Post COVID vaccination (COVAXIN™ -BB152 V) pauci-immune crescentic glomerulonephritis

Bansal, Shyam Bihari; Rana, Abhyuday S; Manhas, Neha; Rana, Abhyuday

doi:10.4103/ijn.ijn_352_21

Cited by 9 publications

(4 citation statements)

References 8 publications

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“… *Including the present case. References: a ( 23 – 47 ); b ( 48 – 52 ); c ( 47 , 48 , 53 – 61 ); d ( 47 , 56 , 62 – 68 ); e ( 48 , 69 ); f ( 47 – 49 , 70 ); g ( 47 , 48 , 53 , 71 – 85 ); h ( 2 , 86 , 87 ). …”

Section: Discussionmentioning

confidence: 99%

ANCA-associated glomerulonephritis and lupus nephritis following COVID-19 vaccination: a case report and literature review

Campos,

Valois,

Magalhães

et al. 2024

Front. Immunol.

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With the coverage of COVID-19 vaccination, it has been possible to observe the potential side effects of SARS-CoV-2 vaccines, with the most common ones being fever, myalgia, headache, and fatigue. However, an association has been observed between new and recurrent kidney injuries, mainly glomerulonephritis and lupus nephritis associated with ANCA, with the Pfizer-BioNTech, Moderna, Sinovac, and AstraZeneca vaccines, although the relationship between them is not clear. We report a case of ANCA-related vasculitis and lupus glomerulonephritis after the second dose of the AstraZeneca vaccine. The elderly patient presented significant worsening of kidney function after immunosuppression and complications after a new onset COVID-19 infection that led to death. We provide a literature review about kidney damage related to ANCA vasculitis after COVID-19 vaccine, aiming for a better understanding of the pathophysiological mechanism of kidney injury, its presentation, and treatment.

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Section: Discussionmentioning

confidence: 99%

ANCA-associated glomerulonephritis and lupus nephritis following COVID-19 vaccination: a case report and literature review

Campos,

Valois,

Magalhães

et al. 2024

Front. Immunol.

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“…Of the 4,102 articles, 48 were assessed for eligibility, and 29 articles, including case reports and case series, were included in the review, reporting 35 patients with COVID-19 vaccine-induced p-ANCA GN. Each study’s characteristics (author and publication year), patient demographics (age and sex), previous medical history, COVID-19 vaccine type, vaccine dose, time to onset of p-ANCA-associated GN post-vaccination, clinical presentation, laboratory findings, histopathological features, treatment modalities, and clinical outcomes are tabulated in Table 3 [ 8 , 10 - 12 , 15 - 39 ].…”

Section: Reviewmentioning

confidence: 99%

A Systematic Review of Perinuclear Antineutrophil Cytoplasmic Antibody-Associated Glomerulonephritis Following Coronavirus Disease 2019 Vaccination: A 2024 Update

Ogieuhi,

Suman,

Kumari

et al. 2024

Cureus

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Antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (GN) is an immune-mediated kidney disease characterized by the inflammation of small blood vessels in the kidney, leading to renal impairment and potentially irreversible damage. Concerns have been raised over the reports of myeloperoxidase/perinuclear (MPO/p) ANCA GN following the coronavirus disease 2019 (COVID-19) vaccination. Our study provides a comprehensive insight into perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA) GN after COVID-19 vaccination. We conducted a comprehensive literature search on PubMed, Cochrane Library, and EMBASE using the Medical Subject Headings (MeSH) terms related to “covid-19 vaccine,” “glomerulonephritis,” “p-ANCA,” and “MPO-ANCA” up to March 5, 2024, to include cases of p-ANCA-associated GN following COVID-19 vaccination. Of the 4,102 articles, we included 29, reporting 35 patients demonstrating COVID-19 vaccine-induced p-ANCA GN, with 23 (65.7%) females and a median age of 69 years (mean ± SD = 63.22 ± 16). Twenty-six (74.28%) patients received the mRNA vaccine (Pfizer = 19, Moderna = 7). Seventeen (48.57%) patients presented with p-ANCA GN after the second dose of the COVID-19 vaccine, with a median gap of 19 days (1-84 days). Constitutional symptoms (54.28%) and acute kidney injury (42.85%) were the most reported initial presentations, and elevated serum creatinine (mean peak serum creatinine = 4.98 ± 5.02 mg/dL), hematuria, and proteinuria were the laboratory findings. MPO/p-ANCA was positive in 31 (88.6%) patients. All patients underwent renal biopsy, and crescentic GN was the most common finding among 27 (77.14%) patients. Management of p-ANCA GN included steroids in 30 (85.71%) patients, followed by rituximab (28.57%), and plasmapheresis (22.86%). Most patients responded well to treatment, with complete remission in 29 (82.86%) and relapse in four (11.42%) patients. Two patients did not achieve remission and became dialysis dependent. ANCA-associated GN is a rare and life-threatening complication of the COVID-19 vaccine, necessitating urgent evaluation and management. COVID-19 vaccine-induced p-ANCA GN should be included in the differential diagnoses of patients presenting with kidney injury after vaccination.

