scholarly journals Cellular immunity predominates over humoral immunity after homologous and heterologous mRNA and vector‐based COVID‐19 vaccine regimens in solid organ transplant recipients

2021 ◽  
Author(s):  
Tina Schmidt ◽  
Verena Klemis ◽  
David Schub ◽  
Sophie Schneitler ◽  
Matthias C. Reichert ◽  
...  
Keyword(s):  
Humoral Immunity ◽  
Cellular Immunity ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Solid Organ Transplant Recipients

scholarly journals Cellular immunity predominates over humoral immunity after the first dose of COVID-19 vaccines in solid organ transplant recipients

2021 ◽  
Author(s):  
Tina Schmidt ◽  
Verena Klemis ◽  
David Schub ◽  
Sophie Schneitler ◽  
Matthias Christian Reichert ◽  
...  
Keyword(s):  
T Cells ◽  
Humoral Immunity ◽  
Cellular Immunity ◽  
Cd8 T Cells ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Specific Antibodies ◽  
Solid Organ Transplant Recipients

Knowledge on the vaccine-induced cellular and humoral immunity and on immunogenicity of vector-based and mRNA vaccines in solid organ transplant recipients is limited. Therefore, SARS-CoV-2 specific T-cells and antibodies were analyzed in 40 transplant recipients and 70 age-matched controls after the first dose of vector-based or mRNA vaccines. Plasmablasts and SARS-CoV-2 specific CD4 and CD8 T-cells were quantified using flow-cytometry. Specific antibodies were analyzed by ELISA and neutralization assay. SARS-CoV-2 specific antibodies and T-cells were induced in both groups with significantly lower levels in patients. While antibodies were detected in 80% of controls and 5.3% of patients, specific CD4 and/or CD8 T-cells were more frequently found in both controls (84.3%) and patients (23.7%). The two vaccine types showed notable differences, as IgG and neutralizing activity were more pronounced after mRNA vaccination (p<0.0001 each), whereas CD4 and CD8 T-cell levels were higher after vector vaccination (p=0.009; p<0.0001). Plasmablast numbers were significantly higher in controls and correlated with SARS-CoV-2 specific IgG- and CD4 T-cell levels. In conclusion, assessment of antibodies is not sufficient to identify COVID-19-vaccine responders. Together with differences in immunogenicity among vaccines, this necessitates combined analysis of humoral and cellular immunity to reliably assess responders among immunocompetent and immunocompromised individuals.

Low-Dose Acitretin for Secondary Prevention of Keratinocyte Carcinomas in Solid-Organ Transplant Recipients

Dermatology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Efrat Solomon-Cohen ◽  
Shiran Reiss-Huss ◽  
Emmilia Hodak ◽  
Batya Davidovici
Keyword(s):  
Secondary Prevention ◽  
Cell Carcinoma ◽  
Low Dose ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Pretreatment Period ◽  
Solid Organ Transplant Recipients

<b><i>Background:</i></b> Keratinocyte carcinomas, particularly squamous cell carcinoma (SCC), occur more frequently and aggressively in solid-organ transplant recipients (SOTRs) than in the general population. Systemic retinoids are effective in secondary prevention of keratinocyte carcinomas in this population, but their use is limited by adverse effects including a rebound effect in cases of treatment discontinuation. <b><i>Objective:</i></b> Our aim was to determine whether low-dose acitretin is efficient in the secondary prevention of keratinocyte carcinomas in SOTRs. <b><i>Methods:</i></b> This retrospective case-crossover study was conducted at a specialized dermatology clinic for SOTRs in a large transplantation center in 2010–2017. Patients with at least 1 previous keratinocyte carcinoma who were treated with acitretin 10 mg/day for 2 years were included. The main outcome was the difference in the number of new keratinocyte carcinomas diagnosed during treatment compared to during the 2-year pretreatment period. <b><i>Results:</i></b> The cohort included 34 SOTRs. A significant reduction in the mean number of new keratinocyte carcinomas during treatment relative to the pretreatment period was observed (1.7 vs. 3.6, –53% <i>p</i> = 0.002). Similar results were noted on analysis by tumor type, for both SCC and basal cell carcinoma. <b><i>Conclusion:</i></b> This study of SOTRs demonstrated positive results for low-dose acitretin as a chemoprevention of keratinocyte carcinomas in this population.

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