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. 2024 Mar 1;12(3):264.
doi: 10.3390/vaccines12030264.

Antibody Response after 3-Dose Booster against SARS-CoV-2 mRNA Vaccine in Kidney Transplant Recipients

Domenico Tripodi  1   2 , Roberto Dominici  1 , Davide Sacco  3   4 , Gennaro Santorelli  5 , Rodolfo Rivera  5 , Sandro Acquaviva  6 , Marino Marchisio  6 , Paolo Brambilla  1   2 , Graziana Battini  5 , Valerio Leoni  1   2
Affiliations

Antibody Response after 3-Dose Booster against SARS-CoV-2 mRNA Vaccine in Kidney Transplant Recipients

Domenico Tripodi et al. Vaccines (Basel). .

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with a high rate of mortality in kidney transplant recipients (KTRs). Current vaccine strategies for KTRs seem to be unable to provide effective protection against coronavirus disease 2019 (COVID-19), and the occurrence of severe disease in some vaccinated KTRs suggested a lack of immunity. We initially analyzed the antibody response in a group of 32 kidney transplant recipients (KTRs) followed at the nephrology and dialysis unit of the Hospital Pio XI of Desio, ASST-Brianza, Italy. Thus, we studied the differences in antibody levels between subjects who contracted SARS-CoV-2 after the booster (8 individuals) and those who did not contract it (24 individuals). Furthermore, we verified if the antibody response was in any way associated with creatinine and eGFR levels. We observed a significant increase in the antibody response pre-booster compared to post-booster using both a Roche assay and DIAPRO assay. In the latter, through immunotyping, we highlight that the major contribution to this increase is specifically due to IgG S1 IgM S2. We observed a significant increase in IgA S1 and IgA NCP (p = 0.045, 0.02) in the subjects who contracted SARS-CoV-2. We did not find significant associations for the p-value corrected for false discovery rate (FDR) between the antibody response to all assays and creatinine levels. This observation allows us to confirm that patients require additional vaccine boosters due to their immunocompromised status and therapy in order to protect them from infections related to viral variants. This is in line with the data reported in the literature, and it could be worthwhile to deeply explore these phenomena to better understand the role of IgA S1 and IgA NCP antibodies in SARS-CoV-2 infection.

Keywords: COVID-19; NCP protein antigens; S1; S2; immunosuppressive drugs; kidney transplantation; mRNA vaccines.

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Conflict of interest statement

Authors Sandro Acquaviva, Marino Marchisio were employed by the company Diagnostics Bioprobes s.r.l. DIA.PRO. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
In (A), paired boxplots for the Roche and DIAPRO assays are displayed. In each graph, the left side represents the pre-booster status (T0) while the right side shows the post-booster scenario (T1). (B) shows a detailed analysis of the immunotyping assay (DIAPRO), specifically, the production of the Ig classes (IgG, IgA, IgM) targeted against the S1, S2, and NCP antigens. Results are provided as natural logarithms to enhance the graphical visualization. In (C), the boxplots represent delta values (post-booster—pre-booster) of the IgA S1 and IgA NCP that were significant in the Wilcoxon test, divided between those who contracted infection (colored in red) and those who did not contract it after the booster (colored in blue).
Figure 1
Figure 1
In (A), paired boxplots for the Roche and DIAPRO assays are displayed. In each graph, the left side represents the pre-booster status (T0) while the right side shows the post-booster scenario (T1). (B) shows a detailed analysis of the immunotyping assay (DIAPRO), specifically, the production of the Ig classes (IgG, IgA, IgM) targeted against the S1, S2, and NCP antigens. Results are provided as natural logarithms to enhance the graphical visualization. In (C), the boxplots represent delta values (post-booster—pre-booster) of the IgA S1 and IgA NCP that were significant in the Wilcoxon test, divided between those who contracted infection (colored in red) and those who did not contract it after the booster (colored in blue).
Figure 1
Figure 1
In (A), paired boxplots for the Roche and DIAPRO assays are displayed. In each graph, the left side represents the pre-booster status (T0) while the right side shows the post-booster scenario (T1). (B) shows a detailed analysis of the immunotyping assay (DIAPRO), specifically, the production of the Ig classes (IgG, IgA, IgM) targeted against the S1, S2, and NCP antigens. Results are provided as natural logarithms to enhance the graphical visualization. In (C), the boxplots represent delta values (post-booster—pre-booster) of the IgA S1 and IgA NCP that were significant in the Wilcoxon test, divided between those who contracted infection (colored in red) and those who did not contract it after the booster (colored in blue).
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