Assessing SARS-CoV-2 Antigen Specific T-cell Responses After mRNA Vaccination and/or Omicron Variant COVID-19 Infection in Patients with Primary Humoral Immunodeficiencies

https://doi.org/10.1016/j.jaci.2022.12.610Get rights and content

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Rationale

SARS-CoV-2 infection has significantly contributed to morbidity and mortality in patients with primary humoral immunodeficiencies, such as those with X-linked agammaglobulinemia (XLA) and common variable immunodeficiency (CVID). Currently, there is insufficient data to determine if mRNA vaccination and/or previous COVID-19 infection confers protection against rapidly mutating SARS-CoV-2 variants in patients with primary humoral immunodeficiencies. Evaluation of T-cell specific immune responses

Methods

All consented patients and healthy controls completed at least 3 doses of an mRNA vaccine series against SARS-CoV-2 and/or had documented COVID-19 infection when the omicron variant was the dominant strain in the United States (December 2021 until present). PBMCs from healthy controls (n=4), XLA (n=8) and CVID (n=8) patients were isolated by using Ficoll gradient density. Following isolation of PBMCs, PBMCs were stimulated with Spike (Wuhan variant), Nucleocapsid, Membrane, BA.1 Spike (omicron

Results

Following stimulation with pooled antigens, increased IFN-y expression in XLA patients was demonstrated when compared to healthy controls (p=0.0078). Overall, CVID patients produced lower IL-2 and IFN-y following antigen specific T-cell stimulation when compared to healthy controls.

Conclusions

Vaccination against SARS-CoV-2 and/or previous omicron variant COVID-19 infection may lead to enhanced antigen specific T-cell responses in certain patients with primary humoral immunodeficiencies.

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