Analysis of the humoral and cellular response after the third COVID-19 vaccination in patients with autoimmune hepatitis.

Autor: Hartl J; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany., Rüther DF; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany., Duengelhoef PM; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; Institute of Immunology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Brehm TT; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany., Steinmann S; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany., Weltzsch JP; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany., Glaser F; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany., Sterneck M; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Sebode M; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany., Weiler-Normann C; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany., Lütgehetmann M; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany.; Department for Clinical Immunology of Infectious Diseases, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.; Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Schaub GM; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany., Haag F; Institute of Immunology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Schramm C; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany.; Martin-Zeitz Center for Rare Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; Hamburg Center for Translational Immunology (HCTI), Hamburg, Germany., Wiesch JSZ; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany., Lohse AW; I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany.; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany.; Hamburg Center for Translational Immunology (HCTI), Hamburg, Germany.
Jazyk: angličtina
Zdroj: Liver international : official journal of the International Association for the Study of the Liver [Liver Int] 2023 Feb; Vol. 43 (2), pp. 393-400. Date of Electronic Publication: 2022 Aug 08.
DOI: 10.1111/liv.15368
Abstrakt: Background & Aims: To explore the humoral and T-cell response to the third COVID-19 vaccination in autoimmune hepatitis (AIH).
Methods: Anti-SARS-CoV-2 antibody titers were prospectively determined in 81 AIH patients and 53 healthy age- and sex-matched controls >7 days (median 35) after the first COVID-19 booster vaccination. The spike-specific T-cell response was assessed using an activation-induced marker assay (AIM) in a subset of patients.
Results: Median antibody levels were significantly lower in AIH compared to controls (10 908 vs. 25 000 AU/ml, p < .001), especially in AIH patients treated with MMF (N = 14, 4542 AU/ml, p = .004) or steroids (N = 27, 7326 AU/ml, p = .020). Also, 48% of AIH patients had antibody titers below the 10% percentile of the healthy controls (9194 AU/ml, p < .001). AIH patients had a high risk of failing to develop a spike-specific T-cell response (15/34 (44%) vs. 2/16 (12%), p = .05) and showed overall lower frequencies of spike-specific CD4 + T cells (median: 0.074% vs 0.283; p = .01) after the booster vaccination compared to healthy individuals. In 34/81 patients, antibody titers before and after booster vaccination were available. In this subgroup, all patients but especially those without detectable/low antibodies titers (<100 AU/ml) after the second vaccination (N = 11/34) showed a strong, 148-fold increase.
Conclusion: A third COVID-19 vaccination efficiently boosts antibody levels and T-cell responses in AIH patients and even seroconversion in patients with the absent immune response after two vaccinations, but to a lower level compared to controls. Therefore, we suggest routinely assessing antibody levels in AIH patients and offering additional booster vaccinations to those with suboptimal responses.
(© 2022 The Authors. Liver International published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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