Case Report: Precision COVID-19 Immunization Strategy to Overcome Individual Fragility: A Case of Generalized Lipodystrophy Type 4

Salvatore Zaffina; Eva Piano Mortari; Reparata Rosa Di Prinzio; Marco Cappa; Antonio Novelli; Emanuele Agolini; Massimiliano Raponi; Bruno Dallapiccola; Franco Locatelli; Carlo Federico Perno; Rita Carsetti

doi:10.3389/fimmu.2022.869042

Case Report: Precision COVID-19 Immunization Strategy to Overcome Individual Fragility: A Case of Generalized Lipodystrophy Type 4

Front Immunol. 2022 Apr 6:13:869042. doi: 10.3389/fimmu.2022.869042. eCollection 2022.

Authors

Affiliations

¹ Occupational Medicine/Health Technology Assessment and Safety Research Unit, Clinical-Technological Innovations Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
² Diagnostic Immunology Research Unit, Multimodal Medicine Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
³ Unit of Endocrinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
⁴ Laboratory of Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
⁵ Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
⁶ Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
⁷ Department of Pediatric Hematology and Oncology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
⁸ Sapienza, University of Rome, Rome, Italy.
⁹ Microbiology and Diagnostic Immunology Unit and Multimodal Medicine Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Abstract

A 48-year-old patient affected with congenital generalized lipodystrophy type 4 failed to respond to two doses of the BNT162b2 vaccine, consisting of lipid nanoparticle encapsulated mRNA. As the disease is caused by biallelic variants of CAVIN1, a molecule indispensable for lipid endocytosis and regulation, we complemented the vaccination cycle with a single dose of the Ad26.COV2 vaccine. Adenovirus-based vaccine entry is mediated by the interaction with adenovirus receptors and transport occurs in clathrin-coated pits. Ten days after Ad26.COV2 administration, S- and RBD-specific antibodies and high-affinity memory B cells increased significantly to values close to those observed in Health Care Worker controls.

Keywords: CAVIN1; SARS-CoV-2 vaccine; case report; congenital generalized lipodystrophy type 4; memory B cells.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Adenovirus Vaccines*
BNT162 Vaccine
COVID-19 Vaccines / adverse effects
COVID-19*
Humans
Lipodystrophy, Congenital Generalized*
Liposomes
Middle Aged
Nanoparticles
SARS-CoV-2
Vaccination

Substances

Adenovirus Vaccines
COVID-19 Vaccines
Lipid Nanoparticles
Liposomes
BNT162 Vaccine