depth, loin muscle area, primal cuts, purge loss, drip loss as well as objective and subjective color. Although not significant (P = 0.07), pork from the γ-tocopherol pigs had a lower pH than the ATA treatment. The γ-tocopherol supplementation tended to have a lighter subjective color (P = 0.06) as well as increased L*, decreased a*, and increased the hue angle calculations at 7d shelf-life. The belly depth was greater (P = 0.01) along with higher lateral (P < 0.01) and a lower vertical (P < 0.01) flex for pigs fed tallow.ConclusionIn conclusion, feeding tallow to heavy weight pigs (150 kg) could improve belly firmness. Also, α-tocopherol did not improve shelf-life stability and γ-tocopherol could negatively affect subject and objective pork loin color.
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Affiliation(s)
- M. Kelley
- University of Kentucky Animal and Food Science
| | - G. Rentfrow
- University of Kentucky Animal and Food Science
| | | | - D. Wang
- University of Kentucky Animal and Food Science
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Fischer D, Ewing S, Wolf D, Pointeau G, Zhang Y, Lipsmeier F, Qian Y, Eng L, Salazar R, Dunaway Young S, Sprengel J, Czech C, Gossens C, Lindemann M. P.190Feasibility, reliability and convergent validity for digital biomarkers captured via a smartphone application (app) to assess motor behaviors in individuals with spinal muscular atrophy (SMA) in the JEWELFISH trial. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Malewicz NM, Walstein K, Heine T, Engler A, Bick A, Cox L, Dötsch A, Westendorf AM, Horn PA, Lindemann M, Peters J, Schäfer ST. Early suppression of peripheral mononuclear blood cells in sepsis in response to stimulation with cytomegalovirus, OKT3, and pokeweed mitogen. J Appl Physiol (1985) 2019; 127:1539-1547. [PMID: 31545153 DOI: 10.1152/japplphysiol.00438.2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Critically ill patients are at risk for sepsis, and immunosuppressive mechanisms may prevail. Whether functional tests are helpful to detect immune alterations is largely unknown. Therefore, we tested the hypotheses that reactivity of peripheral blood mononuclear cells (PBMCs) to secrete interferon-γ (IFNγ) following stimulation in vitro is decreased in patients with early sepsis compared with postoperative patients. IFNγ secretion [enzyme-linked immunospot (ELISpot)] in response to stimulation with cytomegalovirus (CMV), pokeweed mitogen (PWM), muromonab-anti-CD3 (OKT3), and human leukocyte antigen (HLA)-DRA-mRNA expression and serum cytokine concentrations were repeatedly [days 1, 3, 5, and 7 after intensive care unit (ICU) admission] determined in patients with sepsis (n = 7) and patients undergoing major abdominal surgery (radical prostatectomy, cystectomy, n = 10). In a second cohort, HLA-DRA expression was assessed in 80 patients with sepsis, 30 postoperative patients, and 44 healthy volunteers (German clinical trials database no. 00007694). In patients with sepsis, IFNγ secretion (ELISpot) was decreased compared with controls after stimulation with CMV (P = 0.01), OKT3 (P = 0.02), and PWM (P = 0.02 on day 5), whereas unstimulated IFNγ secretion did not differ. HLA-DRA expression was also significantly decreased in patients with sepsis at all time points (P = 0.004) compared with postoperative surgical patients, a finding confirmed in the larger cohort. Reactivity of PBMCs to stimulation with CMV, PWM, and OKT3 as well as HLA-DRA expression was already decreased upon ICU admission in patients with sepsis when compared with postoperative controls, suggesting early depression of acquired immunity. ELISpot assays may help to clinically characterize the time course of immunocompetence in patients with sepsis.NEW & NOTEWORTHY We observed suppression of reactivity to stimulation with cytomegalovirus, muromonab-anti-CD3, and pokeweed mitogen in mononuclear blood cells of patients with early sepsis when compared with postoperative controls. Thus, there is early depression of acquired immunity in sepsis. Enzyme-linked immunospot assays may help to characterize immunocompetence in patients with sepsis.
