SARS-CoV-2 infection in dialysis and kidney transplant patients: immunological and serological response.
COVID-19
Hemodialysis
Kidney transplant
Lymphocytes
SARS-CoV-2
Journal
Journal of nephrology
ISSN: 1724-6059
Titre abrégé: J Nephrol
Pays: Italy
ID NLM: 9012268
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
received:
17
08
2021
accepted:
15
11
2021
pubmed:
25
1
2022
medline:
13
4
2022
entrez:
24
1
2022
Statut:
ppublish
Résumé
Dialysis and kidney transplant patients with moderate-severe COVID-19 have a high mortality rate, around 30%, that is similar in the two populations, despite differences in their baseline characteristics. In these groups, the immunology of the disease has been poorly explored. Thirty-two patients on dialysis or with kidney transplant and SARS-CoV-2 infection requiring hospitalization (COV group) were included in our study. Lymphocyte subsets, dendritic cell (DC) counts and monocyte activation were studied. SARS-CoV-2 anti-spike/anti-nucleocapsid were monitored, and baseline cytokines and chemokines were measured in 10 patients. The COV group, compared to healthy subjects and uninfected dialysis/kidney transplant controls, showed lower numbers of CD4 + and CD8 + T cells, Natural-Killer (NK), B cells, plasmacytoid and myeloid DCs, while the proportion of terminally differentiated B-cells was increased. IL6, IL10, IFN-α and chemokines involved in monocyte and neutrophil recruitment were higher in the COV group, compared to uninfected dialysis/kidney transplant controls. Patients with severe disease had lower CD4 + , CD8 + and B-cell counts and lower monocyte HLA-DR expression. Of note, when comparing dialysis and kidney transplant patients with COVID-19, the latter group presented lower NK and pDC counts and monocyte HLA-DR expression. Up to 60 days after symptom onset, kidney transplant recipients showed lower levels of anti-spike antibodies compared to dialysis patients. During SARS-CoV-2 infection, dialysis and kidney transplant patients manifest immunophenotype abnormalities; these are similar in the two groups, however kidney transplant recipients show more profound alterations of the innate immune system and lower anti-spike antibody response.
Sections du résumé
BACKGROUND
Dialysis and kidney transplant patients with moderate-severe COVID-19 have a high mortality rate, around 30%, that is similar in the two populations, despite differences in their baseline characteristics. In these groups, the immunology of the disease has been poorly explored.
METHODS
Thirty-two patients on dialysis or with kidney transplant and SARS-CoV-2 infection requiring hospitalization (COV group) were included in our study. Lymphocyte subsets, dendritic cell (DC) counts and monocyte activation were studied. SARS-CoV-2 anti-spike/anti-nucleocapsid were monitored, and baseline cytokines and chemokines were measured in 10 patients.
RESULTS
The COV group, compared to healthy subjects and uninfected dialysis/kidney transplant controls, showed lower numbers of CD4 + and CD8 + T cells, Natural-Killer (NK), B cells, plasmacytoid and myeloid DCs, while the proportion of terminally differentiated B-cells was increased. IL6, IL10, IFN-α and chemokines involved in monocyte and neutrophil recruitment were higher in the COV group, compared to uninfected dialysis/kidney transplant controls. Patients with severe disease had lower CD4 + , CD8 + and B-cell counts and lower monocyte HLA-DR expression. Of note, when comparing dialysis and kidney transplant patients with COVID-19, the latter group presented lower NK and pDC counts and monocyte HLA-DR expression. Up to 60 days after symptom onset, kidney transplant recipients showed lower levels of anti-spike antibodies compared to dialysis patients.
CONCLUSIONS
During SARS-CoV-2 infection, dialysis and kidney transplant patients manifest immunophenotype abnormalities; these are similar in the two groups, however kidney transplant recipients show more profound alterations of the innate immune system and lower anti-spike antibody response.
