Accelerated waning of immune responses to a third COVID-19 vaccination in patients with immune-mediated inflammatory diseases.

Autor: Mrak D; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Austria., Kartnig F; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Austria., Sieghart D; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Austria., Simader E; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Austria., Radner H; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Austria., Mandl P; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Austria., Göschl L; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Austria., Hofer P; Department of Pathology, Medical University of Vienna, Vienna, Austria., Deimel T; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Austria., Gessl I; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Austria., Kain R; Department of Pathology, Medical University of Vienna, Vienna, Austria., Winkler S; Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Austria., Smolen JS; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Austria., Perkmann T; Department of Laboratory Medicine, Medical University of Vienna, Austria., Haslacher H; Department of Laboratory Medicine, Medical University of Vienna, Austria., Aletaha D; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Austria., Heinz LX; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Austria. Electronic address: leonhard.heinz@meduniwien.ac.at., Bonelli M; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Austria. Electronic address: michael.bonelli@meduniwien.ac.at.
Jazyk: angličtina
Zdroj: Journal of autoimmunity [J Autoimmun] 2023 Feb; Vol. 135, pp. 102981. Date of Electronic Publication: 2022 Dec 22.
DOI: 10.1016/j.jaut.2022.102981
Abstrakt: Background: A 3 rd COVID-19 vaccination is currently recommended for patients under immunosuppression. However, a fast decline of antibodies against the SARS-CoV-2 receptor-binding domain (RBD) of the spike protein has been observed. Currently it remains unclear whether immunosuppressive therapy affects kinetics of humoral and cellular immune responses.
Methods: 50 patients under immunosuppression and 42 healthy controls (HCs) received a 3 rd dose of an mRNA-based vaccine and were monitored over a 12-weeks period. Humoral immune response was assessed 4 and 12 weeks after 3 rd dose. Antibodies were quantified using the Elecsys Anti-SARS-CoV-2 Spike immunoassay against the receptor-binding domain (RBD) of the spike protein. SARS-CoV-2-specific T cell responses were quantified by IFN-γ ELISpot assays. Adverse events, including SARS-CoV-2 infections, were monitored over a 12-week period.
Results: At week 12, reduced anti-RBD antibody levels were observed in IMID patients as compared to HCs (median antibody level 5345 BAU/ml [1781-10,208] versus 9650 BAU/ml [6633-16,050], p < 0.001). Reduction in relative antibody levels was significantly higher in IMID patients as compared to HCs at week 12 (p < 0.001). Lowest anti-RBD antibody levels were detected in IMID patients who received biological disease-modifying anti-rheumatic drugs (DMARDs) or a combination therapy with conventional synthetic and biological DMARDs. Number of SARS-CoV-2-specific T cells against wildtype and Omicron variants remained stable over 12 weeks in IMID patients. No serious adverse events were reported.
Conclusion: Due to a fast decline in anti-RBD antibodies in IMID patients an early 4 th vaccination should be considered in this vulnerable group of patients.
Competing Interests: Declaration of competing interest DM reports support for meeting attendances from Pfizer and consultation fees from AstraZeneca; JS reports about grants, consulting and personal fees from AbbVie, Amgen, AstraZeneca, Astro, Bristol-Myers Squibb, Celltrion, Gilead-Galapagos, Janssen, Lilly, Pfizer, R-Pharma, Samsung, Sanofi, Chugai, Merck Sharp & Dohme, Novartis-Sandoz Roche, Samsung and UCB and grants from Abbvie, AstraZeneca, Lilly, Novartis, and Roche; HR received speaker fees from Gilead, Merck Sharp and Pfizer and travel support from Janssen; HH received grants from Glock Health, BlueSky Immunotherapies and Neutrolis; DA received grants, speaker fees, or consultancy fees from Abbvie, Amgen, Galapagos, Lilly, Janssen, Merck, Novartis, Pfizer, Sandoz, and Sanofi; RK reports consulting fees from AstraZeneca, Takeda Pharma, MEDahead and Janssen Cilag and speaker fees from Otsuka; ES received travel support from Pfizer, Bristol-Myers Squibb and Boehringer-Ingelheim and speaker fees from Lilly; MB reports about personal fees from Eli-Lilly. All other authors declare no competing interests.
(Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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