COVID-19 Vaccination Induces a Poor Interleukin-21 Memory T-cell Response in Kidney Transplant Recipients
1Internal Medicine, Nephrology and Transplantation, Erasmus MC, Rotterdam, Netherlands, 2Viroscience, Erasmus MC, Rotterdam, Netherlands
Meeting: 2022 American Transplant Congress
Abstract number: 680
Keywords: COVID-19, Kidney transplantation, T cell reactivity, 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: COVID-19-related morbidity and mortality is high among kidney patients. Several studies recently suggested low humoral and cellular immune responses after two doses of mRNA-1273 (Moderna) in these patients. Interleukin (IL)-21 is key in orchestrating an effective immune response against viral infections, is mainly produced by activated CD4+ T-cells and stimulates both humoral and cellular immunity. However, T-cell function may be impaired in kidney patients and this may explain the poor response to vaccination. Currently, there is limited data available on the vaccine-induced IL-21 memory T-cell response in these patients. We studied the induction of SARS-CoV-2-specific IL-21 memory T-cell response after mRNA-1273 vaccination in 3 groups of kidney patients.
*Methods: 113 participants were randomly selected from a prospective controlled multicenter cohort study, including 38 controls, 19 chronic kidney disease (CKD) stages G4/5 (eGFR <30 mL/min/1.73m2), 20 dialysis and 36 kidney transplant patients. All participants received 2 doses of mRNA-1273. To assess the vaccine-induced IL-21 memory T-cell response, we performed an IL-21 ELISpot (per 3.105 PBMCs) in these participants at baseline and 28 days after the second vaccination. SARS-CoV-2 S1-specific IgG antibody levels were already measured in the context of the multicenter cohort study.
*Results: Kidney transplant recipients had a significantly lower number of SARS-CoV-2-specific IL-21 producing memory T-cells when compared to controls (median of 46 versus 146, P<0.001). Participants with CKD G4/5 or on dialysis also had reduced SARS-CoV-2-specific IL-21 producing memory T-cells compared to controls (median of 128 [19-658] and 124 [7-654] versus 146 [10-635], p=0.43 and p=0.45, respectively), but the difference was less pronounced. In addition, a positive correlation was found between the number of SARS-CoV-2-specific IL-21 producing memory T-cells and SARS-CoV-2 S1-specific IgG antibody levels for all groups (Pearson correlation coefficient of 0.2, p=0.028).
*Conclusions: Kidney transplant recipients have an impaired antibody response after two doses of mRNA-1273 (Moderna), which correlates with poor SARS-CoV-2-specific T-cell reactivity. These findings suggest that poor IL-21 memory T-cell response might hamper protection against COVID-19.
To cite this abstract in AMA style:
Malahe SR, Hartog Yden, Kuiper Rde, Reijerkerk D, Geers D, GeurtsvanKessel CH, Kho MM, Vries RDde, Reinders ME, Baan CC. COVID-19 Vaccination Induces a Poor Interleukin-21 Memory T-cell Response in Kidney Transplant Recipients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/covid-19-vaccination-induces-a-poor-interleukin-21-memory-t-cell-response-in-kidney-transplant-recipients/. Accessed May 15, 2025.« Back to 2022 American Transplant Congress