Previous biological therapy and impairment of the IFN-γ/IL-10 axis are associated with low immune response to 17DD-YF vaccination in patients with spondyloarthritis.

Autor:	Casagrande TZ; Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil; Programa de Pós-graduação em Saúde Coletiva da Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil., Costa-Rocha IAD; Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, MG, Brazil., Gavi MBRO; Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil., Miyamoto ST; Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil., Martins PC; Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil., Serrano ÉV; Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil., Dinis VG; Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil; Escola de Ciências da Saúde da Santa Casa de Misericórdia, Vitória, ES, Brazil., Machado KLLL; Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil; Programa de Pós-graduação em Saúde Coletiva da Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil., Gouvea SA; Programa de Pós-graduação em Biotecnologia da Universidade Federal do Espírito Santo, Vitória, ES, Brazil., Caser LC; Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil., Campi-Azevedo AC; Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, MG, Brazil., Teixeira-Carvalho A; Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, MG, Brazil., Peruhype-Magalhães V; Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, MG, Brazil., Bissoli MF; Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil., Gouvea MDPG; Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil; Programa de Pós-graduação em Saúde Coletiva da Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil., Lima SMB; Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil., Miranda EH; Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil., Trindade GF; Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil., Lyra DGP; Departamento de Vigilância das Doenças Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, DF, Brazil., Burian APN; Centro Regional de Imunobiológicos Especiais (CRIE), Vitória, ES, Brazil., Neto LFDSP; Escola de Ciências da Saúde da Santa Casa de Misericórdia, Vitória, ES, Brazil., da Mota LMH; Serviço de Reumatologia do Hospital Universitário de Brasília, Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil., Martins-Filho OA; Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, MG, Brazil., Valim V; Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil; Programa de Pós-graduação em Saúde Coletiva da Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil. Electronic address: valeria.cristo@ebserh.gov.br.
Jazyk:	angličtina
Zdroj:	Vaccine [Vaccine] 2022 Jul 30; Vol. 40 (32), pp. 4580-4593. Date of Electronic Publication: 2022 Jun 18.
DOI:	10.1016/j.vaccine.2022.05.071
Abstrakt:	Yellow fever (YF) vaccination is known to induce a suboptimal response in patients with autoimmune diseases (AIDs). To date, few studies have focused on the performance of 17DD-YF vaccination in patients with spondyloarthritis (SpA). In general, patients with SpA are young and have less comorbidities than other patients with AIDs, and frequently receive biological disease-modifying antirheumatic drugs (DMARDs) that may impact their response to vaccines. Taking this background information, the present study aimed to investigate whether the use of biological DMARDs, even after planned washout, or disease activity measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), would impact the overall performance of planned 17DD-YF primary vaccination in patients with SpA. For this purpose, 74 subjects were enrolled in a prospective study, including adult patients with SpA (SpA; n = 51) and a healthy control (HC; n = 23) group. Analysis of YF specific neutralizing antibodies test (PRNT), along with YF viremia and the levels of serum chemokines, cytokines, and growth factors were performed at distinct time points (D0, D3, D4, D5, D6, D7, D14, and D28). The BASDAI scores were evaluated at D0 and D180. Data demonstrated that overall, the SpA group presented lower PRNT titers and seropositivity rates as compared to the HC group (GeoMean = 112 vs. 440; 73% vs. 96%, respectively). In SpA subgroup analyses, previous biological DMARDs (BIO-IT) led to a lower PRNT titers (BIO-IT 79, 95% CI [39-150] vs. without biological DMARDs [non-BIO-IT] 159, 95% CI [94-267], p < 0.001). The non-BIO-IT group achieved a response similar to the HC group (81% vs. 96%, p = 0.112), whereas the BIO-IT group had a lower seroconversion rate (64% vs. 96% HC, p = 0.007). The BASDAI was not associated with PRNT levels and did not change after 6 months of follow-up. No differences in YF viremia were observed amongst subgroups. Higher baseline levels of serum biomarkers were observed in the BIO-IT group vs. the non-BIO-IT group, as well as in those with a BASDAI ≥ 4 vs. those with a BASDAI < 4. Increasing levels of several biomarkers were observed in SpA, especially in the BIO-IT and BASDAI ≥ 4 subgroups throughout the timeline kinetics, with impairment/disturbance in the IFN-γ/IL-10 axis around the peak of viremia (D5). Altogether, these findings suggested that the use of biological DMARDs impacts the response to the 17DD-YF vaccine, even after planned washout. Therefore, previous biological DMARD therapy, the inflammatory status prior vaccination, and impairment of the IFN-γ/IL-10 axis at the peak of viremia may determine the immunogenicity of 17DD-YF vaccination in patients with SpA. Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2022. Published by Elsevier Ltd.)
Databáze:	MEDLINE
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