{"paper_id":"4c8c2818-d2f3-4c9e-902d-8458ca45624d","body_text":"Serum Unconjugated Bilirubin as a Predictor of Specific Cellular Immunity Response in Kidney Transplant Recipients after Administration of SARS-CoV-2 Inactivated Vaccine | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Serum Unconjugated Bilirubin as a Predictor of Specific Cellular Immunity Response in Kidney Transplant Recipients after Administration of SARS-CoV-2 Inactivated Vaccine Lei Zhang, Jiaqing Yang, Changchun Lai, Min Deng, Xuanying Deng, and 22 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1406060/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose The immunogenicity of SARS-CoV-2 vaccines is poor in kidney transplant recipients (KTRs). The factors related to poor immunogenicity to vaccination in KTRs are not well defined. Methods An observational study was conducted in KTRs and healthy individuals who had received two doses of SARS-CoV-2 inactivated vaccine. IgG antibodies against the receptor-binding domain found in the S1 subunit of the spike protein, and against nucleocapsid protein were measured using enzyme-linked immunosorbent assay. Receptor-binding domain (RBD)-angiotensin-converting enzyme 2 interaction-blocking antibodies were measured using commercial kits. T cell responses against the spike and nucleocapsid proteins were detected using enzyme-linked immunosorbent spot assay. Results No severe adverse effects were observed in KTRs after first or second dose of SARS-CoV-2 inactivated vaccine. IgG antibodies against the receptor- binding domain, and nucleocapsid protein were not effectively induced in a majority of KTRs after second dose of inactivated vaccine. Specific T cell immunity response was detectable in 32%-40% KTRs after second doses of inactivated vaccine. KTRs who developed specific T cell immunity were more likely to be female, and have lower levels of total bilirubin, unconjugated bilirubin, and blood tacrolimus concentration. Multivariate logistic regression analysis found that blood unconjugated bilirubin was significantly negatively associated with SARS-CoV-2 specific T cell immunity response in k KTRs. Conclusions Specific T cell immunity response could be induced in 32%-40% KTRs after two doses of inactivated vaccine. Blood unconjugated bilirubin was negatively associated with specific cellular immunity response in KTRs following vaccination. Kidney transplant recipients COVID-19 Humoral immunity Cellular immunity Inactivated vaccine Figures Figure 1 Figure 2 Full Text Supplementary Files figS1Supplymentalcorrelationship.jpg Figure S1. Correlation between T cell immunity response and anti-SARS-CoV-2 antibody level in healthy participants (HPs) and kidney transplant recipients (KTRs) 21±4 days after the second dose of inactivated vaccine. (A-D) The correlation between spike specific T cells frequency and anti-spike IgG (A), anti-receptor binding domain (RBD) IgG (B), RBD-Angiotensin I-converting enzyme 2 (ACE2) interaction blocking antibody (C), anti-nucleocapsid protein (NP) IgG (D) in HPs after the second dose of inactivated vaccine. (E-H) The correlation between NP-specific T cells frequency and anti-spike IgG (E), anti-receptor binding domain (RBD) IgG (F), RBD-Angiotensin I-converting enzyme 2 (ACE2) interaction-blocking antibody (G), anti-nucleocapsid protein (NP) IgG (H) in HPs after the second dose of inactivated vaccine. (I-L) The correlation between spike specific T cells frequency and anti-spike IgG (I), anti-receptor binding domain (RBD) IgG (J), RBD-Angiotensin I-converting enzyme 2 (ACE2) interaction blocking antibody (K), anti-nucleocapsid protein (NP) IgG (L) in KTRs after the second dose of inactivated vaccine. (M-P) The correlation between NP specific T cells frequency and anti-spike IgG (M), anti-receptor binding domain (RBD) IgG (N), RBD-Angiotensin I-converting enzyme 2 (ACE2) interaction-blocking antibody (O), anti-nucleocapsid protein (NP) IgG (P) in KTRs after the second dose of inactivated vaccine. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-1406060\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":87850292,\"identity\":\"ba84f061-d8d0-4371-a0d7-f507afae51fe\",\"order_by\":0,\"name\":\"Lei Zhang\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Lei\",\"middleName\":\"\",\"lastName\":\"Zhang\",\"suffix\":\"\"},{\"id\":87850293,\"identity\":\"711f005e-3f53-4218-a474-b9e6be1398ce\",\"order_by\":1,\"name\":\"Jiaqing Yang\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Jiaqing\",\"middleName\":\"\",\"lastName\":\"Yang\",\"suffix\":\"\"},{\"id\":87850294,\"identity\":\"35b85638-fe23-4656-9f12-c422da81a0a0\",\"order_by\":2,\"name\":\"Changchun Lai\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Changchun\",\"middleName\":\"\",\"lastName\":\"Lai\",\"suffix\":\"\"},{\"id\":87850295,\"identity\":\"b0a7c242-4767-4e2b-89d4-afe163eede5f\",\"order_by\":3,\"name\":\"Min Deng\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Min\",\"middleName\":\"\",\"lastName\":\"Deng\",\"suffix\":\"\"},{\"id\":87850296,\"identity\":\"1f8d3d42-ab7e-48ef-8911-4dae1e120d29\",\"order_by\":4,\"name\":\"Xuanying 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Zhu\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Jinhong\",\"middleName\":\"\",\"lastName\":\"Zhu\",\"suffix\":\"\"},{\"id\":87850303,\"identity\":\"2bced109-71ab-4352-b9ac-b84f1e1c1ca0\",\"order_by\":11,\"name\":\"Jiali Fang\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Jiali\",\"middleName\":\"\",\"lastName\":\"Fang\",\"suffix\":\"\"},{\"id\":87850304,\"identity\":\"6b2603d8-28a0-417d-9ac2-c469ccabab30\",\"order_by\":12,\"name\":\"Jingcai Hou\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Jingcai\",\"middleName\":\"\",\"lastName\":\"Hou\",\"suffix\":\"\"},{\"id\":87850305,\"identity\":\"e413fc58-9f8a-4586-89b0-1aa498335427\",\"order_by\":13,\"name\":\"Na Li\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Na\",\"middleName\":\"\",\"lastName\":\"Li\",\"suffix\":\"\"},{\"id\":87850306,\"identity\":\"3ceb601f-fc9d-4dbf-b76c-5a0ddaaa1f50\",\"order_by\":14,\"name\":\"Xingqiang Lai\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Xingqiang\",\"middleName\":\"\",\"lastName\":\"Lai\",\"suffix\":\"\"},{\"id\":87850307,\"identity\":\"ae0723bb-e31c-40c3-aa79-1f4eab3cc35d\",\"order_by\":15,\"name\":\"Feifei Ma\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Feifei\",\"middleName\":\"\",\"lastName\":\"Ma\",\"suffix\":\"\"},{\"id\":87850308,\"identity\":\"e8faf215-33cf-45a8-8d14-2641fd16ef69\",\"order_by\":16,\"name\":\"Ning Li\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Ning\",\"middleName\":\"\",\"lastName\":\"Li\",\"suffix\":\"\"},{\"id\":87850309,\"identity\":\"e0101967-61a9-4164-868c-61397f041492\",\"order_by\":17,\"name\":\"Guanghui Li\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Guanghui\",\"middleName\":\"\",\"lastName\":\"Li\",\"suffix\":\"\"},{\"id\":87850310,\"identity\":\"23ef96ee-6dc3-4fec-b6e1-b1a32d9f2d40\",\"order_by\":18,\"name\":\"Weiya Kong\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Weiya\",\"middleName\":\"\",\"lastName\":\"Kong\",\"suffix\":\"\"},{\"id\":87850311,\"identity\":\"e2dff36e-8833-4b73-b9bd-7795b5c5b8dd\",\"order_by\":19,\"name\":\"Weiting Zhang\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Weiting\",\"middleName\":\"\",\"lastName\":\"Zhang\",\"suffix\":\"\"},{\"id\":87850312,\"identity\":\"3e813544-2952-4cb5-a282-607dd1970e68\",\"order_by\":20,\"name\":\"Jiale Kang\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Jiale\",\"middleName\":\"\",\"lastName\":\"Kang\",\"suffix\":\"\"},{\"id\":87850313,\"identity\":\"25034422-4cc7-40d8-9f78-dedc26568845\",\"order_by\":21,\"name\":\"Jiali Li\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Jiali\",\"middleName\":\"\",\"lastName\":\"Li\",\"suffix\":\"\"},{\"id\":87850314,\"identity\":\"cc847a0d-3ff5-4906-b505-187bc991c65f\",\"order_by\":22,\"name\":\"Haoyu 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Chen\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Ling\",\"middleName\":\"\",\"lastName\":\"Chen\",\"suffix\":\"\"},{\"id\":87850318,\"identity\":\"50820a17-2efc-46e6-9c2d-6d0587ee82f3\",\"order_by\":26,\"name\":\"tianxing ji\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA80lEQVRIie2PsWoCQRCG51iwGtl2D5S8woiFCIe+ykHgKos8wsLBphLbS5enCClnWbCSXCukiVgLe2XAQI6AlybcphTcr5m/mI9/BiASuUKSEoDbiQDSs6cMpdQhRVwUmByqh2KUVhzqEV2aTtG7jHQeEB6l5c9XN5rJ50Ih1UjAiW9W/YfZ9a7AefWxVYrecSa0SJ9eAr8MTYa0t0ZRq8w1D8QwoNgv0560dwOV0xsS52HF/bTURhAT/0shNzZF24LJQdM9ppUte3+ZbOyxORm3pHoH7nxeLKUsrW/6FH1JKu+a9R+Lv9x1SXLvYiQSidww30FOU8pFUcKxAAAAAElFTkSuQmCC\",\"orcid\":\"https://orcid.org/0000-0001-6760-9775\",\"institution\":\"Guangzhou Medical University Second Affiliated Hospital\",\"correspondingAuthor\":true,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"tianxing\",\"middleName\":\"\",\"lastName\":\"ji\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2022-03-01 02:25:14\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-1406060/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-1406060/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":18837701,\"identity\":\"9c2d7927-a829-4f9f-9c9a-660601b3db8c\",\"added_by\":\"auto\",\"created_at\":\"2022-03-03 20:38:09\",\"extension\":\"jpg\",\"order_by\":1,\"title\":\"Figure 1\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":7125798,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eAnti-SARS-CoV-2 antibodies in kidney transplant recipients (KTR) and healthy participants (HPs) at 21±4 days (KTRs1 and HPs1) and 40±9 days (KTRs2 and HPs2) after the second dose of SARS-CoV-2 inactivated vaccine compared with KTRs or HPs without vaccination (KTRs0 and HPs0). (A) The optical density of anti-S1 IgG antibody in KTRs and HPs without vaccination and in 21±4 days and 40±9 days after the second dose of SARS-CoV-2 inactivated vaccine. (B) The optical density of anti-receptor binding domain (RBD) IgG antibody in KTRs and HPs without vaccination and in 21±4 days and 40±9 days after the second dose of SARS-CoV-2 inactivated vaccine. (C) The RBD-Angiotensin I Converting Enzyme 2 (ACE2) interaction blocking antibody in KTRs and HPs without vaccination and in 21±4 days and 40±9 days after the second dose of SARS-CoV-2 inactivated vaccine. (D) The optical density of anti-receptor binding domain (RBD) IgG antibody in KTRs and HPs without vaccination and in 21±4 days and 40±9 days after the second dose of SARS-CoV-2 inactivated vaccine. The horizontal dotted line indicates the cut-off value for positivity. The cut-off value was calculated using mean + 3 standard deviation (SD) optical density of plasma samples from HPs and KTRs without vaccination.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"renamed53f4e.