Intradermal skin test with mRNA vaccines as a surrogate marker of T cell immunity in immunocompromised patients - 10/07/23
Summary |
Objectives |
Intradermal skin test (IDT) with mRNA vaccines may represent a simple, reliable, and affordable tool to measure T cell response in immunocompromised patients who failed to mount serological responses following vaccination with mRNA covid-19 vaccines.
Methods |
We compared anti-SARS-CoV-2 antibodies and cellular responses in vaccinated immunocompromised patients (n = 58), healthy seronegative naive controls (NC, n = 8), and healthy seropositive vaccinated controls (VC, n = 32) by Luminex, spike-induced IFN-γ Elispot and an IDT. A skin biopsy 24 h after IDT and single-cell RNAseq was performed in three vaccinated volunteers.
Results |
Twenty-five percent of seronegative NC had a positive Elispot (2/8) and IDT (1/4), compared to 95% (20/21) and 93% (28/30) in seropositive VC, respectively. Single-cell RNAseq data in the skin of VC showed a predominant mixed population of effector helper and cytotoxic T cells. The TCR repertoire revealed 18/1064 clonotypes with known specificities against SARS-CoV-2, among which six were spike-specific. Seronegative immunocompromised patients with positive Elispot and IDT were in 83% (5/6) treated with B cell-depleting reagents, while those with negative IDT were all transplant recipients.
Conclusions |
Our results indicate that delayed local reaction to IDT reflects vaccine-induced T-cell immunity opening new perspectives to monitor seronegative patients and elderly populations with waning immunity.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Intradermal skin test (IDT) with mRNA COVID-19 vaccines can be used as a surrogate of T cell immunity. |
• | COVID-19 mRNA vaccines induce the trafficking of mainly T cells with a memory profile. |
• | Seronegative immunocompromised patients with T cell immunity are mainly under B cell-depleting therapy. |
• | Seronegative immunocompromised patients without detectable T cell immunity are mainly transplant recipients. |
Keywords : SARS-CoV-2, COVID, T cells, Vaccine, Skin, Immunosuppression
Plan
Vol 87 - N° 2
P. 111-119 - août 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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