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Dynamics of SARS-CoV-2 immunity after vaccination and breakthrough infection in rituximab-treated rheumatoid arthritis patients: a prospective cohort study.
Kared, Hassen; Jyssum, Ingrid; Alirezaylavasani, Amin; Egner, Ingrid M; The Tran, Trung; Tietze, Lisa; Lund, Katrine Persgård; Tveter, Anne Therese; Provan, Sella A; Ørbo, Hilde; Haavardsholm, Espen A; Vaage, John Torgils; Jørgensen, Kristin; Syversen, Silje Watterdal; Lund-Johansen, Fridtjof; Goll, Guro Løvik; Munthe, Ludvig A.
Afiliación
  • Kared H; Department of Immunology, Oslo University Hospital, Oslo, Norway.
  • Jyssum I; KG Jebsen Centre for B cell Malignancies, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
  • Alirezaylavasani A; Precision Immunotherapy Alliance, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
  • Egner IM; Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.
  • The Tran T; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
  • Tietze L; Department of Immunology, Oslo University Hospital, Oslo, Norway.
  • Lund KP; KG Jebsen Centre for B cell Malignancies, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
  • Tveter AT; Precision Immunotherapy Alliance, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
  • Provan SA; Department of Immunology, Oslo University Hospital, Oslo, Norway.
  • Ørbo H; KG Jebsen Centre for B cell Malignancies, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
  • Haavardsholm EA; Precision Immunotherapy Alliance, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
  • Vaage JT; Department of Immunology, Oslo University Hospital, Oslo, Norway.
  • Jørgensen K; Precision Immunotherapy Alliance, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
  • Syversen SW; ImmunoLingo Convergence Center, University of Oslo, Oslo, Norway.
  • Lund-Johansen F; