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Germinal center responses to SARS-CoV-2 mRNA vaccines in healthy and immunocompromised individuals
Open accessPreprint — published as 10.1016/j.cell.2022.01.027
Abstract
SUMMARY: Vaccine-mediated immunity often relies on the generation of protective antibodies and memory B cells, which commonly stem from germinal center (GC) reactions. An in-depth comparison of the GC responses elicited by SARS-CoV-2 mRNA vaccines in healthy and immunocompromised individuals has not yet been performed due to the challenge of directly probing human lymph nodes. In this study, through a fine-needle-aspiration-based approach, we profiled the immune responses to SARS-CoV-2 mRNA vaccines in lymph nodes of healthy individuals and kidney transplant (KTX) recipients. We found that, unlike healthy subjects, KTX recipients presented deeply blunted SARS-CoV-2-specific GC B cell responses coupled with severely hindered T follicular helper cells, SARS-CoV-2 receptor-binding-domain-specific memory B cells and neutralizing antibodies. KTX recipients also displayed reduced SARS-CoV-2-specific CD4 and CD8 T cell frequencies. Broadly, these data indicate impaired GC-derived immunity in immunocompromised individuals, and suggest a GC-origin for certain humoral and memory B cell responses following mRNA vaccination.
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“mRNA vaccines induce robust germinal center responses in humans (14, 15), which result in memory B cells that are specific for both the full-length SARS-CoV-2 spike protein and the spike receptor-binding domain (RBD) (16–18).”
From mRNA vaccines induce durable immune memory to SARS-CoV-2 and variants of concern (2021) · cites this paper as [15]
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Quiroga, B., Soler, M. J., Ortíz, A., & de Sequera, P. (2023) · Nefrología (English Edition) · doi:10.1016/j.nefroe.2023.04.005 · Cited by 9
T cell help in the autoreactive germinal center
Akama‐Garren, E. H., & Carroll, M. C. (2022) · Scandinavian Journal of Immunology · doi:10.1111/sji.13192 · Cited by 16
Lee, J. H., Sutton, H., Cottrell, C., et al. (2021) · bioRxiv · doi:10.1101/2021.12.20.473537 · Cited by 10
Marina-Zárate, E., Sutton, H. J., Lopez, P. G., Altheide, T. K., Bick, M., Burton, I., Ben‐Akiva, E., Michaels, K. K., Hyacinth, K., Healy, B. S., et al. (2025) · Immunity · doi:10.1016/j.immuni.2025.10.008 · Cited by 18
Provine, N. M., Al‐Diwani, A., Agarwal, D., Dooley, K., Heslington, A., Murchison, A. G., Garner, L. C., Sheerin, F., Klenerman, P., & Irani, S. R. (2024) · European Journal of Immunology · doi:10.1002/eji.202350872 · Cited by 11
“This approach has permitted studying both B cells and T-follicular helper (T FH ) cells, which support GC formation and maintenance [15].”
Self-citationBaron, F., Canti, L., Ariën, K. K., Kemlin, D., Desombere, I., Gerbaux, M., Pannus, P., Beguin, Y. P., Marchant, A., & Humblet‐Baron, S. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.827242 · Cited by 12
“A recent study (still in pre-print format) reported an extensive comparison of immunogenicity of anti-SARS-CoV-2 mRNA vaccine in healthy subjects and in 10 kidney transplant recipients (129).”
BackgroundImmune Response to MVA-BN Vaccination for Mpox: Current Evidence and Future Directions
Byrne, J., Katoto, P., Kirenga, B., et al. (2025) · Vaccines · doi:10.3390/vaccines13090930 · Cited by 8
“Although mRNA vaccines, such as those targeting SARS-CoV-2, have been shown to induce prolonged germinal centre activity [71], this may not be a universal feature of all non-replicating platforms.”
Ayuk, H. S., Pierzchalski, A., Tal, T. L., Myhre, O., Lindeman, B., Smith, N. M., Stojanovska, V., & Zenclussen, A. C. (2025) · Environment International · doi:10.1016/j.envint.2025.109409 · Cited by 6
Boyd, M. A. A., Hoppé, A. C., Kelleher, A. D., & Munier, C. M. L. (2023) · Immunology and Cell Biology · doi:10.1111/imcb.12635 · Cited by 7
“compared LN FNB samples from healthy participants (n = 15) and those on immunosuppressant drugs following kidney transplant (n = 13).(67) Draining and nondraining (n = 4) LNs were sampled 14 days following primary and 8 days following secondary SARS-CoV-2 mRNA vaccination.”
BackgroundInfluentialImpact of Metabolic States on SARS-CoV-2 Vaccine Responses in Mouse Models of Obesity and Diabetes
Smith, O. A., Fujimoto, B., Wong, T. A. S., To, A., Odo, T., Ball, A. H., Haun, B. K., Muramatsu, H., Tam, Y. K., Pardi, N., et al. (2024) · COVID · doi:10.3390/covid5010002 · Cited by 7
“Adjuvanted vaccines likely promote robust affinity maturation due to prolonged antigen exposure’s “depot effect” [77,78], while modified mRNA vaccines promote strong affinity maturation through Tfh cell and GC activation [71– 74].”
A cluster of broadly neutralizing IgG against BK polyomavirus in a repertoire dominated by IgM
Nguyen, N., Devilder, M., Gautreau-Rolland, L., et al. (2023) · Life Science Alliance · doi:10.26508/lsa.202201567 · Cited by 6
Validation of ligand tetramers for the detection of antigen-specific lymphocytes
Fitzpatrick, K., Degefu, H. N., Poljakov, K., et al. (2022) · bioRxiv · doi:10.1101/2022.10.24.513230 · Cited by 6
“For antigen-specific B cell detection, the most used tools are fluorochrome-conjugated antigen/peptide tetramers, fluorochrome-conjugated virus-like particles as well as other types of fluorochromeconjugated ligands (For an incomplete crosssection, see (1-232)).”
MethodImmunogenicity of SARS-CoV-2 Trimeric Spike Protein Associated to Poly(I:C) Plus Alum
dos-Santos, J. S., Firmino-Cruz, L., da Fonseca-Martins, A. M., Oliveira-Maciel, D., Pérez, G., Pereira, V. A. R., Dumard, C. H., Guedes-da-Silva, F. H., Santos, A. C. V., Leandro, M. D. S., et al. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.884760 · Cited by 7
Dhawan, M. K., Thakur, N., Sharma, M. K., & Rabaan, A. A. (2025) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2025.117936 · Cited by 5
Cowpox to COVID: History of vaccination in the immunocompromised host
Schaenman, J. M. D., & Avery, R. K. (2023) · Transplant Infectious Disease · doi:10.1111/tid.14051 · Cited by 6
Miyamoto, S., Kuroda, Y., Kanno, T., Ueno, A., Shiwa-Sudo, N., Iwata‐Yoshikawa, N., Sakai, Y., Nagata, N., Arashiro, T., Ainai, A., et al. (2023) · iScience · doi:10.1016/j.isci.2023.106694 · Cited by 6
“The vaccination dose interval that affects the induction of cross-neutralizing responses can be considered equivalent to the vaccination-infection interval in breakthrough infections in terms of the time taken for the antibody affinity maturation derived frommemory B cells in germinal centers after mRNA vaccination.(1…”
Plasma EV-miRNAs as Potential Biomarkers of COVID-19 Vaccine Immune Response in Cancer Patients
Almeida, B., Dias, T. R., Cruz, P., Sousa‐Pimenta, M., Teixeira, A. L., Pereira, C. E., Costa‐Silva, B., Oliveira, J., Medeiros, R., & Dias, F. (2024) · Vaccines · doi:10.3390/vaccines12080848 · Cited by 6
Advances and challenges in investigating B-cells via single-cell transcriptomics
Skinner, O. P., Asad, S., & Haque, A. (2024) · Current Opinion in Immunology · doi:10.1016/j.coi.2024.102443 · Cited by 6
Pettini, E., Ciabattini, A., Fiorino, F., et al. (2024) · Vaccines · doi:10.3390/vaccines12040368 · Cited by 4
“Eliciting broad reactive memory B cells is a key aspect in vaccine development, since memory B cells take an important part in the immune response, acting as a secondary defense line and triggering a rapid increase in Ab-secreting plasma cells in case of pathogen exposure ([17]).”
BackgroundLuthria, G., Baratto, L., Adams, L. C., Morakote, W., & Daldrup-Link, H. E. (2023) · Journal of Nuclear Medicine · doi:10.2967/jnumed.123.266271 · Cited by 4
“Recent efforts to understand the immune response to mRNA vaccines revealed germinal center responses in axillary lymph nodes ( 2 ).”
BackgroundScholte, L. L. S., Leggat, D. J., Cohen, K. W., et al. (2023) · STAR Protocols · doi:10.1016/j.xpro.2023.102576 · Cited by 4
Hu, X., Karthigeyan, K. P., Herbek, S. L., Valencia, S. M., Jenks, J. A., Webster, H. S., Miller, I. G., Connors, M., Pollara, J., Andy, C., et al. (2023) · medRxiv · doi:10.1101/2023.08.02.23293386 · Cited by 10
“332 The gB/MF59 vaccinees were a lower age range (12-17) than that of mRNA-1647 (18-49) and 333 only female gender, though most vaccinees in the mRNA-1647 cohort were female (76%).”
BackgroundPainter, M. M., Johnston, T. S., Lundgreen, K. A., Santos, J. J. D. S., Qin, J. S., Goel, R. R., Apostolidis, S. A., Mathew, D., Fulmer, B., Williams, J. C., et al. (2023) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2023.02.05.527215 · Cited by 7
“Vaccination also generates long-lasting germinal centers 12, 13 that produce durable and stable populations of memory B cells, including cells capable of cross-binding the highly mutated RBD of Omicron variants 11, 14, 15 .”
Self-citationSannier, G., Nicolas, A., Dubé, M., Marchitto, L., Nayrac, M., Tastet, O., Chatterjee, D., Tauzin, A., Lima-Barbosa, R., Laporte, M., et al. (2023) · Cell Reports Medicine · doi:10.1016/j.xcrm.2023.100955 · Cited by 6
Kim, W. (2024) · Immune Network · doi:10.4110/in.2024.24.e28 · Cited by 5
“Human GC reactions to vaccination were observed in draining axillary lymph nodes for at Human B Cell Responses to SARS-CoV-2 mRNA Vaccination https://doi.org/10.4110/in.2024.24.e28 2/13 https://immunenetwork.org least 6 months following mRNA vaccination (13-17).”
BackgroundInfluentialJung, M., Kim, H., Choi, E., Shin, M., & Shin, S. J. (2024) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2024.2317439 · Cited by 5
“219,220,288 Certainly, thoughtful consideration from diverse perspectives is imperative in the development or selection of adjuvants for vaccines targeting the elderly in the future.”
BackgroundRamirez, S. I., Lopez, P. G., Faraji, F., Parikh, U. M., Heaps, A., Ritz, J., Moser, C., Eron, J. J., Wohl, D. A., Currier, J. S., et al. (2023) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2023.10.25.564014 · Cited by 3
“Given the biological dependence of the antibody response on CD4 T cell help mediated by T FH cells (51, 52), some statistical association between antibodies and viral load would always be expected, even if, hypothetically, viral control was exclusively mediated by T cells.”
BackgroundSelf-citationSeija, M., García‐Luna, J., Rammauro, F., Brugnini, A., Trías, N., Astesiano, R., Santiago, J., Orihuela, N., Zulberti, C., Machado, D., et al. (2023) · Frontiers in Immunology · doi:10.3389/fimmu.2023.1202630 · Cited by 3
Connors, J., Joyner, D., Mege, N. J., et al. (2022) · Research Square · doi:10.21203/rs.3.rs-2199652/v1 · Cited by 3
Ferreira, I., Lee, C. Q., Foster, W., et al. (2022) · medRxiv · doi:10.1101/2022.10.13.22281024 · Cited by 3
Killian, J. T., King, R. G., Lucander, A. C. K., Kizziah, J. L., Fucile, C., Díaz-Avalos, R., Qiu, S., Silva-Sánchez, A., Mousseau, B. J., Macon, K. J., et al. (2025) · Immunity · doi:10.1016/j.immuni.2025.10.014 · Cited by 6
SARS-CoV-2 S protein activates the HIV latent reservoir through the mTOR pathway
Xu, L., Chen, L., Wang, H., et al. (2025) · bioRxiv · doi:10.1101/2025.08.18.670887 · Cited by 2
“When the immune system is stimulated, these latent viruses may be reactivated, leading to HIV replication and transmission [5, 6].”
Lu, B., Chaudhary, O., Banoth, B., Nadkarni, J., Zong, W., Mausser, E., Danz, H., Motwani, M., Ruiz, S., Zhang, D., et al. (2025) · Vaccines · doi:10.3390/vaccines13030263 · Cited by 1
“In contrast, mice immunized with the rHA-AF03 vaccine showed dramatically different antibody response kinetics, with peak GMT titers of 95 [34, 264] and 226 [105, 488] at the 21-day prime–boost interval for the homologous A/Tasmania/503/2020 (H3N2).”
Response to COVID-19 vaccination imaged by PD-L1 PET scanning
MacManus, M. P., Akhurst, T., Lewin, S. R., et al. (2024) · EJNMMI Reports · doi:10.1186/s41824-024-00196-7 · Cited by 2
“…are important for the generation of high-quality spike protein-specific antibodies following COVID-19 mRNA vaccination, and vaccination has been associated with increased intranodal and circulating T follicular helper cells that express high levels of PD-1 (Locci et al. 2013; Lederer et al. 2022).”
BackgroundWouters, C., Sachithanandham, J., Akin, E., Pieterse, L., Fall, A., Truong, T., Bard, J. D., Yee, R., Sullivan, D. J., Mostafa, H. H., et al. (2024) · Viruses · doi:10.3390/v16091436 · Cited by 2
“Rapid changes in variant composition within an individual suggest the selection of variants containing certain mutations that promote increased replication fitness, escape from anti-SARS-CoV-2 antibodies or plasma administered thera-peutically, or both [3].”
BackgroundMudd, P., Borcherding, N., Kim, W., et al. (2023) · Research Square · doi:10.21203/rs.3.rs-3304466/v1 · Cited by 2
Faliti, C. E., Anam, F. A., Cheedarla, N., Woodruff, M. C., Usman, S. Y., Runnstrom, M. C., Van, T. T. P., Kyu, S. Y., Ahmed, H., Morrison-Porter, A., et al. (2023) · medRxiv · doi:10.1101/2023.06.08.23291159 · Cited by 4
“FNA has also been used to demonstrate defective GC reactions and memory B cell formation in kidney transplant recipients 63 .”
Frölke, S. C., Geers, D., Amirkhan, K. G., Pathmarajah, D. S., van der Bom‐Baylon, N. D., Idu, M. M., van Gils, M. J., Claireaux, M. A. F., Geerlings, S. E., Rispens, T., et al. (2025) · Scientific Reports · doi:10.1038/s41598-025-27815-y · Cited by 1
“It was also stated that human GC responses to COVID-19 vaccines are restricted to draining axillary LNs, from where the vaccine was originally injected, as the contralateral LNs displayed a trend for lower frequencies of GC B-cells that were not SARS-CoV-2-specific 11 .”
Siu, J. H. Y., Coelho, S., Palomeras, A., Belij‐Rammerstorfer, S., Barman, N., Lee, C. H.-J., Ströbel, T., Thorpe, C. J., Kaur, C., Cole, T., et al. (2025) · EBioMedicine · doi:10.1016/j.ebiom.2025.106036 · Cited by 3
“48,49 Our data show that whilst some non-specific changes occur in the ndLN, the coordinated swelling and adaptive immune cell increase are restricted to draining lymphatic tissue in the week post vaccination.”
