Higher Proinflammatory Cytokines Are Associated with Increased Antibody Titer After a Third Dose of SARS-CoV-2 Vaccine in Solid Organ Transplant Recipients

A. H. Karaba¹, X. Zhu¹, S. E. Benner¹, O. Akinde¹, Y. Eby¹, K. H. Wang¹, S. Saraf², J. M. Garonzik-Wang³, S. L. Klein¹, J. R. Bailey¹, A. L. Cox¹, J. N. Blankson¹, C. M. Durand¹, D. L. Segev¹, W. A. Werbel¹, A. A. Tobian¹

¹Johns Hopkins University, Baltimore, MD, ²National Institute of Allergy and Infectious Diseases, Bethesda, MD, ³University of Wisconsin School of Medicine and Health, Madison, WI

Meeting: 2022 American Transplant Congress

Abstract number: 681

Keywords: Antibodies, COVID-19, Inflammation, Vaccination

Topic: Clinical Science » Infection Disease » 24 - All Infections (Excluding Kidney & Viral Hepatitis)

Session Information

Session Name: All Infections (Excluding Kidney & Viral Hepatitis) I

Session Type: Poster Abstract

Date: Saturday, June 4, 2022

Session Time: 5:30pm-7:00pm

Presentation Time: 5:30pm-7:00pm

Location: Hynes Halls C & D

*Purpose: Solid organ transplant recipients (SOTRs) are at increased risk for severe COVID-19 and exhibit lower antibody responses to SARS-CoV-2 vaccines. This study aimed to determine if pre-vaccination cytokine levels are associated with antibody response to SARS-CoV-2 vaccination.

*Methods: A cross-sectional study was performed among 58 SOTRs before and after two-dose mRNA vaccine series, 35 additional SOTRs before and after a third vaccine dose, with comparison to 16 healthy controls (HCs). Anti-spike antibody was assessed using the IgG Euroimmun ELISA. Electrochemiluminescence detection-based multiplexed sandwich immunoassays were used to quantify plasma cytokine and chemokine concentrations (n=20 analytes). Concentrations between SOTRs and HCs, stratified by ultimate antibody response to the vaccine, were compared using Wilcoxon-rank-sum test with false discovery rates (FDR) computed to correct for multiple comparisons.

*Results: In the study population, 100% of HCs, 59% of SOTRs after two doses and 63% of SOTRs after three doses had a detectable antibody response. Multiple baseline cytokines were elevated in SOTRs versus HCs. There was no significant difference in cytokine levels between SOTRs with high vs low-titer antibodies after two doses of vaccine. However, as compared to poor antibody responders, SOTRs who went on to develop a high-titer antibody response to a third dose of vaccine had significantly higher pre-third dose levels of several innate immune cytokines including IL-17, IL-2Ra, IL-6, IP-10, MIP-1α, and TNF-α (FDR <0.05).

*Conclusions: A specific inflammatory profile or immune state may identify which SOTRs are likely to develop stronger sero-response and possible protection after a third dose of SARS-CoV-2 vaccine.

To cite this abstract in AMA style:

Karaba AH, Zhu X, Benner SE, Akinde O, Eby Y, Wang KH, Saraf S, Garonzik-Wang JM, Klein SL, Bailey JR, Cox AL, Blankson JN, Durand CM, Segev DL, Werbel WA, Tobian AA. Higher Proinflammatory Cytokines Are Associated with Increased Antibody Titer After a Third Dose of SARS-CoV-2 Vaccine in Solid Organ Transplant Recipients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/higher-proinflammatory-cytokines-are-associated-with-increased-antibody-titer-after-a-third-dose-of-sars-cov-2-vaccine-in-solid-organ-transplant-recipients/. Accessed May 18, 2025.

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