Defining Clinical and Immunological Predictors of Poor Immune Responses to COVID-19 mRNA Vaccines in Patients with Primary Antibody Deficiency

Authors

Junghee Jenny Shin, Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, New Haven, Connecticut, 06520, USA.
Jennefer Par-Young, Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, New Haven, Connecticut, 06520, USA.
Serhan Unlu, Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, New Haven, Connecticut, 06520, USA.
Andrew McNamara, Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, 06516, USA.
Hong-Jai Park, Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, New Haven, Connecticut, 06520, USA.
Min Sun Shin, Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, New Haven, Connecticut, 06520, USA.
Renelle J. Gee, Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, New Haven, Connecticut, 06520, USA.
Hester Doyle, Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, New Haven, Connecticut, 06520, USA.
Yuliya Afinogenova, Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, New Haven, Connecticut, 06520, USA.Follow

Document Type

Article

Publication Title

Journal of clinical immunology

Abstract

Immune responses to coronavirus disease 2019 (COVID-19) mRNA vaccines in primary antibody deficiencies (PADs) are largely unknown. We investigated antibody and CD4 T-cell responses specific for SARS-CoV-2 spike protein (S) before and after vaccination and associations between vaccine response and patients' clinical and immunological characteristics in PADs. The PAD cohort consisted of common variable immune deficiency (CVID) and other PADs, not meeting the criteria for CVID diagnosis (oPADs). Anti-S IgG, IgA, and IgG subclasses 1 and 3 increased after vaccination and correlated with neutralization activity in HCs and patients with oPADs. However, 42% of CVID patients developed such responses after the 2nd dose. A similar pattern was also observed with S-specific CD4 T-cells as determined by OX40 and 4-1BB expression. Patients with poor anti-S IgG response had significantly lower levels of baseline IgG, IgA, CD19 B-cells, switched memory B-cells, naïve CD8 T-cells, and a higher frequency of EM CD8 T-cells and autoimmunity compared to patients with adequate anti-S IgG responses. Patients with oPADs can develop humoral and cellular immune responses to vaccines similar to HCs. However, a subset of CVID patients exhibit impairment in developing such responses, which can be predicted by the baseline immune profile and history of autoimmunity.

First Page

1137

Last Page

1150

DOI

10.1007/s10875-022-01296-4

Publication Date

8-1-2022

Recommended Citation

Shin, Junghee Jenny; Par-Young, Jennefer; Unlu, Serhan; McNamara, Andrew; Park, Hong-Jai; Shin, Min Sun; Gee, Renelle J.; Doyle, Hester; and Afinogenova, Yuliya, "Defining Clinical and Immunological Predictors of Poor Immune Responses to COVID-19 mRNA Vaccines in Patients with Primary Antibody Deficiency" (2022). Internal Medicine. 176.
https://scholar.bridgeporthospital.org/internal_medicine/176

Identifier

35713752 (pubmed); PMC9203263 (pmc); 10.1007/s10875-022-01296-4 (doi); 10.1007/s10875-022-01296-4 (pii)