Clinicopathological and immunological features of new onset kidney disease: a rare event after SARS-CoV-2 vaccination
作者机构：Renal DivisionDepartment of MedicinePeking University First Hospital Renal Pathology CenterInstitute of NephrologyPeking University Key Laboratory of Renal DiseaseMinistry of Health of China Key Laboratory of CKD Prevention and TreatmentMinistry of Education of China Research Units of Diagnosis and Treatment of Immune-Mediated Kidney DiseasesChinese Academy of Medical Sciences State Key Laboratory of Genetic Resources and EvolutionKunming Institute of ZoologyChinese Academy of Sciences Central Laboratory and Liver Disease Research CenterThe Affiliated Hospital of Yunnan University Laboratory of Electron MicroscopyPathological CentrePeking University First Hospital State Key Laboratory for Conservation and Utilization of Bio-Resource and School of Life SciencesYunnan University
出 版 物：《National Science Review》 (国家科学评论(英文版))
年 卷 期：2023年第10卷第5期
页 面：112-123页
核心收录：
学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100401[医学-流行病与卫生统计学] 10[医学]
基 金：supported by the National Natural Science Foundation of China (91742205,82170711,82070733and 81625004) the Beijing Nova Program,Peking University Medicine Seed Fund for Interdisciplinary Research(BMU2022MX025) the Clinical Medicine Plus X—Young Scholars Project of Peking University (PKU2021LCXQ017) Fundamental Research Funds for the Central Universities,the CAMS Innovation Fund for Medical Sciences (2019-I2M-5-046) the Yunnan Provincial Science and Technology Department (202102AA100051 and 202003AC100010,China) the Beijing Young Scientist Program(BJJWZYJH01201910001006)
主 题：kidney disease SARS-CoV-2 vaccination abnormal immune response
摘 要：The onset of various kidney diseases has been reported after severe acute respiratory syndrome coronavirus2(SARS-CoV-2) vaccination.However,detailed clinical and pathological features are lacking.We screened and analyzed patients with newly diagnosed kidney diseases after inactivated SARS-CoV-2 vaccination in Peking University First Hospital from January 2021 to August 2021,and compared them with the reported cases in the literature.We obtained samples of blood,urine and renal biopsy tissues.Clinical and laboratory information,as well as light microscopy,immunostaining and ultrastructural observations,were described.The SARS-CoV-2 spike protein and nucle oprotein were stained using the immunofluorescence technique in the kidney biopsy samples.SARS-CoV-2 specific antibodies were tested using magnetic particle chemiluminescence immunoassay.The study group included 17 patients with a range of conditions including immune-complex-mediated kidney diseases(IgA nephropathy,membranous nephropathy and lupus nephritis),podocytopathy(minimal change disease and focal segmental glomerulosclerosis) and others(antineutrophil-cytoplasmic-antibody-associated vasculitis,anti-glomerular basement membrane nephritis,acute tubulointerstitial nephritis and thrombotic micro angiopathy).Seven patients(41.18%)developed renal disease after the first dose and ten(58.82%) after the second dose.The kidney disease spectrum as well as clinicopathological features are similar across different types of SARS-CoV-2 vaccines.We found no definitive evidence of SARS-CoV-2 spike protein or nucleoprotein deposition in the kidney biopsy samples.Seropositive markers implicated abnormal immune responses in predisposed individuals.Treatment and follow-up(median=86 days) showed that biopsy diagnosis informed treatment and prognosis in all patients.In conclusion,we observed various kidney diseases following SARS-CoV-2 vaccine administration,which show a high consistency across different types of SARS-CoV-2 vaccines.Our findings provide evidence against direct vaccine protein deposition as the major pathomechanism,but implicate abnormal immune responses in predisposed individuals.These findings expand our understanding of SARS-CoV-2 vaccine renal safety.
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