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J Med Virol . Memory B Cells Provide Long-Term Protection to Vaccinated Kidney Transplant Recipients Against SARS-CoV-2 Variants

tetano

Editor, Senior Moderator
J Med Virol


. 2024 Nov;96(11):e70037.
doi: 10.1002/jmv.70037. Memory B Cells Provide Long-Term Protection to Vaccinated Kidney Transplant Recipients Against SARS-CoV-2 Variants

Maxime Espi[SUP] 1 [/SUP], Xavier Charmetant[SUP] 1 2 3 [/SUP], Ilies Benotmane[SUP] 4 5 [/SUP], Katia Lefsihane[SUP] 1 [/SUP], Véronique Barateau[SUP] 1 [/SUP], Floriane Gallais[SUP] 6 [/SUP], Hafsa Boulenouar[SUP] 5 [/SUP], Anne Ovize[SUP] 7 [/SUP], Alexia Barbry[SUP] 7 [/SUP], Christine Bouz[SUP] 7 [/SUP], Emmanuel Morelon[SUP] 1 2 3 [/SUP], Thierry Defrance[SUP] 1 [/SUP], Samira Fafi-Kremer[SUP] 5 6 [/SUP], Sophie Caillard[SUP] 4 5 [/SUP], Olivier Thaunat[SUP] 1 2 3 [/SUP]



Affiliations
Abstract

Kidney transplant recipients (KTRs) are highly vulnerable to COVID-19. An intensified scheme of vaccination offers short-term protection to the 50%-75% of KTRs able to develop a germinal center reaction, required for the generation of neutralizing titers of antibodies (NAbs). However, the duration of this vaccinal protection is unknown. In-depth longitudinal analysis of the immune response to vaccination of 33 KTRs demonstrates that the low peak of IgGs, the progressive decline in antibody titers, and the emergence of a variant of concerns (VOC) of SARS-CoV2, synergize to let 2/3 of responders to vaccine without NAbs after only a few months. Yet, a retrospective study of an independent cohort of 274 KTRs, revealed that the risk of severe COVID-19 in the latter was low, similar to that of patients with serum neutralizing capacity against VOC. Our work links this late vaccine protection with the presence of memory B cells, which are generated during the initial vaccine-induced germinal center reaction, have a wide repertoire directed against conserved spike epitopes, and rapidly differentiate into IgG-producing plasma cells upon antigenic rechallenge. We conclude that in contrast with a serological layer that goes fading rapidly, the cellular layer of humoral memory provides an efficient long-term protection against VOC to KTRs. This illustration of the complementary roles of the two layers of the humoral memory has implications in immunopathology beyond the COVID-19 in KTRs.

Keywords: coronavirus; disease control; immune responses; vaccines/vaccine strains; virus classification.

 
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