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“…The BZN-phosphonate ( 4 ) adsorbed on alum, significantly reduced systemic exposure, and created a depot effect for both antigen and adjuvant. Recently, Bharat Biotech used an alum-adsorbed TLR7/8 agonist (Algel-IMDG) − as a vaccine adjuvant in BBV152 (COVAXIN), a whole-virion inactivated SARS-CoV-2 vaccine. − The binding affinity of the imidazoquinoline-based TLR7/8 agonist was improved by linking a potent TLR7/8 agonist with gallic acid . The majority of currently available vaccines contain aluminum salt based adjuvants termed “Alum” which promote a CD4 + T helper 2 (Th2) skewed response. , On the other hand, TLR7 agonists trigger predominantly Th1 type immune responses. , Therefore, adsorption of TLR7 selective ligands to aluminum salts may facilitate balanced Th1 and Th2 immune activation resulting in enhanced adjuvant activity.…”

Section: Introductionmentioning

confidence: 99%

Design and Synthesis of Polyphenolic Imidazo[4,5-c]quinoline Derivatives to Modulate Toll Like Receptor-7 Agonistic Activity and Adjuvanticity

Kumar,

Sihag,

Patil

et al. 2024

ACS Pharmacol. Transl. Sci.

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TLR-7/8 agonists are a well-known class of vaccine adjuvants, with a leading example now included in Covaxin, a licensed human COVID-19 vaccine. This thereby provides the opportunity to develop newer, more potent adjuvants based on structure−function studies of these classes of compounds. Imidazoquinoline-based TLR7/8 agonists are the most potent, but when used as a vaccine adjuvant side effects can arise due to diffusion from the injection site into a systemic circulation. In this work, we sought to address this issue through structural modifications in the agonists to enhance their adsorption capacity to the classic adjuvant alum. We selected a potent TLR7-selective agonist, BBIQ (EC 50 = 0.85 μM), and synthesized polyphenolic derivatives to assess their TLR7 agonistic activity and adjuvant potential alone or in combination with alum. Most of the phenolic derivatives were more active than BBIQ and, except for 12b, all were TLR7 specific. Although the synthesized compounds were less active than resiquimod, the immunization data on combination with alum, specifically the IgG1, IgG2b and IgG2c responses, were superior in comparison to BBIQ as well as the reference standard resiquimod. Compound 12b was 5-fold more potent (EC 50 = 0.15 μM in TLR7) than BBIQ and induced double the IgG response to SARS-CoV-2 and hepatitis antigens. Similarly, compound 12c (EC 50 = 0.31 μM in TLR7) was about 3-fold more potent than BBIQ and doubled the IgG levels. Even though compound 12d exhibited low TLR7 activity (EC 50 = 5.13 μM in TLR7), it demonstrated superior adjuvant results, which may be attributed to its enhanced alum adsorption capability as compared with BBIQ and resiquimod. Alum-adsorbed polyphenolic TLR7 agonists thereby represent promising combination adjuvants resulting in a balanced Th1/Th2 immune response.

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Post COVID vaccination (COVAXIN™ -BB152 V) pauci-immune crescentic glomerulonephritis

Cited by 9 publications

References 8 publications

ANCA-associated glomerulonephritis and lupus nephritis following COVID-19 vaccination: a case report and literature review

ANCA-associated glomerulonephritis and lupus nephritis following COVID-19 vaccination: a case report and literature review

A Systematic Review of Perinuclear Antineutrophil Cytoplasmic Antibody-Associated Glomerulonephritis Following Coronavirus Disease 2019 Vaccination: A 2024 Update

Design and Synthesis of Polyphenolic Imidazo[4,5-c]quinoline Derivatives to Modulate Toll Like Receptor-7 Agonistic Activity and Adjuvanticity

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