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Dynamics of SARS-CoV-2 Spike receptor-binding domain-targeted specific peripheral memory B cells in patients with end-stage chronic kidney disease undergoing replacement therapy following COVID-19 vaccination
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  • Ángela Sánchez,
  • Nayara Panizo,
  • Estela Giménez,
  • Eliseo Albert,
  • Marco Montomoli,
  • Irina Sanchis,
  • Julia Kanter,
  • José Luis Górriz,
  • David Navarro
Ángela Sánchez
Hospital Clinico Universitario
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Nayara Panizo
Hospital Clinico Universitario Servicio de Nefrologia
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Estela Giménez
Hospital Clinico Universitario
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Eliseo Albert
Hospital Clinico Universitario
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Marco Montomoli
Hospital Clinico Universitario Servicio de Nefrologia
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Irina Sanchis
Hospital Clinico Universitario Servicio de Nefrologia
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Julia Kanter
Hospital Universitario Doctor Peset
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José Luis Górriz
Hospital Clinico Universitario Servicio de Nefrologia
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David Navarro
Hospital Clinico Universitario

Corresponding Author:[email protected]

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Abstract

Memory B cells (MBCs) are responsible for maintaining long-lasting functional B-cell immune responses. Little is known about the kinetics of peripheral blood (PB) SARS-CoV-2 vaccine-induced MBCs in end-stage chronic kidney disease (CKD) patients undergoing replacement therapies. We investigated this issue in this prospective, observational cohort study including 27 patients (9 females and 18 males; median age, 68.4 years, range 48-82) comprising 20 hemodialysis patients and 7 Kidney transplant recipients. SARS-CoV-2-Receptor-Binding Domain (RBD)-targeted PB-MBCs were enumerated by flow cytometry using a tetramer-binding assay after the second COVID-19 mRNA vaccine dose (Post-2D), before (Pre-3D), and after the first mRNA vaccine booster dose (Post-3D). Commercially available electrochemiluminescent immunoassays were used to measure total anti-RBD antibodies targeting an IgG against the S trimeric protein. Overall, 18/27 patients (66.6%) exhibited detectable RBD-MBC responses at Post-2D, 12/27 (44.4%) at Pre-3D, and 16/27 (59.2%) at Post-3D. RBD-MBC levels dropped non-significantly between post-2D and Pre-3D ( P=0.38). A non-significant increase in RBD-MBCs was noticed post-3D ( P=0.65). Overall, both antibody specificities displayed the same dynamics but the drop in anti-trimeric spike antibody levels between Post-2D and Pre-3D and increases post-3D were statistically significant ( P<0.001). No correlation (rho = 0.05; P=0.64) was observed between total antibodies against RBD and RBD-MBC counts. The correlation between IgG antibodies against the trimeric S protein and SARS-CoV-2 RBD-MBC counts was very weak (rho, 0.18; P=0.11). In summary, waning RBD-MBC counts Pre-3D and increases post-3D are less marked than that of anti-RBD and anti-S trimeric antibodies.