Immune Senescence Markers Predict the Cellular Immune Response to BNT162b2 Vaccination in Hemodialysis Patients

Jens T Van Praet; Marie De Groote; Dirk De Bacquer; Ellen Verhalleman; Ziggy Welvaert; Jan Emmerechts; Marijke Reynders; An S De Vriese

doi:10.1093/ofid/ofac585

Immune Senescence Markers Predict the Cellular Immune Response to BNT162b2 Vaccination in Hemodialysis Patients

Open Forum Infect Dis. 2022 Oct 31;9(11):ofac585. doi: 10.1093/ofid/ofac585. eCollection 2022 Nov.

Authors

Jens T Van Praet^{1

2}, Marie De Groote³, Dirk De Bacquer⁴, Ellen Verhalleman⁵, Ziggy Welvaert⁵, Jan Emmerechts⁶, Marijke Reynders⁷, An S De Vriese^{1

2}

Affiliations

¹ Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium.
² Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.
³ Department of Geriatrics, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium.
⁴ Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
⁵ Department of Occupational Therapy, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium.
⁶ Department of Laboratory Hematology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium.
⁷ Department of Medical Microbiology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium.

Abstract

Background: Chronic kidney disease is associated with increased risk of frailty and accelerated immune senescence, potentially affecting the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination.

Methods: Humoral and cellular responses against the spike protein of SARS-CoV-2 were determined in 189 COVID-naive hemodialysis patients at week 4 and 8 after vaccination with 2 doses of BNT162b2. Frailty indicators and immune senescence markers were determined at baseline to identify predictors of the immune response.

Results: Controlling for age, activities of daily living (ADLs), instrumental ADLs, walking pace, and the clinical frailty score correlated negatively and hand grip strength positively with the humoral response. Controlling for age, the proportions of memory CD4⁺ T cells, memory CD8⁺ T cells, CD28^null T cells, and CD57⁺CD8⁺ T cells correlated negatively with the humoral response, whereas the proportions of memory CD4⁺ T cells and CD28^null T cells correlated negatively and the CD4/CD8 ratio positively with the cellular response. In a multivariate model, only the proportions of memory CD4⁺ T cells and CD28^null T cells independently predicted the cellular response.

Conclusions: Markers of immune senescence, but not frailty indicators, independently predict the cellular immune response after vaccination in hemodialysis patients, overruling the effect of chronological age.

Keywords: BNT162b2 vaccination; COVID-19; SARS-CoV-2; frailty; hemodialysis; immune response; immune senescence.