Evidence of potent humoral immune activity in COVID-19-infected kidney transplant recipients
Evidence of potent humoral immune activity in COVID-19-infected kidney transplant recipients
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DOI：
10.1111/ajt.16261
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发表时间：
2020-10-02
影响因子：
8.8
通讯作者：
Cravedi, Paolo
中科院分区：
文献类型：
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作者：
Hartzell, Susan;Bin, Sofia;Cravedi, Paolo
尽管长期免疫抑制，肾移植受者是否能够产生有效的抗严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 的适应性免疫反应尚不清楚，这对治疗具有重要意义。在此，我们通过流式细胞术以及血清抗体检测，分析了 18 名患有活动性 2019 年冠状病毒病 (COVID-19) 感染的肾移植受者和 36 名匹配的未感染 COVID-19 的移植对照者的外周血细胞表面和细胞内细胞因子表型。我们观察到，在 COVID-19 受试者中，总淋巴细胞明显减少，循环记忆 CD4+ 和 CD8+T 细胞也明显减少。我们还发现，在 COVID-19 个体中，无反应性和衰老的 CD8(+)T 细胞较少，但各组之间耗竭的 CD8(+)T 细胞以及这些 CD4(+)T 细胞亚群中的任何一个都没有差异。我们还观察到 COVID-19 患者中 B 细胞激活的频率更高。 18 名 COVID-19 受试者中，有 16 名接受了抗 SARS-CoV-2 血清抗体检测，结果显示免疫球蛋白 M 或免疫球蛋白 G 滴度呈阳性。其他分析显示免疫表型与 COVID-19 疾病严重程度之间没有显着相关性。我们的研究结果表明，因急性 COVID-19 感染而入院的免疫抑制肾移植受者可以产生 SARS-CoV-2 反应性适应性免疫反应。这些发现提出了一种可能性，即可能不需要对所有患有活动性 COVID-19 的肾移植受者进行经验性减少免疫抑制治疗。
Whether kidney transplant recipients are capable of mounting an effective anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) adaptive immune response despite chronic immunosuppression is unknown and has important implications for therapy. Herein, we analyzed peripheral blood cell surface and intracellular cytokine phenotyping by flow cytometry along with serum antibody testing in 18 kidney transplant recipients with active coronavirus disease 2019 (COVID-19) infection and 36 matched, transplanted controls without COVID-19. We observed significantly fewer total lymphocytes and fewer circulating memory CD4(+)and CD8(+)T cells in the COVID-19 subjects. We also showed fewer anergic and senescent CD8(+)T cells in COVID-19 individuals, but no differences in exhausted CD8(+)T cells, nor in any of these CD4(+)T cell subsets between groups. We also observed greater frequencies of activated B cells in the COVID-19 patients. Sixteen of 18 COVID-19 subjects tested for anti-SARS-CoV-2 serum antibodies showed positive immunoglobulin M or immunoglobulin G titers. Additional analyses showed no significant correlation among immune phenotypes and degrees of COVID-19 disease severity. Our findings indicate that immunosuppressed kidney transplant recipients admitted to the hospital with acute COVID-19 infection can mount SARS-CoV-2-reactive adaptive immune responses. The findings raise the possibility that empiric reductions in immunosuppressive therapy for all kidney transplant recipients with active COVID-19 may not be required.