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-1406060/v1/e9dc310a528452ac1682a2dd.jpg\"},{\"id\":18837700,\"identity\":\"37c9f032-74a2-414c-a714-d97d5316420b\",\"added_by\":\"auto\",\"created_at\":\"2022-03-03 20:38:09\",\"extension\":\"jpg\",\"order_by\":2,\"title\":\"Figure 2\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":12275082,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eT cell responses to pooled peptides from SARS-CoV-2 spike and nucleocapsid protein (NP) in kidney transplant recipients (KTR) and healthy participants (HPs) at 21±4 days (KTRs1 and HPs1) and 40±9 days (KTRs2 and HPs2) after the second dose of SARS-CoV-2 inactivated vaccine compared with KTRs or HPs without vaccination (KTRs0 and HPs0). (A) T cell responses targeted against SARS-CoV-2 spike in KTRs and HPs without vaccination, or at 21±4 days and 40±9 days after the second dose of inactivated vaccine. (B) The kinetic of spike specific T cells frequency in paired samples from KTRs and HPs at 21±4 days (KTRs1 and HPs1) and 40±9 days after the second dose of inactivated vaccine. (C) T cell responses targeted against SARS-CoV-2 NP in KTRs and HPs without vaccination or at 21±4 days and 40±9 days after the second dose of inactivated vaccine. (D) The kinetic of NP-specific T cell frequency in paired samples from KTRs and HPs at 21±4 days (KTRs1 and HPs1) and 40±9 days after the second dose of inactivated vaccine. (E) T cell responses targeted against SARS-CoV-2 spike and NP in KTRs and HPs without vaccination or at 21±4 days and 40±9 days after the second dose of inactivated vaccine. (F) The kinetic of spike and NP- specific T cell frequency in paired samples from KTRs and HPs at 21±4 days (KTRs1 and HPs1) and 40±9 days after the second dose of inactivated vaccine. The dotted line represents the cut-off value, which was calculated using mean ± 2 standard deviations (SD) spike or NP-specific T cell frequency of HPs and KTRs without vaccination and COVID-19 history.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"renamede9ca2.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-1406060/v1/f6ebf5cd56173b900b27d3da.jpg\"},{\"id\":18837768,\"identity\":\"c4e90093-3a54-4e62-a534-535f82132c28\",\"added_by\":\"auto\",\"created_at\":\"2022-03-03 20:38:24\",\"extension\":\"pdf\",\"order_by\":1,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":413005,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"20220223JCIsubmit.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-1406060/v1_covered.pdf\"},{\"id\":18837699,\"identity\":\"24a5b41f-56ba-40cf-ad9e-1db3a5221265\",\"added_by\":\"auto\",\"created_at\":\"2022-03-03 20:38:09\",\"extension\":\"jpg\",\"order_by\":1,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":4058046,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eFigure S1. Correlation between T cell immunity response and anti-SARS-CoV-2 antibody level in healthy participants (HPs) and kidney transplant recipients (KTRs) 21±4 days after the second dose of inactivated vaccine. (A-D) The correlation between spike specific T cells frequency and anti-spike IgG (A), anti-receptor binding domain (RBD) IgG (B), RBD-Angiotensin I-converting enzyme 2 (ACE2) interaction blocking antibody (C), anti-nucleocapsid protein (NP) IgG (D) in HPs after the second dose of inactivated vaccine. (E-H) The correlation between NP-specific T cells frequency and anti-spike IgG (E), anti-receptor binding domain (RBD) IgG (F), RBD-Angiotensin I-converting enzyme 2 (ACE2) interaction-blocking antibody (G), anti-nucleocapsid protein (NP) IgG (H) in HPs after the second dose of inactivated vaccine. (I-L) The correlation between spike specific T cells frequency and anti-spike IgG (I), anti-receptor binding domain (RBD) IgG (J), RBD-Angiotensin I-converting enzyme 2 (ACE2) interaction blocking antibody (K), anti-nucleocapsid protein (NP) IgG (L) in KTRs after the second dose of inactivated vaccine. (M-P) The correlation between NP specific T cells frequency and anti-spike IgG (M), anti-receptor binding domain (RBD) IgG (N), RBD-Angiotensin I-converting enzyme 2 (ACE2) interaction-blocking antibody (O), anti-nucleocapsid protein (NP) IgG (P) in KTRs after the second dose of inactivated vaccine.