Immune responses to SARS-CoV-2 mRNA vaccination in people with idiopathic CD4 lymphopenia - 05/02/24
Abstract |
Background |
The immunogenicity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccines is variable in individuals with different inborn errors of immunity or acquired immune deficiencies and is yet unknown in people with idiopathic CD4 lymphopenia (ICL).
Objective |
We sought to determine the immunogenicity of mRNA vaccines in patients with ICL with a broad range of CD4 T-cell counts.
Methods |
Samples were collected from 25 patients with ICL and 23 age- and sex-matched healthy volunteers (HVs) after their second or third SARS-CoV-2 mRNA vaccine dose. Anti-spike and anti-receptor binding domain antibodies were measured. T-cell receptor sequencing and stimulation assays were performed to quantify SARS-CoV-2–specific T-cell responses.
Results |
The median age of ICL participants was 51 years, and their median CD4 count was 150 cells/μL; 11 participants had CD4 counts ≤100 cells/μL. Anti-spike IgG antibody levels were greater in HVs than in patients with ICL after 2 and 3 doses of mRNA vaccine. There was no detectable significant difference, however, in anti-S IgG between HVs and participants with ICL and CD4 counts >100 cells/μL. The depth of spike-specific T-cell responses by T-cell receptor sequencing was lower in individuals with ICL. Activation-induced markers and cytokine production of spike-specific CD4 T cells in participants with ICL did not differ significantly compared with HVs after 2 or 3 vaccine doses.
Conclusions |
Patients with ICL and CD4 counts >100 cells/μL can mount vigorous humoral and cellular immune responses to SARS-CoV-2 vaccination; however, patients with more severe CD4 lymphopenia have blunted vaccine-induced immunity and may require additional vaccine doses and other risk mitigation strategies.
Le texte complet de cet article est disponible en PDF.Key words : Idiopathic CD4 lymphopenia, SARS-CoV-2, COVID-19, mRNA vaccines, immune response
Abbreviations used : anti-S, COVID-19, HV, ICL, IQR, IRB, NIH, RBD, SARS-CoV-2, TCR
Plan
Vol 153 - N° 2
P. 503-512 - février 2024 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.