Identifiants
pubmed: 35067905
doi: 10.1007/s40620-021-01214-8
pii: 10.1007/s40620-021-01214-8
pmc: PMC8784230
doi:
Substances chimiques
HLA-DR Antigens
0
Types de publication
Journal Article
Research Support, N.I.H., Intramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
745-759Informations de copyright
© 2021. The Author(s) under exclusive licence to Italian Society of Nephrology.
Références
J Clin Invest. 2020 May 1;130(5):2620-2629
pubmed: 32217835
Nephrol Dial Transplant. 2010 Jan;25(1):205-12
pubmed: 19684120
J Infect Dis. 2020 Jun 29;222(2):206-213
pubmed: 32427334
Exp Mol Med. 2012 Aug 31;44(8):465-72
pubmed: 22617684
Am J Transplant. 2020 Nov;20(11):3149-3161
pubmed: 32786152
Nat Med. 2021 Jan;27(1):28-33
pubmed: 33442016
Transpl Int. 2021 Mar;34(3):596-599
pubmed: 33481306
JCI Insight. 2021 Jan 11;6(1):
pubmed: 33232303
JAMA. 2012 Jun 20;307(23):2526-33
pubmed: 22797452
Front Immunol. 2020 May 01;11:827
pubmed: 32425950
Kidney Int. 2020 Jul;98(1):20-26
pubmed: 32437768
JAMA Intern Med. 2020 Jul 1;180(7):934-943
pubmed: 32167524
Nat Med. 2020 Oct;26(10):1636-1643
pubmed: 32839624
Nature. 2020 Jul;583(7816):437-440
pubmed: 32434211
Transplantation. 2014 Jun 15;97(11):1178-84
pubmed: 24892964
Kidney Int. 2011 Jul;80(2):208-17
pubmed: 21525849
J Am Soc Nephrol. 2021 Feb;32(2):385-396
pubmed: 33154174
PLoS One. 2017 Jan 25;12(1):e0170806
pubmed: 28122021
Liver Transpl. 2013 Oct;19(10):1099-107
pubmed: 23894100
Science. 2020 Oct 23;370(6515):
pubmed: 32972995
Am J Transplant. 2020 Nov;20(11):3019-3029
pubmed: 32627319
Science. 2020 Sep 4;369(6508):
pubmed: 32669297
Science. 2020 Oct 23;370(6515):
pubmed: 32972996
Biol Blood Marrow Transplant. 2011 Feb;17(2):205-13
pubmed: 20736080
Immunity. 2021 Jun 8;54(6):1257-1275.e8
pubmed: 34051148
Nature. 2020 Aug;584(7821):430-436
pubmed: 32640463
Nat Med. 2020 Oct;26(10):1623-1635
pubmed: 32807934
Am J Transplant. 2021 May;21(5):1825-1837
pubmed: 33098200
Nephrol Dial Transplant. 2003 May;18(5):983-9
pubmed: 12686675
Kidney Int. 2020 Jun;97(6):1083-1088
pubmed: 32354634
Elife. 2021 Mar 11;10:
pubmed: 33704068
Transplant Proc. 2012 Jun;44(5):1407-11
pubmed: 22664025
Nature. 2020 Aug;584(7821):463-469
pubmed: 32717743
Kidney Int Rep. 2020 Apr 04;5(5):580-585
pubmed: 32292866
Nat Rev Nephrol. 2013 May;9(5):255-65
pubmed: 23507826
Science. 2020 Sep 4;369(6508):1210-1220
pubmed: 32788292
Exp Clin Transplant. 2020 Jun;18(3):275-283
pubmed: 32519618
J Investig Med. 2001 Sep;49(5):442-9
pubmed: 11523700
J Clin Immunol. 2020 Oct;40(7):970-973
pubmed: 32594342
Cell Host Microbe. 2020 Jun 10;27(6):992-1000.e3
pubmed: 32320677
Clin Exp Immunol. 2003 Oct;134(1):63-9
pubmed: 12974756
Nephron. 2021;145(4):363-370
pubmed: 33902031