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"figS1Supplymentalcorrelationship.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-1406060/v1/bb56fa6db792333a7a3048e3.jpg\"}],\"financialInterests\":\"\",\"formattedTitle\":\"Serum Unconjugated Bilirubin as a Predictor of Specific Cellular Immunity Response in Kidney Transplant Recipients after Administration of SARS-CoV-2 Inactivated Vaccine\",\"fulltext\":[{\"header\":\"Full Text\",\"content\":\"This preprint is available for \\u003ca href='/article/rs-1406060/latest.pdf' target='_blank'\\u003edownload as a PDF\\u003c/a\\u003e.\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":false,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":true,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":true,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Kidney transplant recipients, COVID-19, Humoral immunity, Cellular immunity, Inactivated vaccine\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-1406060/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-1406060/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"Purpose\\n\\nThe immunogenicity of SARS-CoV-2 vaccines is poor in kidney transplant recipients (KTRs). The factors related to poor immunogenicity to vaccination in KTRs are not well defined.\\n\\nMethods\\n\\nAn observational study was conducted in KTRs and healthy individuals who had received two doses of SARS-CoV-2 inactivated vaccine. IgG antibodies against the receptor-binding domain found in the S1 subunit of the spike protein, and against nucleocapsid protein were measured using enzyme-linked immunosorbent assay. Receptor-binding domain (RBD)-angiotensin-converting enzyme 2 interaction-blocking antibodies were measured using commercial kits. T cell responses against the spike and nucleocapsid proteins were detected using enzyme-linked immunosorbent spot assay.\\n\\nResults\\n\\nNo severe adverse effects were observed in KTRs after first or second dose of SARS-CoV-2 inactivated vaccine. IgG antibodies against the receptor- binding domain, and nucleocapsid protein were not effectively induced in a majority of KTRs after second dose of inactivated vaccine. Specific T cell immunity response was detectable in 32%-40% KTRs after second doses of inactivated vaccine. KTRs who developed specific T cell immunity were more likely to be female, and have lower levels of total bilirubin, unconjugated bilirubin, and blood tacrolimus concentration. Multivariate logistic regression analysis found that blood unconjugated bilirubin was significantly negatively associated with SARS-CoV-2 specific T cell immunity response in k KTRs.\\n\\nConclusions\\n\\nSpecific T cell immunity response could be induced in 32%-40% KTRs after two doses of inactivated vaccine. Blood unconjugated bilirubin was negatively associated with specific cellular immunity response in KTRs following vaccination.\",\"manuscriptTitle\":\"Serum Unconjugated Bilirubin as a Predictor of Specific Cellular Immunity Response in Kidney Transplant Recipients after Administration of SARS-CoV-2 Inactivated Vaccine\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2022-03-03 20:38:07\",\"doi\":\"10.21203/rs.3.rs-1406060/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"83739e0c-e83b-4758-99d9-b04974b0c8fb\",\"owner\":[],\"postedDate\":\"March 3rd, 2022\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2022-03-03T20:38:07+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2022-03-03 20:38:07\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-1406060\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-1406060\",\"identity\":\"rs-1406060\",\"version\":[\"v1\"]},\"buildId\":\"ehx78VzkSd0WSzXnipQa-\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}