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Affiliation(s)
- N M Malewicz
- Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen & Universitätsklinikum, Essen, Germany
| | - K Walstein
- Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen & Universitätsklinikum, Essen, Germany
| | - T Heine
- Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen & Universitätsklinikum, Essen, Germany
| | - A Engler
- Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen & Universitätsklinikum, Essen, Germany
| | - A Bick
- Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen & Universitätsklinikum, Essen, Germany
| | - L Cox
- Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen & Universitätsklinikum, Essen, Germany
| | - A Dötsch
- Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen & Universitätsklinikum, Essen, Germany
| | - A M Westendorf
- Institute for Medical Microbiology, Universität Duisburg-Essen & Universitätsklinikum, Essen, Germany
| | - P A Horn
- Institute for Transfusion Medicine, Universität Duisburg-Essen & Universitätsklinikum, Essen, Germany
| | - M Lindemann
- Institute for Transfusion Medicine, Universität Duisburg-Essen & Universitätsklinikum, Essen, Germany
| | - J Peters
- Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen & Universitätsklinikum, Essen, Germany
| | - S T Schäfer
- Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen & Universitätsklinikum, Essen, Germany.,Department of Anaesthesiology, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich, Germany
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Thoens C, Heinold A, Lindemann M, Horn PA, Chang DI, Scherbaum N, Timm J, Heinemann FM. A Single-Nucleotide Polymorphism Upstream of the HLA-C Locus Is Associated With an Anti-Hepatitis C Virus-Seronegative State in a High-Risk Exposed Cohort. J Infect Dis 2019; 218:2016-2019. [PMID: 30102364 DOI: 10.1093/infdis/jiy492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 08/07/2018] [Indexed: 02/07/2023] Open
Abstract
In this study, we examined the impact of the rs9264942 single-nucleotide polymorphism, previously shown to be associated with human immunodeficiency virus infection status and HLA-C expression, on the hepatitis C virus status in 359 people who inject drugs (PWID). The linkage of rs9264942 alleles to HLA-C antigens assigned to different expression levels was confirmed. Multivariate analysis revealed the age (P = .003) and the rs9264942 genotype (P = .006) to be independent factors for the classification to the PWID groups. Our study showed that the presence of the rs9264942 C/C genotype was associated with persistent seronegativity.
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Affiliation(s)
- Christine Thoens
- Institute of Virology, University Hospital Duesseldorf, Heinrich Heine University, Germany
| | - Andreas Heinold
- Institute for Transfusion Medicine, University Hospital Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, Germany
| | - Peter A Horn
- Institute for Transfusion Medicine, University Hospital Essen, Germany
| | - Dae-In Chang
- LVR-Hospital Essen, Department of Addictive Behaviour and Addiction Medicine, Medical Faculty, University of Duisburg-Essen, Germany
| | - Norbert Scherbaum
- LVR-Hospital Essen, Department of Addictive Behaviour and Addiction Medicine, Medical Faculty, University of Duisburg-Essen, Germany
| | - Joerg Timm
- Institute of Virology, University Hospital Duesseldorf, Heinrich Heine University, Germany
| | - Falko M Heinemann
- Institute for Transfusion Medicine, University Hospital Essen, Germany
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Domouchtsidou A, Barsegian V, Mueller SP, Lobachevsky P, Best J, Horn PA, Bockisch A, Lindemann M. DNA lesions correlate with lymphocyte function after selective internal radiotherapy. Cancer Immunol Immunother 2019; 68:907-915. [PMID: 30877323 PMCID: PMC11028059 DOI: 10.1007/s00262-019-02323-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 03/11/2019] [Indexed: 12/24/2022]
Abstract
