Humoral responses to multiple SARS-CoV-2 variants after two doses of vaccine in kidney transplant patients

ABSTRACT

Background: The COVID-19 pandemic has led to millions of fatalities globally. Kidney transplant (KT) patients, given their comorbidities and under immunosuppressant drugs, are identified as a high-risk group. Though vaccination remains pivotal for pandemic control, some studies indicate that KT exhibits diminished immune reactions to SARS-CoV-2 vaccines. Therefore, evaluating the vaccine responses in KT, especially the humoral responses against emergent variants is crucial.

Methods: We developed a multiplexed SARS-CoV-2 variant protein microarray, incorporating the extracellular domain (ECD) and the receptor binding domain (RBD) of the spike proteins from the variants. This was employed to investigate the collective humoral responses after administering two doses of mRNA-1273 and AZD1222 vaccines in KT under immunosuppressive drugs and in healthy controls.

Results: After two doses of either mRNA-1273 or AZD1222, the KT generally showed lower surrogate neutralizing and total antibodies against spike ECD in multiple variants compared to healthy controls. Although two doses of mRNA-1273 induced 1.5–2 fold more surrogate neutralizing and total antibodies than AZD1222 in healthy controls, the KT subjects with two doses of mRNA-1273 generally exhibited higher surrogate neutralizing but similar total antibodies against spike ECD in multiple variants. There were moderate to high correlations between the surrogate neutralizing and total antibodies against spike ECDs.

Conclusion: This study offers pivotal insights into the relative vulnerability of KT concerning humoral immunity and the evolving mutations of SARS-CoV-2. Such findings are useful for evaluating vaccine responses and recommending vaccine episodes for KT.

KEYWORDS:

• Kidney transplant recipients
• COVID-19
• SARS-CoV-2
• vaccine
• angiotensin-converting enzyme 2
• variants of concern

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets generated in this study are available from the corresponding author upon reasonable request.

Author contributions

P.-X.D., S.-S.C., T.-S.H., P.-S.T., and G.-D.S. performed the experimental work. P.-X.D., S.-S.C., H.-C.S., and G.-D.S. contributed to the manuscript preparation. G.-D.S. contributed expertise and supervision to the entire project.

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/21505594.2024.2351266.

Additional information

Funding

This work was supported in part by the National Science and Technology Council, Grants NSTC 112-2320-B-006 -050 -MY3 (G.-D.S.), NSTC 112-2628-B-006 -004 - (G.-D.S.), Hsinchu Science Park Bureau NSTC B11301 (G.-D.S.), NSTC 112-2321-B-006-008- (G.-D.S., T.-S.H.), NSTC 111-2622-E-006-042- (G.-D.S., T.-S.H.), NSTC 112-2622-8-182A-001 -IE (G.-D.S., T.-S.H.), NSTC 113-2327-B-006-002- (G.-D.S., T.-S.H.), NSTC 113-2321-B-006-007- (G.-D.S., T.-S.H.), NSTC 111-2622-E-006 -042- (T.-S.H.), and NSTC 110-2622-E-006-030- (T.-S.H.). The study was partly supported by a research grant from the Ministry of Health and Welfare (MOHW112-TDU-B-211-144003, MOHW111-TDU-B-211-134003, MOHW113-TDU-B-212-114008, MOHW113-TDU-B-211-114008), the Headquarters of University Advancement at the National Cheng Kung University (NCKU), Ministry of Education, Taiwan, University Center for Bioscience and Biotechnology, National Cheng Kung University, Taiwan, and the NCKU Epidemic Prevention Scientific Research Center. We thank Prof. Chien-Sheng Chen for providing the microarray printer. The funders had no role in study design, data collection, analysis, publication decision, or manuscript preparation.