Suffolk Reporter

Fighting infections poses significant challenges for individuals with chronic diseases, a situation exacerbated during the Covid-19 pandemic. A recent study by Stony Brook Medicine reveals that advanced kidney disease impairs the survival of B cells, which are crucial for producing antibodies to combat microbes. This finding highlights a weakened immune response to influenza in such patients and has been published in Nature Communications.

Kidney disease is identified as a major comorbid condition linked to severe infections and related deaths. According to the International Society of Nephrology, infections account for 20% of deaths among kidney disease patients. During the Covid-19 pandemic, mortality rates were significantly higher for those with kidney disease compared to individuals with normal kidney function.

Partha Biswas, DVM, PhD, from Stony Brook University's Renaissance School of Medicine, led this research to understand why kidney disease patients struggle to mount an effective immune response. The focus was on uremia, a condition involving toxic metabolite accumulation due to impaired blood filtration by the kidneys.

Clinical studies often report inadequate B cell-mediated antibody responses in kidney disease patients following infection or vaccination. Dr. Biswas notes that most studies associating kidney disease with abnormal B cell responses are either conducted on immunocompromised kidney transplant patients or are correlational.

Using a well-characterized murine model of kidney disease that leads to renal dysfunction, researchers examined immune responses in healthy mice and those with kidney disease after immunization or influenza virus infection. This triggered a germinal center response in the spleen crucial for developing protective antibodies.

The study provides mechanistic insights into how kidney disease adversely affects protective B cell responses during infection and immunization. Dr. Biswas believes these findings could inform strategies to enhance antibody production post-vaccination in people with kidney disease.

Currently, efforts are underway using this experimental system to explore responses to SARS-CoV-2 vaccination in individuals with kidney disease. The research may also have implications for other respiratory viruses and bacterial infections affecting these patients.

This study received support from multiple National Institutes of Health grants awarded to Dr. Biswas (AI142354, AI162616, AI159058, and AI181831). Collaborators included scientists from the University of Pittsburgh and the Medical College of Georgia.