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
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.