Distinct neutralising and complement-fixing antibody responses can be induced to the same antigen in haemodialysis patients after immunisation with different vaccine platforms
Distinct neutralising and complement-fixing antibody responses can be induced to the same antigen in haemodialysis patients after immunisation with different vaccine platforms
Background/objectives: generalised immune dysfunction in chronic kidney disease, especially in patients requiring haemodialysis (HD), significantly enhances the risk of severe infections. Vaccine-induced immunity is typically reduced in HD populations. The SARS-CoV-2 pandemic provided an opportunity to examine the magnitude and functionality of antibody responses in HD patients to a previously unencountered antigen-Spike (S)-glycoprotein-after vaccination with different vaccine platforms (viral vector (VV); mRNA (mRV)).
Methods: we compared the total and functional anti-S antibody responses (cross-variant neutralisation and complement binding) in 187 HD patients and 43 healthy controls 21-28 days after serial immunisation.
Results: after 2 doses of the same vaccine, HD patients had anti-S antibody levels and a complement binding capacity comparable to controls. However, 2 doses of mRV induced greater polyfunctional antibody responses than VV (defined by the presence of both complement binding and cross-variant neutralisation activity). Interestingly, an mRV boost after 2 doses of VV significantly enhanced antibody functionality in HD patients without a prior history of SARS-CoV-2 infection.
Conclusions: HD patients can generate near-normal, functional antigen-specific antibody responses following serial vaccination to a novel antigen. Encouragingly, exploiting immunological memory by using mRNA vaccines and boosting may improve the success of vaccination strategies in this vulnerable patient population.
Wall, Nadezhda
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Lamerton, Rachel
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Ashford, Fiona
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Perez-Toledo, Marisol
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Jasiulewicz, Aleksandra
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Banham, Gemma D.
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Newby, Maddy L.
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Faustini, Sian E.
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Richter, Alex G.
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Selvaskandan, Haresh
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Billany, Roseanne E.
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Adenwalla, Sherna F.
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Henderson, Ian R.
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Crispin, Max
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Graham-Brown, Matthew
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Harper, Lorraine
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Cunningham, Adam F.
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25 December 2024
Wall, Nadezhda
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Lamerton, Rachel
02c5bf93-80b1-4fee-b676-f22007a19096
Ashford, Fiona
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Perez-Toledo, Marisol
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Jasiulewicz, Aleksandra
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Banham, Gemma D.
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Newby, Maddy L.
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Faustini, Sian E.
fc25e886-bb2c-4c9c-a421-df8e00e6b1ba
Richter, Alex G.
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Selvaskandan, Haresh
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Billany, Roseanne E.
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Adenwalla, Sherna F.
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Henderson, Ian R.
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Crispin, Max
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Graham-Brown, Matthew
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Harper, Lorraine
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Cunningham, Adam F.
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Wall, Nadezhda, Lamerton, Rachel, Ashford, Fiona, Perez-Toledo, Marisol, Jasiulewicz, Aleksandra, Banham, Gemma D., Newby, Maddy L., Faustini, Sian E., Richter, Alex G., Selvaskandan, Haresh, Billany, Roseanne E., Adenwalla, Sherna F., Henderson, Ian R., Crispin, Max, Graham-Brown, Matthew, Harper, Lorraine and Cunningham, Adam F.
(2024)
Distinct neutralising and complement-fixing antibody responses can be induced to the same antigen in haemodialysis patients after immunisation with different vaccine platforms.
Vaccines, 13 (1), [7].
(doi:10.3390/vaccines13010007).
Abstract
Background/objectives: generalised immune dysfunction in chronic kidney disease, especially in patients requiring haemodialysis (HD), significantly enhances the risk of severe infections. Vaccine-induced immunity is typically reduced in HD populations. The SARS-CoV-2 pandemic provided an opportunity to examine the magnitude and functionality of antibody responses in HD patients to a previously unencountered antigen-Spike (S)-glycoprotein-after vaccination with different vaccine platforms (viral vector (VV); mRNA (mRV)).
Methods: we compared the total and functional anti-S antibody responses (cross-variant neutralisation and complement binding) in 187 HD patients and 43 healthy controls 21-28 days after serial immunisation.
Results: after 2 doses of the same vaccine, HD patients had anti-S antibody levels and a complement binding capacity comparable to controls. However, 2 doses of mRV induced greater polyfunctional antibody responses than VV (defined by the presence of both complement binding and cross-variant neutralisation activity). Interestingly, an mRV boost after 2 doses of VV significantly enhanced antibody functionality in HD patients without a prior history of SARS-CoV-2 infection.
Conclusions: HD patients can generate near-normal, functional antigen-specific antibody responses following serial vaccination to a novel antigen. Encouragingly, exploiting immunological memory by using mRNA vaccines and boosting may improve the success of vaccination strategies in this vulnerable patient population.
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vaccines-13-00007
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Accepted/In Press date: 16 December 2024
Published date: 25 December 2024
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Local EPrints ID: 503255
URI: http://eprints.soton.ac.uk/id/eprint/503255
ISSN: 2076-393X
PURE UUID: f52d0979-4903-4a02-9832-d528032e83a2
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Date deposited: 25 Jul 2025 16:38
Last modified: 22 Aug 2025 02:19
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Contributors
Author:
Nadezhda Wall
Author:
Rachel Lamerton
Author:
Fiona Ashford
Author:
Marisol Perez-Toledo
Author:
Aleksandra Jasiulewicz
Author:
Gemma D. Banham
Author:
Maddy L. Newby
Author:
Sian E. Faustini
Author:
Alex G. Richter
Author:
Haresh Selvaskandan
Author:
Roseanne E. Billany
Author:
Sherna F. Adenwalla
Author:
Ian R. Henderson
Author:
Matthew Graham-Brown
Author:
Lorraine Harper
Author:
Adam F. Cunningham
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