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Sejdic A, Hartling HJ, Holler JG, Klingen Gjærde L, Lindegaard B, Dungu AM, Gnesin F, Møller MEE, Teglgaard RS, Niemann CU, Brooks PT, Jørgensen CS, Franck KT, Fischer TK, Marquart HV, Harboe ZB, Ostrowski SR. Immune cell populations and induced immune responses at admission in patients hospitalized with vaccine breakthrough SARS-CoV-2 infections. Front Immunol 2024; 15:1360843. [PMID: 38903511 PMCID: PMC11188326 DOI: 10.3389/fimmu.2024.1360843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 05/17/2024] [Indexed: 06/22/2024] Open
Abstract
Background Vaccine breakthrough SARS-CoV-2 infections are common and of clinical and public health concern. However, little is known about the immunological characteristics of patients hospitalized due to these infections. We aimed to investigate and compare immune cell subpopulations and induced immune responses in vaccinated and non-vaccinated patients hospitalized with severe COVID-19. Methods A nested case-control study on adults (≥ 18 years) who received at least two doses of a mRNA-COVID-19 vaccine and were hospitalized with SARS-CoV-2 breakthrough infections and severe COVID-19 between January 7, 2021, and February 1, 2022, were eligible for inclusion. Age- and sex-matched non-vaccinated controls were identified. Immunophenotyping was performed using a custom-designed 10-color flow cytometry prefabricated freeze-dried antibody panel (DuraClone, Beckman Coulter (BC), Brea, Calif). TruCulture (Myriad RBM, Austin, USA) was used to assess induced immune response in whole blood, revealing different critical signaling pathways as a proxy for immune function. All samples were obtained within 48 hours of admission. Results In total, 20 hospitalized patients with severe COVID-19 and a breakthrough SARS-CoV-2 infection were included, ten vaccinated and ten non-vaccinated patients. Vaccinated patients had lower concentrations of CD19 B cells (p = 0.035), naïve CD4 T cells (p = 0.015), a higher proportion of γδ1 T cells (p = 0.019), and higher unstimulated immune cell release of IL-10 (p = 0.015). Conclusion We observed immunological differences between vaccinated and non-vaccinated patients hospitalized due to severe COVID-19 that indicate that vaccinated patients had lower B cell concentrations, lower concentrations of CD4 naïve T cells, a skewed gamma-delta V1/V2 ratio, and an exaggerated IL-10 response at admission. These results could indicate a suboptimal immune response involved in SARS-CoV-2 breakthrough infections that cause severe COVID-19 in vaccinated adults. However, the sample size was small, and further research is needed to confirm these results.
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Affiliation(s)
- Adin Sejdic
- Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital – North Zealand, Hillerød, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hans Jakob Hartling
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jon Gitz Holler
- Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital – North Zealand, Hillerød, Denmark
| | - Lars Klingen Gjærde
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Birgitte Lindegaard
- Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital – North Zealand, Hillerød, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Arnold Matovu Dungu
- Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital – North Zealand, Hillerød, Denmark
| | - Filip Gnesin
- Department of Cardiology, Copenhagen University Hospital – North Zealand, Hillerød, Denmark
| | | | | | - Carsten Utoft Niemann
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Patrick Terrence Brooks
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | | | | | - Thea K. Fischer
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Research, Copenhagen University Hospital – North Zealand, Hillerød, Denmark
| | - Hanne Vibeke Marquart
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Zitta Barrella Harboe
- Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital – North Zealand, Hillerød, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sisse Rye Ostrowski
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
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D’Orso S, Pirronello M, Verdiani A, Rossini A, Guerrera G, Picozza M, Sambucci M, Misiti A, De Marco L, Salvia A, Caltagirone C, Giardina E, Battistini L, Borsellino G. Primary and Recall Immune Responses to SARS-CoV-2 in Breakthrough Infection. Vaccines (Basel) 2023; 11:1705. [PMID: 38006037 PMCID: PMC10675240 DOI: 10.3390/vaccines11111705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/19/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Breakthrough infections in SARS-CoV-2 vaccinated individuals are an ideal circumstance for the simultaneous exploration of both the vaccine-induced memory reaction to the spike (S) protein and the primary response to the membrane (M) and nucleocapsid (N) proteins generated by natural infection. We monitored 15 healthcare workers who had been vaccinated with two doses of Pfizer BioNTech BNT162b2 and were then later infected with the SARS-CoV-2 B.1.617.2. (Delta) variant, analysing the antiviral humoral and cellular immune responses. Natural infection determined an immediate and sharp rise in anti-RBD antibody titres and in the frequency of both S-specific antibody secreting cells (ASCs) and memory B lymphocytes. T cells responded promptly to infection by activating and expanding already at 2-5 days. S-specific memory and emerging M- and N-specific T cells both expressed high levels of activation markers and showed effector capacity with similar kinetics but with different magnitude. The results show that natural infection with SARS-CoV-2 in vaccinated individuals induces fully functional and rapidly expanding T and B lymphocytes in concert with the emergence of novel virus-specific T cells. This swift and punctual response also covers viral variants and captures a paradigmatic case of a healthy adaptive immune reaction to infection with a mutating virus.