Tiselius, E., Sundberg, E., Amor, A. R., Andersson, H., Varnaite, R., Kolstad, L., Akaberi, D., Ling, J., Harila‐Saari, A. H., Saghafian‐Hedengren, S., et al. (2025) · Frontiers in Immunology · doi:10.3389/fimmu.2025.1613778
“We hypothesize that this may be due to a blunted GC reaction caused by immunosuppressive treatment, as has been suggested in immunosuppressed adults (44) where SARS-CoV-2-speci fi c GC B cell populations were strongly associated with the ability to produce SARS-CoV-2 nAbs.”
Knox, J. J., Lee, I., Blumberg, E. A., Rosenfeld, A. M., Meng, W., Liu, F., Kearns, C., O’Doherty, U., Shaked, A. A., Olthoff, K. M., et al. (2025) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiaf250 · Cited by 3
“Prior studies supported our rationale by demonstrating a range of impaired SARS-CoV-2 vaccine–specific B-cell immunity [7, 8] and associating vaccine responsiveness with frequencies of transitional or switched memory B cells (MBCs) in kidney transplant recipients [9, 10].”
Loe-Sack-Sioe, G. E., de Vos, D. W., Visser, L. G., Jochems, S. P., & Roukens, A. H. E. (2025) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2025.2503602 · Cited by 1
Bibliometric and visual analysis of research related to kidney disease and COVID-19
Sun, M., Wang, D., Wu, H., et al. (2025) · Discover medicine · doi:10.1007/s44337-025-00277-x · Cited by 1
Metadata
- Authors
- Lederer, K., Parvathaneni, K., Painter, M. M., Bettini, E., Agarwal, D., Lundgreen, K. A., Weirick, M., Goel, R. R., Xu, X., Drapeau, E. M., Gouma, S., Greenplate, A. R., Coz, C. L., Romberg, N., Jones, L., Rosen, M., Besharatian, B., Kaminiski, M., Weiskopf, D., Sette, A., Hensley, S. E., Bates, P., Wherry, E. J., Naji, A., Bhoj, V., & Locci, M.
- Affiliations
- University of Pennsylvania (US)
- Harvard University (US)
- Children's Hospital of Philadelphia (US)
- La Jolla Institute for Immunology (US)
- Corresponding author
- Naji, Ali
- Bhoj, Vijay
- Locci, Michela
- ORCID
- Lederer, Katlyn
- Parvathaneni, Kalpana
- Painter, Mark M.
- Bettini, Emily
- Agarwal, Divyansh
- Lundgreen, Kendall A.
- Weirick, Madison
- Goel, Rishi R.
- Drapeau, Elizabeth M.
- Gouma, Sigrid
- Greenplate, Allison R.
- Coz, Carole Le
- Romberg, Neil
- Besharatian, Behdad
- Weiskopf, Daniela
- Sette, Alessandro
- Hensley, Scott E.
- Bates, Paul
- Wherry, E. John
- Naji, Ali
- Bhoj, Vijay
- Locci, Michela
- Venue
- Cell
- Publisher
- openRxiv
- Published
- 2021-09-21
- Volume
- 185
- Issue
- 6
- Pages
- 1008-1024.e15
- ISSN
- 0092-8674 (ISSN-L)
- PMC
- PMC8475965
- OpenAlex
- W4221071417
- Cited by
- 179
- References
- 0
- Citations by year
- 2026: 15 · 2025: 33 · 2024: 33 · 2023: 45 · 2022: 44 · 2021: 9
- FWCI
- 19.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cell (publishedVersion)
- medRxiv (acceptedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Institutional Repository University of Antioquia (University of Antioquia) (publishedVersion, cc-by)
- PubMed Central (submittedVersion)
- Funders
- National Institutes of Health (Nr. 75N9301900065, 75N9301900065)
- National Blood Foundation
- National Institute of Allergy and Infectious Diseases (R21AI142638, R01AI152236, R01AI146101, R01AI146026, R01AI123738, 75N9301900065, U19AI082630, R01AI153064)
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
- Life Sciences › Immunology and Microbiology › Immunology › Immune responses and vaccinations
- Keywords
- germinal center, COVID-19 mRNA vaccine, immunocompromised patients, kidney transplant recipients, memory B cells, T follicular helper cells, neutralizing antibodies, vaccine-induced immunity, humoral immunity, CD4 and CD8 T cells, lymph node fine needle aspiration
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