Factors associated with immune responses to SARS-CoV-2 vaccination in individuals with autoimmune diseases.

Autor: Anderson E; Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell, Manhasset, New York, USA.; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA., Powell M; Department of Microbiology and Immunology, School of Medicine, Emory University, Atlanta, Georgia, USA., Yang E; Division of Immunology and Rheumatology, Department of Medicine, and.; Institute for Immunity, Transplantation and Infection, School of Medicine, Stanford University, Stanford, California, USA., Kar A; Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell, Manhasset, New York, USA., Leung TM; Biostatistics Unit, Office of Academic Affairs, Northwell, New Hyde Park, New York, USA., Sison C; Biostatistics Unit, Office of Academic Affairs, Northwell, New Hyde Park, New York, USA., Steinberg R; Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell, Manhasset, New York, USA., Mims R; Department of Microbiology and Immunology, School of Medicine, Emory University, Atlanta, Georgia, USA., Choudhury A; Division of Immunology and Rheumatology, Department of Medicine, and.; Institute for Immunity, Transplantation and Infection, School of Medicine, Stanford University, Stanford, California, USA., Espinosa C; Division of Immunology and Rheumatology, Department of Medicine, and.; Institute for Immunity, Transplantation and Infection, School of Medicine, Stanford University, Stanford, California, USA., Zelmanovich J; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA., Okoye NC; Department of Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA., Choi EJ; Department of Dermatology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA., Marder G; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA., Narain S; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA., Gregersen PK; Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell, Manhasset, New York, USA.; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA., Mackay M; Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell, Manhasset, New York, USA.; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA., Diamond B; Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell, Manhasset, New York, USA.; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA., Levy T; Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell, Manhasset, New York, USA., Zanos TP; Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell, Manhasset, New York, USA., Khosroshahi A; Division of Rheumatology, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA., Sanz I; Division of Rheumatology, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA., Luning Prak ET; Department of Pathology and Laboratory Medicine, and., Bar-Or A; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Merrill J; Oklahoma Medical Research Foundation and University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA., Arriens C; Oklahoma Medical Research Foundation and University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA., Pardo G; Oklahoma Medical Research Foundation and University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA., Guthridge J; Oklahoma Medical Research Foundation and University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA., James J; Oklahoma Medical Research Foundation and University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA., Payne A; Department of Dermatology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA., Utz PJ; Division of Immunology and Rheumatology, Department of Medicine, and.; Institute for Immunity, Transplantation and Infection, School of Medicine, Stanford University, Stanford, California, USA., Boss JM; Department of Microbiology and Immunology, School of Medicine, Emory University, Atlanta, Georgia, USA., Aranow C; Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell, Manhasset, New York, USA.; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA., Davidson A; Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell, Manhasset, New York, USA.; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.
Jazyk: angličtina
Zdroj: JCI insight [JCI Insight] 2024 Jun 04; Vol. 9 (13). Date of Electronic Publication: 2024 Jun 04.
DOI: 10.1172/jci.insight.180750
Abstrakt: Patients with autoimmune diseases are at higher risk for severe infection due to their underlying disease and immunosuppressive treatments. In this real-world observational study of 463 patients with autoimmune diseases, we examined risk factors for poor B and T cell responses to SARS-CoV-2 vaccination. We show a high frequency of inadequate anti-spike IgG responses to vaccination and boosting in the autoimmune population but minimal suppression of T cell responses. Low IgG responses in B cell-depleted patients with multiple sclerosis (MS) were associated with higher CD8 T cell responses. By contrast, patients taking mycophenolate mofetil (MMF) exhibited concordant suppression of B and T cell responses. Treatments with highest risk for low anti-spike IgG response included B cell depletion within the last year, fingolimod, and combination treatment with MMF and belimumab. Our data show that the mRNA-1273 (Moderna) vaccine is the most effective vaccine in the autoimmune population. There was minimal induction of either disease flares or autoantibodies by vaccination and no significant effect of preexisting anti-type I IFN antibodies on either vaccine response or breakthrough infections. The low frequency of breakthrough infections and lack of SARS-CoV-2-related deaths suggest that T cell immunity contributes to protection in autoimmune disease.
Databáze: MEDLINE