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The 13-valent pneumococcal conjugate vaccine (PCV13) has superior immunogenicity in some categories of immunocompromised adults; however, its effect on the immune response in CKD patients has only been addressed by two recent studies with conflicting results. The effect of PPV23 or PCV13 on B cells in these patients has not been previously studied. We studied the absolute numbers and proportions of B cells and subpopulations in two groups of adult patients with severe CKD pre- and 7\u2009days post-immunization with PCV13: pneumococcal vaccine na\u00efve and previously immunized with PPV23 (over one year ago).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>PPV23 immunized patients had significantly lower proportions and absolute numbers of class switched memory (CD19\u2009+\u2009CD27\u2009+\u2009IgM-), as well as lower absolute numbers of IgM memory (CD19\u2009+\u2009CD27\u2009+\u2009IgM+) and class switched B cells (CD19\u2009+\u2009CD27-IgM-) compared to PPV23 na\u00efve patients. Following PCV13 immunization, the differences in absolute numbers of B-cell subpopulations between groups remained significant. The PPV23 immunized group had higher proportions of CD5- B cells along with lower proportions and absolute numbers of CD5+ B cells compared to PPV23 na\u00efve patients both pre- and post-immunization with PCV13. However, previous PPV23 immunization did not have a noticeable effect on the numbers of total IgG or serotype 6B and 14 specific antibody-secreting cells detected 7\u2009days post-immunization with PCV13. Nevertheless, fold increase in anti-serotype 14 IgG concentrations 28\u2009days post-PCV13 was greater in PPV23 na\u00efve than in previously immunized patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The results suggest that immunization with PPV23 may result in long-term changes in B-cell subpopulations such as increased prevalence of CD5- B cells and decreased prevalence of class switched memory B cells in the peripheral blood. Because previous immunization with PPV23 in patients with CKD is associated with a significant decrease in the total class switched memory B cells in response to subsequent immunization with PCV13, this may reduce PCV13 immunogenicity in the setting of PPV23 followed by PCV13.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Trial registration<\/jats:title>\n<jats:p>Registered February 24, 2015 at <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> (NCT 02370069).<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12865-019-0325-9","type":"journal-article","created":{"date-parts":[[2019,11,12]],"date-time":"2019-11-12T10:03:49Z","timestamp":1573553029000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The effect of pneumococcal immunization on total and antigen-specific B cells in patients with severe chronic kidney disease"],"prefix":"10.1186","volume":"20","author":[{"given":"Gabrielle Nicole","family":"Gaultier","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"McCready","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Ulanova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2019,11,12]]},"reference":[{"key":"325_CR1","doi-asserted-by":"publisher","unstructured":"Levin A, Tonelli M, Bonventre J, Coresh J, Donner JA, Fogo AB, et al. 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