SARS-CoV-2-specific immune responses converge in kidney disease patients and controls with hybrid immunity

Muriel Aguilar-Bretones, Yvette den Hartog, Laura L.A. van Dijk, S. Reshwan K. Malahe, Marjolein Dieterich, Héctor Tejeda Mora, Yvonne M. Mueller, Marion P.G. Koopmans, Marlies E.J. Reinders, Carla C. Baan, Gijsbert P. van Nierop*, Rory D. de Vries*, Alferso C. Abrahams, Marije C. Baas, Marc H. Hemmelder, Pim Bouwmans, Marc A.G.J. ten Dam, Lennert Gommers, Aiko P.J. de Vries

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Healthy individuals with hybrid immunity, due to a SARS-CoV-2 infection prior to first vaccination, have stronger immune responses compared to those who were exclusively vaccinated. However, little is known about the characteristics of antibody, B- and T-cell responses in kidney disease patients with hybrid immunity. Here, we explored differences between kidney disease patients and controls with hybrid immunity after asymptomatic or mild coronavirus disease-2019 (COVID-19). We studied the kinetics, magnitude, breadth and phenotype of SARS-CoV-2-specific immune responses against primary mRNA-1273 vaccination in patients with chronic kidney disease or on dialysis, kidney transplant recipients, and controls with hybrid immunity. Although vaccination alone is less immunogenic in kidney disease patients, mRNA-1273 induced a robust immune response in patients with prior SARS-CoV-2 infection. In contrast, kidney disease patients with hybrid immunity develop SARS-CoV-2 antibody, B- and T-cell responses that are equally strong or stronger than controls. Phenotypic analysis showed that Spike (S)-specific B-cells varied between groups in lymph node-homing and memory phenotypes, yet S-specific T-cell responses were phenotypically consistent across groups. The heterogeneity amongst immune responses in hybrid immune kidney patients warrants further studies in larger cohorts to unravel markers of long-term protection that can be used for the design of targeted vaccine regimens.

Original languageEnglish
Article number93
Journalnpj Vaccines
Issue number1
Publication statusPublished - 28 May 2024

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