{"title":"肾移植受者接种第四剂 SARS-CoV-2 mRNA 疫苗的增效作用。","authors":"Ayaka Hayashi, Mayuko Kawabe, Izumi Yamamoto, Yutaro Ohki, Akimitsu Kobayashi, Fumihiko Urabe, Jun Miki, Hiroki Yamada, Nanae Matsuo, Yudo Tanno, Tetsuya Horino, Ichiro Ohkido, Takahiro Kimura, Hiroyasu Yamamoto, Takashi Yokoo","doi":"10.1007/s10157-025-02651-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Solid organ transplant recipients taking immunosuppressive drugs are at greater risk of severe COVID-19 than the general population. In particular, kidney transplant recipients (KTRs) are known to have lower seropositivity after basal doses of SARS-CoV-2 vaccines, and the strategy of administering booster doses in these immunocompromised individuals has been promoted worldwide.</p><p><strong>Methods: </strong>This study evaluated the effect of a fourth dose (D4) of SARS-CoV-2 vaccine in Japanese KTRs. Anti-spike (anti-S) IgG antibody titers at 1 and 3 months after D4 of SARS-CoV-2 vaccine were evaluated in 75 KTRs.</p><p><strong>Results: </strong>The median anti-S IgG antibody titers at 1 and 3 months after D4 were 4728.1 (interquartile range [IQR]: 643.2-13,953.1) AU/mL and 3778 (IQR: 642-9436.6) AU/mL, respectively. The seropositivity rate after D4 was 85.1% at 1 month and 83.1% at 3 months, and the seroconversion rate was 28.6% (4 of 14 KTRs seronegative after the third dose). Factors associated with poor humoral responses were shorter time post-transplant to infection, a higher mycophenolate mofetil dose, a lower lymphocyte count, and a lower estimated glomerular filtration rate.</p><p><strong>Conclusion: </strong>This study demonstrates some efficacy of D4 of SARS-CoV-2 vaccine in KTRs who are seronegative after three doses and encourages consideration of further booster doses of the SARS-CoV-2 vaccine.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Booster effect of the fourth dose of the SARS-CoV-2 mRNA vaccine in kidney transplant recipients.\",\"authors\":\"Ayaka Hayashi, Mayuko Kawabe, Izumi Yamamoto, Yutaro Ohki, Akimitsu Kobayashi, Fumihiko Urabe, Jun Miki, Hiroki Yamada, Nanae Matsuo, Yudo Tanno, Tetsuya Horino, Ichiro Ohkido, Takahiro Kimura, Hiroyasu Yamamoto, Takashi Yokoo\",\"doi\":\"10.1007/s10157-025-02651-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Solid organ transplant recipients taking immunosuppressive drugs are at greater risk of severe COVID-19 than the general population. In particular, kidney transplant recipients (KTRs) are known to have lower seropositivity after basal doses of SARS-CoV-2 vaccines, and the strategy of administering booster doses in these immunocompromised individuals has been promoted worldwide.</p><p><strong>Methods: </strong>This study evaluated the effect of a fourth dose (D4) of SARS-CoV-2 vaccine in Japanese KTRs. Anti-spike (anti-S) IgG antibody titers at 1 and 3 months after D4 of SARS-CoV-2 vaccine were evaluated in 75 KTRs.</p><p><strong>Results: </strong>The median anti-S IgG antibody titers at 1 and 3 months after D4 were 4728.1 (interquartile range [IQR]: 643.2-13,953.1) AU/mL and 3778 (IQR: 642-9436.6) AU/mL, respectively. The seropositivity rate after D4 was 85.1% at 1 month and 83.1% at 3 months, and the seroconversion rate was 28.6% (4 of 14 KTRs seronegative after the third dose). Factors associated with poor humoral responses were shorter time post-transplant to infection, a higher mycophenolate mofetil dose, a lower lymphocyte count, and a lower estimated glomerular filtration rate.</p><p><strong>Conclusion: </strong>This study demonstrates some efficacy of D4 of SARS-CoV-2 vaccine in KTRs who are seronegative after three doses and encourages consideration of further booster doses of the SARS-CoV-2 vaccine.</p>\",\"PeriodicalId\":10349,\"journal\":{\"name\":\"Clinical and Experimental Nephrology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-03-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical and Experimental Nephrology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10157-025-02651-6\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Experimental Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10157-025-02651-6","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Booster effect of the fourth dose of the SARS-CoV-2 mRNA vaccine in kidney transplant recipients.
Background: Solid organ transplant recipients taking immunosuppressive drugs are at greater risk of severe COVID-19 than the general population. In particular, kidney transplant recipients (KTRs) are known to have lower seropositivity after basal doses of SARS-CoV-2 vaccines, and the strategy of administering booster doses in these immunocompromised individuals has been promoted worldwide.
Methods: This study evaluated the effect of a fourth dose (D4) of SARS-CoV-2 vaccine in Japanese KTRs. Anti-spike (anti-S) IgG antibody titers at 1 and 3 months after D4 of SARS-CoV-2 vaccine were evaluated in 75 KTRs.
Results: The median anti-S IgG antibody titers at 1 and 3 months after D4 were 4728.1 (interquartile range [IQR]: 643.2-13,953.1) AU/mL and 3778 (IQR: 642-9436.6) AU/mL, respectively. The seropositivity rate after D4 was 85.1% at 1 month and 83.1% at 3 months, and the seroconversion rate was 28.6% (4 of 14 KTRs seronegative after the third dose). Factors associated with poor humoral responses were shorter time post-transplant to infection, a higher mycophenolate mofetil dose, a lower lymphocyte count, and a lower estimated glomerular filtration rate.
Conclusion: This study demonstrates some efficacy of D4 of SARS-CoV-2 vaccine in KTRs who are seronegative after three doses and encourages consideration of further booster doses of the SARS-CoV-2 vaccine.
期刊介绍：
Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.
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