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Affiliation(s)
- Silvia D’Orso
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Marta Pirronello
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Alice Verdiani
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Angelo Rossini
- Medical Services, Santa Lucia Foundation IRCCS, 00179 Rome, Italy; (A.R.); (A.S.)
| | - Gisella Guerrera
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Mario Picozza
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Manolo Sambucci
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Andrea Misiti
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Lorenzo De Marco
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Antonino Salvia
- Medical Services, Santa Lucia Foundation IRCCS, 00179 Rome, Italy; (A.R.); (A.S.)
| | - Carlo Caltagirone
- Department of Clinical and Behavioral Neurology, Santa Lucia Foundation IRCCS, 00179 Rome, Italy;
| | - Emiliano Giardina
- Genomic Medicine Laboratory UILDM, Santa Lucia Foundation IRCCS, 00179 Rome, Italy;
- Medical Genetics Laboratory, Department of Biomedicine and Prevention, Tor Vergata University, 00133 Rome, Italy
| | - Luca Battistini
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Giovanna Borsellino
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
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Stai S, Fylaktou A, Kasimatis E, Xochelli A, Lioulios G, Nikolaidou V, Papadopoulou A, Myserlis G, Iosifidou AM, Iosifidou MA, Papagianni A, Yannaki E, Tsoulfas G, Stangou M. Immune Profile Determines Response to Vaccination against COVID-19 in Kidney Transplant Recipients. Vaccines (Basel) 2023; 11:1583. [PMID: 37896986 PMCID: PMC10611345 DOI: 10.3390/vaccines11101583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/27/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND AND AIM Immune status profile can predict response to vaccination, while lymphocyte phenotypic alterations represent its effectiveness. We prospectively evaluated these parameters in kidney transplant recipients (KTRs) regarding Tozinameran (BNT162b2) vaccination. METHOD In this prospective monocenter observational study, 39 adult KTRs, on stable immunosuppression, naïve to COVID-19, with no protective humoral response after two Tozinameran doses, received the third vaccination dose, and, based on their immunity activation, they were classified as responders or non-responders. Humoral and cellular immunities were assessed at predefined time points (T0: 48 h before the first, T1: 48 h prior to the third and T2: three weeks after the third dose). RESULTS Responders, compared to non-responders, had a higher total and transitional B-lymphocyte count at baseline (96.5 (93) vs. 51 (52)cells/μL, p: 0.045 and 9 (17) vs. 1 (2)cells/μL, p: 0.031, respectively). In the responder group, there was a significant increase, from T0 to T1, in the concentrations of activated CD4+ (from 6.5 (4) to 10.08 (11)cells/μL, p: 0.001) and CD8+ (from 8 (19) to 14.76 (16)cells/μL, p: 0.004) and a drop in CD3+PD1+ T-cells (from 130 (121) to 30.44 (25)cells/μL, p: 0.001), while naïve and transitional B-cells increased from T1 to T2 (from 57.55 (66) to 1149.3 (680)cells/μL, p < 0.001 and from 1.4 (3) to 17.5 (21)cells/μL, p: 0.003). The percentages of memory and marginal zone B-lymphocytes, and activated CD4+, CD8+ and natural killer (NK) T-cells significantly increased, while those of naïve B-cells and CD3+PD1+ T-cells reduced from T0 to T1. CONCLUSIONS Responders and non-responders to the third BNT162b2 dose demonstrated distinct initial immune cell profiles and changes in cellular subpopulation composition following vaccination.
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Affiliation(s)
- Stamatia Stai
- School of Medicine, Aristotle University of Thessaloniki, 45642 Thessaloniki, Greece; (S.S.); (E.K.); (G.L.); (G.M.); (A.M.I.); (M.A.I.); (A.P.); (G.T.)
- Department of Nephrology, Hippokration Hospital, 54642 Thessaloniki, Greece
| | - Asimina Fylaktou
- Department of Immunology, National Histocompatibility Center, Hippokration General Hospital, 54642 Thessaloniki, Greece; (A.F.); (A.X.); (V.N.)
| | - Efstratios Kasimatis
- School of Medicine, Aristotle University of Thessaloniki, 45642 Thessaloniki, Greece; (S.S.); (E.K.); (G.L.); (G.M.); (A.M.I.); (M.A.I.); (A.P.); (G.T.)
- Department of Nephrology, Hippokration Hospital, 54642 Thessaloniki, Greece
| | - Aliki Xochelli
- Department of Immunology, National Histocompatibility Center, Hippokration General Hospital, 54642 Thessaloniki, Greece; (A.F.); (A.X.); (V.N.)
| | - Georgios Lioulios
- School of Medicine, Aristotle University of Thessaloniki, 45642 Thessaloniki, Greece; (S.S.); (E.K.); (G.L.); (G.M.); (A.M.I.); (M.A.I.); (A.P.); (G.T.)
