Trajectories of humoral and cellular immunity and responses to a third dose of mRNA vaccines against SARS-CoV-2 in patients with a history of anti-CD20 therapy.

Autor:	Sidler D; Department of Nephrology and Hypertension, Inselspital University Hospital Bern, Bern, Switzerland., Born A; Department of Nephrology and Hypertension, Inselspital University Hospital Bern, Bern, Switzerland., Schietzel S; Department of Nephrology and Hypertension, Inselspital University Hospital Bern, Bern, Switzerland., Horn MP; Department of Clinical Chemistry, Inselspital Universitatsspital Bern, Bern, Switzerland., Aeberli D; Department of Rheumatology and Immunology, Inselspital University Hospital Bern, Bern, Switzerland., Amsler J; Department of Rheumatology and Immunology, Inselspital University Hospital Bern, Bern, Switzerland., Möller B; Department of Rheumatology and Immunology, Inselspital University Hospital Bern, Bern, Switzerland., Njue LM; Department of Haematology and Central Haematology Laboratory, Inselspital University Hospital Bern, Bern, Switzerland., Medri C; Department of Haematology and Central Haematology Laboratory, Inselspital University Hospital Bern, Bern, Switzerland., Angelillo-Scherrer A; Department of Haematology and Central Haematology Laboratory, Inselspital University Hospital Bern, Bern, Switzerland., Borradori L; Department of Dermatology, Inselspital University Hospital Bern, Bern, Switzerland., Seyed Jafari SM; Department of Dermatology, Inselspital University Hospital Bern, Bern, Switzerland., Radonjic-Hoesli S; Department of Dermatology, Inselspital University Hospital Bern, Bern, Switzerland., Chan A; Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland., Hoepner R; Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland., Bacher U; Department of Haematology and Central Haematology Laboratory, Inselspital University Hospital Bern, Bern, Switzerland., Mani LY; Department of Nephrology and Hypertension, Inselspital University Hospital Bern, Bern, Switzerland., Iype JM; Department of Clinical Chemistry, Inselspital Universitatsspital Bern, Bern, Switzerland., Suter-Riniker F; Institute of Infectious Diseases, University of Bern, Bern, Switzerland., Staehelin C; Department of Infectious Diseases, Inselspital University Hospital Bern, Bern, Switzerland., Nagler M; Department of Clinical Chemistry, Inselspital Universitatsspital Bern, Bern, Switzerland., Hirzel C; Department of Infectious Diseases, Inselspital University Hospital Bern, Bern, Switzerland., Maurer B; Department of Rheumatology and Immunology, Inselspital University Hospital Bern, Bern, Switzerland., Moor MB; Department of Nephrology and Hypertension, Inselspital University Hospital Bern, Bern, Switzerland matthias.moor@dbmr.unibe.ch.
Jazyk:	angličtina
Zdroj:	RMD open [RMD Open] 2022 Mar; Vol. 8 (1).
DOI:	10.1136/rmdopen-2021-002166
Abstrakt:	Background: The majority of patients with B-cell-depleting therapies show compromised vaccination-induced immune responses. Herein, we report on the trajectories of anti-SARS-CoV-2 immune responses in patients of the RituxiVac study compared with healthy volunteers and investigate the immunogenicity of a third vaccination in previously humoral non-responding patients. Methods: We investigated the humoral and cell-mediated immune response after SARS-CoV-2 messanger RNA vaccination in patients with a history with anti-CD20 therapies. Coprimary outcomes were antispike and SARS-CoV-2-stimulated interferon-γ concentrations in vaccine responders 4.3 months (median; IQR: 3.6-4.8 months) after first evaluation, and humoral and cell-mediated immunity (CMI) after a third vaccine dose in previous humoral non-responders. Immunity decay rates were compared using analysis of covariance in linear regression. Results: 5.6 months (IQR: 5.1-6.7) after the second vaccination, we detected antispike IgG in 88% (29/33) and CMI in 44% (14/32) of patients with a humoral response after two-dose vaccination compared with 92% (24/26) healthy volunteers with antispike IgG and 69% (11/16) with CMI 6.8 months after the second vaccination (IQR: 6.0-7.1). Decay rates of antibody concentrations were comparable between patients and controls (p=0.70). In two-dose non-responders, a third SARS-CoV-2 vaccine elicited humoral responses in 19% (6/32) and CMI in 32% (10/31) participants. Conclusion: This study reveals comparable immunity decay rates between patients with anti-CD20 treatments and healthy volunteers, but inefficient humoral or CMI after a third SARS-CoV-2 vaccine in most two-dose humoral non-responders calling for individually tailored vaccination strategies in this population.Trial registration numberNCT04877496; ClinicalTrials.gov number. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu