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Easy approach to detect cell immunity to COVID vaccines in common variable immunodeficiency patients
Yvelise Barrios1, Andrés Franco1, Cristina Alava-Cruz2
1Department of Immunology, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Spain.
Insights
Cutaneous delayed-type hypersensitivity (DTH) effectively assesses T-cell function post-COVID vaccination in Common Variable Immunodeficiency (CVID) patients. This simple skin test shows high correlation with ex vivo assays, offering a precise and sensitive immune response evaluation.
Area of Science:
- Immunology
- Vaccinology
- Clinical Medicine
Background:
- Assessing immune response after COVID vaccination is challenging for patients with primary antibody deficiencies like Common Variable Immunodeficiency (CVID).
- Cutaneous delayed-type hypersensitivity (DTH) presents a potential method for evaluating T-cell function due to its simplicity and cost-effectiveness.
Purpose of the Study:
- To evaluate the utility of DTH skin testing in assessing cellular immune response (CIR) following COVID-19 vaccination in CVID patients.
- To compare DTH results with established methods for measuring humoral immune response (HIR) and ex vivo CIR.
Main Methods:
- Seventeen CVID patients received two doses of the Pfizer-BioNTech mRNA COVID-19 vaccine.
- Humoral Immune Response (HIR) was measured via specific IgG antibodies.
- Cellular Immune Response (CIR) was assessed using an ex vivo interferon-gamma release assay (IGRA) and an in vivo DTH skin test.
Main Results:
- 12 out of 17 CVID patients showed elevated specific anti-spike protein IgG antibodies post-vaccination.
- Ex vivo CIR was positive in 14 out of 17 patients, with no T-cell defects observed.
- A positive DTH skin test was recorded in 16 out of 17 CVID patients, correlating well with ex vivo CIR results.
Conclusions:
- DTH skin testing is a validated and reliable method for evaluating CIR post-COVID vaccination in CVID patients.
- CIR assessment via DTH demonstrates high precision and sensitivity compared to antibody-based methods in CVID.
- DTH offers a simple, cost-effective tool for assessing T-cell function, with potential for implementation in large-scale COVID-19 vaccine response monitoring.
Background:
Patients with primary antibody deficiencies, such as Common Variable Immunodeficiency (CVID), have some problems to assess immune response after coronavirus disease (COVID) vaccination. Cutaneous delayed-type hypersensitivity (DTH) has the potential to be used as a useful, simple, and cheaper tool to assess T-cell (T lymphocyte) function.
Methods:
Seventeen patients with CVID, a rare disease, received two doses of the mRNA-based Pfizer-BioNTech COVID-19 vaccine. Humoral Immune Response (HIR) was determined by measuring specific immunoglobulin G (IgG) antibodies, and Cellular Immune Response (CIR) was evaluated using an ex vivo interferon-gamma release assay (IGRA) and in vivo by DTH skin test.
Results:
Two weeks after the second dose of the vaccine, 12 out of 17 CVID patients have high optical density (OD) ratios of specific anti-spike protein (S) IgG whereas five patients were negative or low. Ex vivo CIR was considered positive in 14 out of 17 S1-stimulated patients. Unspecific stimulation was positive in all 17 patients showing no T-cell defect. A positive DTH skin test was observed in 16 CVID patients. The only patient with negative DTH also had negative ex vivo CIR.
Conclusions:
The use of DTH to evaluate CIR was validated with an optimal correlation with the ex vivo CIR. The CIR after vaccination in patients with antibody deficiencies seems to have high precision and more sensitivity to antibodies-based methods in CVID.
Clinical Implications:
There is a remarkable correlation between cutaneous DTH and ex vivo IGRA after COVID vaccination. A COVID-specific skin DTH test could be implemented in large populations.
Capsule Summary:
Cutaneous delayed-type hypersensitivity has the potential to be used as a useful, simple, and cheaper tool to assess T-cell functioning.
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