T-cell immunity associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or vaccination in solid organ transplant recipients (SOTRs) is poorly understood. To address this, we measured T-cell responses in 50 SOTRs with prior SARS-CoV-2 infection. The majority of patients mounted SARS-CoV-2–specific CD4+ T-cell responses against spike (S), nucleocapsid, and membrane proteins; CD8+ T-cell responses were generated to a lesser extent. CD4+ T-cell responses correlated with antibody levels. Severity of disease and mycophenolate dose were moderately associated with lower proportions of antigen-specific T cells. Relative to nontransplant controls, SOTRs had perturbations in both total and antigen-specific T cells, including higher frequencies of total PD-1+ CD4+ T cells. Vaccinated SOTRs (n = 55) mounted significantly lower proportions of S-specific polyfunctional CD4+ T cells after 2 doses, relative to unvaccinated SOTRs with prior coronavirus disease 2019. Together, these results suggest that SOTRs generate robust T-cell responses following natural infection that correlate with disease severity but generate comparatively lower T-cell responses following mRNA vaccination.

中文翻译：

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与实体器官移植接受者的疫苗接种相比，严重急性呼吸系统综合症冠状病毒 2 感染会引起更大的 T 细胞反应

对实体器官移植受者 (SOTR) 中与严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染或疫苗接种相关的 T 细胞免疫知之甚少。为了解决这个问题，我们测量了 50 个先前感染过 SARS-CoV-2 的 SOTR 中的 T 细胞反应。大多数患者对刺突蛋白 (S)、核衣壳和膜蛋白产生 SARS-CoV-2 特异性 CD4+ T 细胞反应；CD8+ T 细胞反应的产生程度较小。CD4+ T 细胞反应与抗体水平相关。疾病严重程度和霉酚酸酯剂量与较低比例的抗原特异性 T 细胞中度相关。相对于非移植对照，SOTR 在总 T 细胞和抗原特异性 T 细胞中都有扰动，包括更高频率的总 PD-1+ CD4+ T 细胞。