In patients with non-resectable hepatic malignancies selective internal radiotherapy (SIRT) with yttrium-90 is an effective therapy. However, previous data indicate that SIRT leads to impaired immune function. The aim of the current study was to determine the extent of DNA lesions in peripheral blood mononuclear cells of SIRT patients and to correlate these lesions with cellular immune responses. In ten patients γH2AX and 53BP1 foci were determined. These foci are markers of DNA double-strand breaks (DSBs) and occur consecutively. In parallel, lymphocyte proliferation was assessed after stimulation with the T cell mitogen phytohemagglutinin. Analyses of vital cells were performed prior to and 1 h and 1 week after SIRT. 1 h and 1 week after SIRT numbers of γH2AX and of 53BP1 foci were more than threefold larger than before (p < 0.01). Already at baseline, foci were more abundant than published in healthy controls. Lymphocyte proliferation at baseline was below the normal range and further decreased after SIRT. Prior to therapy, there was an inverse correlation between lymphocyte proliferation and the quotient 53BP1/γH2AX; which could be considered as a measure of the course of DNA DSB repair (r = - 0.94, p < 0.0001). Proliferative responses were inversely correlated with 53BP1 foci prior to therapy and γH2AX and 53BP1 foci 1 h after therapy (r < - 0.65, p < 0.05). In conclusion, DNA foci in SIRT patients were correlated with impaired in vitro immune function. Unrepaired DNA DSBs or cell cycle arrest due to repair may cause this impairment.
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Affiliation(s)
- Aglaia Domouchtsidou
- Institute for Transfusion Medicine, University Hospital Essen, Virchowstraße 179, 45147, Essen, Germany
| | - Vahé Barsegian
- Institute of Nuclear Medicine, Helios Kliniken, Schwerin, Germany
| | - Stefan P Mueller
- Department of Nuclear Medicine, University Hospital, Essen, Germany
| | | | - Jan Best
- Department of Gastroenterology and Hepatology, University Hospital, Essen, Germany
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Peter A Horn
- Institute for Transfusion Medicine, University Hospital Essen, Virchowstraße 179, 45147, Essen, Germany
| | - Andreas Bockisch
- Department of Nuclear Medicine, University Hospital, Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, Virchowstraße 179, 45147, Essen, Germany.
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Wagner E, Teschner D, Wolschke C, Janson D, Schaefer-Eckart K, Gaertner J, Mielke S, Schreder M, Kobbe G, Kondakci M, Klein S, Heidenreich D, Kreil S, Hilgendorf I, von Lilienfeld-Toal M, Verbeek M, Grass S, Ditschkowski M, Gromke T, Koch M, Huenig T, Lindemann M, Schmidt T, Rascle A, Guldan H, Barabas S, Deml L, Wagner R, Wolff D. Clinical Validation of a Novel Elispot-Based Diagnostic Assay: Monitoring Cytomegalovirus-Specific Cell-Mediated Immunity and Risk Stratification in Hematopoietic Stem Cell Transplant Recipients. Biol Blood Marrow Transplant 2019. [DOI: 10.1016/j.bbmt.2018.12.555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kelley M, Rentfrow G, Lindemann M, Wang D. Effect of Different Fat Sources and Vitamin E Isoforms/Levels on Carcass Characteristics and Meat Quality of Pigs Grown to 150 Kg. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb2019.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Banas B, Steubl D, Renders L, Chittka D, Banas M, Wekerle T, Koch M, Witzke O, Lindemann M, Muehlfeld A, Sommerer C, Habicht A, Hugo C, Huenig T, Mielke S, Schreder M, Wagner E, Teschner D, Klein S, Heidenreich D, Kreil S, Schaefer-Eckart K, Gaertner J, Verbeek M, Grass S, Wolschke C, Janson D, Kobbe G, Kondakci M, Ditschkowski M, Gromke T, Hilgendorf I, Lilienfeld-Toal MV, Schmidt T, Rascle A, Barabas S, Deml L, Wagner R, Kraemer B, Krueger B, Wolff D. 1575. Clinical Validation of a Novel ELISpot-based in vitro Diagnostic Assay to Monitor CMV-Specific Cell-Mediated Immunity in SOT and HSCT Immunocompromised Patients. Open Forum Infect Dis 2018. [PMCID: