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Published on: May 2, 2013
RSVPreF3OA vaccine responses in kidney transplant recipients and dialysis patients versus healthy controls
Hector Rincon-Arevalo1,2,3,4, Fabian Halleck1, Dorottya Böger3
1Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Insights
Respiratory syncytial virus (RSV) vaccination in kidney transplant recipients (KTR) induced robust immune responses comparable to healthy controls. Dialysis patients (DP) showed a delayed and weaker response to the RSV prefusion F protein vaccine.
Area of Science:
- Immunology
- Vaccinology
- Virology
Background:
- Respiratory syncytial virus (RSV) poses a significant threat to immunocompromised individuals, including kidney transplant recipients (KTR) and dialysis patients (DP).
- Limited data exists on the immune response to RSV prefusion F protein vaccines in these vulnerable populations.
- Understanding vaccine-induced B and T cell responses is crucial for optimizing protection in KTR and DP.
Purpose of the Study:
- To investigate the humoral and cellular immune responses following RSVPreF3OA vaccination in KTR, DP, and healthy controls (HC).
- To compare the immune signatures induced by RSV vaccination in KTR and DP, considering the effects of immunosuppression and uremia.
- To provide detailed immunophenotyping of vaccine-specific B and T cells over 90 days post-vaccination.
Main Methods:
- An observational cohort study involving 23 KTR, 14 DP, and 24 HC vaccinated with RSVPreF3OA.
- Collection of blood and saliva at baseline, day 30, and day 90 post-vaccination.
- Quantification of RSV-specific serum IgG/IgA, salivary antibodies, and antigen-specific B and T cells using ELISA and spectral flow cytometry.
Main Results:
- RSVPreF3OA vaccination in KTR led to increased serum and salivary antibodies and expansion of RSV-specific B cells with a unique memory phenotype.
- Induction of RSV-specific T cells with effector cytokine production was observed in KTR, similar to HC.
- Responses in DP were delayed and attenuated compared to KTR and HC, although B and T cells showed comparable phenotypic and functional characteristics across all groups.
Conclusions:
- RSVPreF3OA vaccination elicits protective immune responses in KTR that are comparable to those in HC.
- DP exhibit modestly lower cellular and humoral responses to the RSV vaccine compared to KTR and HC.
- This study offers detailed immunophenotyping of RSV vaccine responses, informing vaccination strategies for vulnerable populations.
Background:
Respiratory syncytial virus (RSV) causes severe respiratory illness in vulnerable populations, including kidney transplant recipients (KTRs) and dialysis patients (DPs). Despite the availability of RSV prefusion F protein-based vaccines, immune phenotyping of vaccine-specific B and T cells in KTRs and DPs remains limited. We hypothesized that RSVPreF3OA vaccination induces distinct immune signatures in KTRs and DPs compared with healthy controls (HCs), reflecting the impact of immunosuppression and uraemia on vaccine-induced B and T cell responses.
Methods:
In this observational cohort, we analysed humoral and cellular responses following routine vaccination with the adjuvanted prefusion F protein-based RSVPreF3OA vaccine in 23 KTRs, 14 DPs and 24 HCs. Blood and saliva were collected at baseline and on days 30 and 90 post-vaccination. RSV-specific serum immunoglobulin G/immunoglobulin A, salivary antibodies and antigen-specific B and T cells were quantified by enzyme-linked immunosorbent assay and spectral flow cytometry, with tetanus- and severe acute respiratory syndrome coronavirus 2-specific responses assessed in parallel.
Results:
In KTRs, vaccination induced increases in serum and salivary antibodies, expansion of RSV-specific B cells with enrichment of a switched memory phenotype unique to RSV-specific B cells and induction of RSV-A- and RSV-B-specific T cells with effector cytokine production. These signatures resembled those observed in HCs, whereas responses in DPs were delayed and attenuated. Across cohorts, RSV-specific B and T cells showed comparable phenotypic and functional characteristics.
Conclusions:
This study provides detailed immunophenotyping of RSVPreF3OA vaccine responses in KTRs, DPs and HCs over 90 days, showing that RSVPreF3OA vaccination induces protective RSV responses among KTRs comparable to HCs while DPs mount modestly lower cellular and humoral responses.
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