Cellular and humoral immune responses to COVID-19 booster vaccination in Japanese dialysis patients

Clin Exp Nephrol. 2024 Jul;28(7):674-682. doi: 10.1007/s10157-024-02477-8. Epub 2024 Mar 8.

Abstract

Background: Dialysis patients are susceptible to developing severe coronavirus disease 2019 (COVID-19) due to hypoimmunity. Antibody titers against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) after the primary vaccinations are lower in hemodialysis (HD) patients than in healthy individuals. This study aimed to evaluate the effect of a SARS-CoV-2 booster vaccination in HD and peritoneal dialysis (PD) patients based on antibody titers and cellular and humoral immunity.

Methods: Participants of the control, HD, and PD groups were recruited from 12 facilities. SARS-CoV-2 antigen-specific cytokine and IgG-antibody levels were measured. Regulatory T cells and memory B cells were counted using flow cytometry at 6 months after primary vaccination with BNT162b2 and 3 weeks after the booster vaccination in HD and PD patients and compared with those of a control group.

Results: Booster vaccination significantly enhanced the levels of antibodies, cytokines, and memory B cells in three groups. The HD group showed significantly higher levels of IgG-antibodies, IL-1β, IL-2, IL-4, IL-17, and memory B cells than those in the control group at 3 weeks after the booster dose. The PD group tended to show similar trends to HD patients but had similar levels of IgG-antibodies, cytokines, and memory B cells to the control group.

Conclusions: HD patients had significantly stronger cellular and humoral immune responses than the control 3 weeks after the booster dose. Our findings will help in developing better COVID-19 vaccination strategies for HD and PD patients.

Keywords: BNT162b2 vaccine; Booster vaccine; COVID-19; Hemodialysis; Hypoimmunity; Peritoneal dialysis.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Viral* / blood
  • BNT162 Vaccine* / immunology
  • COVID-19 Vaccines / immunology
  • COVID-19* / immunology
  • COVID-19* / prevention & control
  • Cytokines / blood
  • East Asian People
  • Female
  • Humans
  • Immunity, Cellular
  • Immunity, Humoral*
  • Immunization, Secondary*
  • Immunoglobulin G / blood
  • Japan
  • Male
  • Memory B Cells / immunology
  • Middle Aged
  • Peritoneal Dialysis
  • Renal Dialysis*
  • SARS-CoV-2 / immunology
  • T-Lymphocytes, Regulatory / immunology

Substances

  • Antibodies, Viral
  • BNT162 Vaccine
  • Cytokines
  • COVID-19 Vaccines
  • Immunoglobulin G