PMC6252655 DOI: 10.1093/ofid/ofy210.1403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Impaired cytomegalovirus (CMV)-specific cell-mediated immunity (CMV-CMI) is a major cause of uncontrolled CMV reactivation and associated complications in both solid-organ transplantation (SOT) and hematopoietic stem cell transplantation (HSCT). Reliably assessing CMV-CMI is desirable to individually adjust antiviral and immunosuppressive therapy. We demonstrate here the suitability of a novel IFN-γ ELISpot assay (T-Track® CMV), based on the stimulation of PBMC with pp65 and IE-1 CMV proteins, to monitor CMV-CMI in SOT and HSCT patients. Methods Two independent prospective, longitudinal, observational, multicenter studies were conducted: in 86 intermediate-risk (D−/R+, D+/R+) renal transplant recipients (completed), and in 175 intermediate- or high-risk (D+/R+, D+/R−, D−/R+) HSCT recipients (ongoing). In both studies, patients underwent pre-emptive antiviral therapy. CMV-CMI, CMV load and clinical complications were monitored over ~6 months post-transplantation. Results In the kidney transplantation setting, 95% and 88–92% of IFN-γ ELISpot test results were positive pre- and post-transplantation, respectively. CMV-specific response was reduced following immunosuppressive therapy and increased in patients with graft rejection, indicating the ability of the assay to monitor the patients’ immunosuppressive state. Interestingly, median pp65-specific response was 9-fold higher in patients with self-clearing viral load compared with antivirally-treated patients prior to first detection of CMV (MWU; P < 0.001), suggesting that reactivity to pp65 is a potential immunocompetence marker. In HSCT patients, interim data analysis indicates that pp65-specific CMI measured after resolution of a primary CMV reactivation (requiring antiviral treatment) is a fair predictor of occurrence of recurrent CMV reactivation. Out of 71 patients (25 D+/R+, 3 D+/R−, 43 D−/R+) who experienced a primary CMV reactivation, 27 encountered a recurrent CMV reactivation. Interestingly, 39/44 (89%) patients free of recurrent reactivation had a positive pp65-specific test result following primary CMV reactivation. Conclusion Altogether, this novel IFN-γ ELISpot assay is a highly sensitive immune-monitoring tool with a potential use for the risk assessment of CMV-related clinical complications after SOT and HSCT. Disclosures All authors, Lophius Biosciences: Investigator, Research support.
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Affiliation(s)
- Bernhard Banas
- University Medical Center Regensburg, Regensburg, Germany
| | | | - Lutz Renders
- Klinikum rechts der Isar TU Munich, Munich, Germany
| | | | - Miriam Banas
- University Medical Center Regensburg, Regensburg, Germany
| | | | - Martina Koch
- UKE University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | | | | | | | - Thomas Huenig
- University Medical Center Wuerzburg, Wuerzburg, Germany
| | | | | | - Eva Wagner
- University Medical Center of the JGU Mainz, Mainz, Germany
| | | | - Stefan Klein
- UMM University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Daniela Heidenreich
- UMM University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sebastian Kreil
- UMM University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | | | | | | | - Sandra Grass
- Klinikum rechts der Isar TU Munich, Munich, Germany
| | | | - Dietlinde Janson
- UKE University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Guido Kobbe
- University Medical Center Duesseldorf, Duesseldorf, Germany
| | | | | | | | | | | | | | | | | | | | - Ralf Wagner
- University Medical Center Regensburg, Regensburg, Germany
- Lophius Biosciences, Regensburg, Germany
| | - Bernhard Kraemer
- UMM University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Bernd Krueger
- UMM University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Daniel Wolff
- University Medical Center Regensburg, Regensburg, Germany
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