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. 2022 Oct:74:101670.
doi: 10.1016/j.trim.2022.101670. Epub 2022 Jul 11.

SARS-CoV-2 mRNA vaccination is not associated with the induction of anti-HLA or non-HLA antibodies

Veerle P W M Wijtvliet  1 , Sonja Verheyden  2 , Barbara Depreter  2 , Christine Heylen  3 , Elke Coeman  3 , Steven Abrams  4 , Benedicte Y De Winter  5 , Annick Massart  6 , Rachel Hellemans  6 , Lissa Pipeleers  7 , Frans H J Claas  8 , Kevin K Ariën  9 , Karl Martin Wissing  7 , Daniel Abramowicz  6 , Kristien J Ledeganck  5
Affiliations

SARS-CoV-2 mRNA vaccination is not associated with the induction of anti-HLA or non-HLA antibodies

Veerle P W M Wijtvliet et al. Transpl Immunol. 2022 Oct.

Abstract

Background: SARS-CoV-2 vaccination is strongly recommended in kidney transplant recipients (KTR) and dialysis patients. Whether these vaccinations may trigger alloantibodies, is still debated.

Methods: In the current study we evaluated the effect of SARS-CoV-2 mRNA vaccines on anti-Human Leukocyte Antigen (HLA) and 60 anti-non-HLA antibody profiles in clinically stable KTR and dialysis patients. In total, we included 28 KTR, 30 patients on haemodialysis, 25 patients on peritoneal dialysis and 31 controls with a positive seroresponse 16-21 days after the first dose of either the SARS-CoV-2 mRNA BNT162b2 or mRNA-1273 vaccine. Both anti-HLA and anti-non-HLA antibodies were determined prior to vaccination and 21 to 35 days after the second vaccine dose.

Results: Overall, the proportion of patients with detectable anti-HLA antibodies was similar before and after vaccination (class I 14% vs. 16%, p = 0.48; class II 25% before and after vaccination). After vaccination, there was no pattern in 1) additionally detected anti-HLA antibodies, or 2) the levels of pre-existing ones. Additional anti-non-HLA antibodies were detected in 30% of the patients, ranging from 1 to 5 new anti-non-HLA antibodies per patient. However, the clinical significance of anti-non-HLA antibodies is still a matter of debate. To date, only a significant association has been found for anti-non-HLA ARHGDIB antibodies and long-term kidney graft loss. No additionally developed anti-ARHGDIB antibodies or elevated level of existing anti-ARHGDIB antibodies was observed.

Conclusion: The current data indicate that SARS-CoV-2 mRNA vaccination does not induce anti-HLA or anti-non-HLA antibodies, corroborating the importance of vaccinating KTR and dialysis patients.

Keywords: Antibodies; Human leukocyte antigen (HLA); Minor antigen; SARS-CoV-2; Vaccination.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Flow-chart of patient selection. Abbreviations: CTR = controls; HD = patients on haemodialysis; HLA = human leukocyte antigens; KTR = kidney transplant recipients; PD = patients on peritoneal dialysis.
Fig. 2
Fig. 2
Percentage of patients with positive antibody responses (to at least one bead) pre-vaccination (white) and 1 month after 2-dose SARS-CoV-2 mRNA vaccination (black). P-values were calculated using the McNemar's test with continuity correction. The frequency of anti-HLA antibodies remained overall unchanged post-vaccination in the study group of 114 subjects (28 kidney transplant recipients, 30 patients on haemodialysis, 25 patients on peritoneal dialysis and 31 controls). Abbreviations: CTR = controls; HD = patients on haemodialysis; HLA = human leukocyte antigens; KTR = kidney transplant recipients; PD = patients on peritoneal dialysis.
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