Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Differences in Response by Immunosuppressed Kidney Transplant Patients to Moderna mRNA-1273 versus Pfizer-BioNTech

Dulat Bekbolsynov
ORCID logo ,
Andrew Leland Waack
,
Camryn Buskey
,
Shalmali Sandeep Bhadkamkar
,
Keegan Rengel
,
Winnifer Petersen
,
Mary Lee Brown
,
Tanaya Sparkle
ORCID logo ,
Dinkar Kaw
,
Fayeq Jeelani Syed
,
Saurabh Chattopadhyay
ORCID logo ,
Ritu Chakravarti
ORCID logo ,
Sadik Khuder
,
Beata Mierzejewska
,
Michael Rees
,
Stanislaw Stepkowski
*
Version 1 : Received: 17 October 2023 / Approved: 18 October 2023 / Online: 19 October 2023 (04:48:14 CEST)

A peer-reviewed article of this Preprint also exists.

Bekbolsynov, D.; Waack, A.; Buskey, C.; Bhadkamkar, S.; Rengel, K.; Petersen, W.; Brown, M.L.; Sparkle, T.; Kaw, D.; Syed, F.J.; Chattopadhyay, S.; Chakravarti, R.; Khuder, S.; Mierzejewska, B.; Rees, M.; Stepkowski, S. Differences in Responses of Immunosuppressed Kidney Transplant Patients to Moderna mRNA-1273 Versus Pfizer-BioNTech. Vaccines 2024, 12, 91. Bekbolsynov, D.; Waack, A.; Buskey, C.; Bhadkamkar, S.; Rengel, K.; Petersen, W.; Brown, M.L.; Sparkle, T.; Kaw, D.; Syed, F.J.; Chattopadhyay, S.; Chakravarti, R.; Khuder, S.; Mierzejewska, B.; Rees, M.; Stepkowski, S. Differences in Responses of Immunosuppressed Kidney Transplant Patients to Moderna mRNA-1273 Versus Pfizer-BioNTech. Vaccines 2024, 12, 91.

Abstract

Immunosuppressed kidney transplant (KT) recipients respond weaker to COVID-19 vaccination than immunocompetent individuals. We tested antiviral IgG response in 99 KT-recipients and 66 healthy volunteers who were vaccinated with mRNA-1273 Moderna or BNT162b2 Pfizer-BioNTech vaccines. A subgroup of participants had their peripheral blood leukocytes (PBLs) evaluated for the frequency of T helper 1 (Th1) cells producing IL-2, IFN-γ and/or TNF-α, and IL-10-producing T-regulatory 1 (Tr) cells. Among KT-recipients, 45.8% had anti-SARS-CoV-2 IgG compared to 74.1% of healthy volunteers (p=0.009); also, anti-viral IgG levels were lower in recipients than in volunteers (p=0.001). When defined as non-responders (≤2,000 U/ml IgG), Moderna’s group had 10.8% and Pfizer-BioNTech’s group had 34.3% of non-responders at 6 months (p=0.023); similarly, 15.7% and 31.3% non-responders were in Moderna and Pfizer-BioNTech groups at 12 months, respectively (p=0.067). There were no non-responders among controls. Healthy volunteers had higher Th1 levels than KT recipients, while Moderna produced higher Th1 response than Pfizer-BioNTech. In contrast, Pfizer-BioNTech vaccine induced higher Tr1 response than Moderna vaccine (p<0.05); overall, IgG levels correlated with Th1(fTTNF-α)/Tr1(fTIL-10) ratios. We propose that the higher number of non-responders in Pfizer-BioNTech group than Moderna group was caused by more potent activity of regulatory Tr1 cells in KT-recipients vaccinated with Pfizer-BioNTech vaccine.

Keywords

SARS-CoV-2; kidney transplantation; mRNA vaccine; seropositivity; immunocompromised.

Subject

Medicine and Pharmacology, Transplantation

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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