- Department of Nephrology, Hippokration Hospital, 54642 Thessaloniki, Greece
| | - Vasiliki Nikolaidou
- Department of Immunology, National Histocompatibility Center, Hippokration General Hospital, 54642 Thessaloniki, Greece; (A.F.); (A.X.); (V.N.)
| | - Anastasia Papadopoulou
- Hematology Department, Hematopoietic Cell Transplantation Unit, Gene and Cell Therapy Center, “George Papanikolaou” Hospital, 57010 Thessaloniki, Greece; (A.P.); (E.Y.)
| | - Grigorios Myserlis
- School of Medicine, Aristotle University of Thessaloniki, 45642 Thessaloniki, Greece; (S.S.); (E.K.); (G.L.); (G.M.); (A.M.I.); (M.A.I.); (A.P.); (G.T.)
- Department of Transplant Surgery, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Artemis Maria Iosifidou
- School of Medicine, Aristotle University of Thessaloniki, 45642 Thessaloniki, Greece; (S.S.); (E.K.); (G.L.); (G.M.); (A.M.I.); (M.A.I.); (A.P.); (G.T.)
| | - Myrto Aikaterini Iosifidou
- School of Medicine, Aristotle University of Thessaloniki, 45642 Thessaloniki, Greece; (S.S.); (E.K.); (G.L.); (G.M.); (A.M.I.); (M.A.I.); (A.P.); (G.T.)
| | - Aikaterini Papagianni
- School of Medicine, Aristotle University of Thessaloniki, 45642 Thessaloniki, Greece; (S.S.); (E.K.); (G.L.); (G.M.); (A.M.I.); (M.A.I.); (A.P.); (G.T.)
- Department of Nephrology, Hippokration Hospital, 54642 Thessaloniki, Greece
| | - Evangelia Yannaki
- Hematology Department, Hematopoietic Cell Transplantation Unit, Gene and Cell Therapy Center, “George Papanikolaou” Hospital, 57010 Thessaloniki, Greece; (A.P.); (E.Y.)
| | - Georgios Tsoulfas
- School of Medicine, Aristotle University of Thessaloniki, 45642 Thessaloniki, Greece; (S.S.); (E.K.); (G.L.); (G.M.); (A.M.I.); (M.A.I.); (A.P.); (G.T.)
- Department of Transplant Surgery, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Maria Stangou
- School of Medicine, Aristotle University of Thessaloniki, 45642 Thessaloniki, Greece; (S.S.); (E.K.); (G.L.); (G.M.); (A.M.I.); (M.A.I.); (A.P.); (G.T.)
- Department of Nephrology, Hippokration Hospital, 54642 Thessaloniki, Greece
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Pellicano C, Colalillo A, Basile V, Marino M, Basile U, La Gualana F, Mezzaroma I, Visentini M, Rosato E. The Effect of SARS-CoV-2 Vaccination on B-Cell Phenotype in Systemic Sclerosis Patients. J Pers Med 2022; 12:jpm12091420. [PMID: 36143205 PMCID: PMC9500778 DOI: 10.3390/jpm12091420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 01/10/2023] Open
Abstract
Objective: to assess the influence of SARS-CoV-2 mRNA vaccine on B-cell phenotypes in systemic sclerosis (SSc). Methods: peripheral blood B-cell subpopulations were evaluated before (t1) and 3 months (t3) after the second dose of vaccine in 28 SSc patients. Peripheral blood B-cell subpopulations were evaluated in 21 healthy controls (HCs) only at t1. Anti-spike IgG levels were evaluated at t3 in both cohorts. Results: SSc patients presented higher naive, double-negative, and CD21low B cells compared to HCs. IgM-memory and switched-memory B cells were lower in SSc patients than HCs. No differences in anti-spike IgG levels after vaccination were observed between SSc patients and HCs. Anti-spike IgG levels after vaccination were lower in SSc patients with increased CD21low B cells at baseline compared to SSc patients with normal CD21low B cells. A positive correlation was found between IgG levels and naive B cells. A negative linear correlation was shown between IgG levels and IgM-memory, switched-memory, double-negative, and CD21low B cells. Conclusions: SARS-CoV-2 mRNA vaccine response is normal in SSc patients not undergoing immunosuppressive therapy. The normal number of naive B cells is a positive marker of antibody response. The increased percentage of CD21low B cells represents a negative marker of antibody response.
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Affiliation(s)
- Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Amalia Colalillo
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Valerio Basile
- Clinical Pathology Unit and Cancer Biobank, Department of Research and Advanced Technologies, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Mariapaola Marino
- Department of Translational Medicine and Surgery, Section of General Pathology, “A. Gemelli” IRCCS, Catholic University of the Sacred Heart, 00168 Rome, Italy
| | - Umberto Basile
- Department of Laboratory and Infectious Disease Sciences, “A. Gemelli” IRCCS, Catholic University of the Sacred Heart, 00168 Rome, Italy
- Correspondence:
| | - Francesca La Gualana
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Ivano Mezzaroma
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Marcella Visentini
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
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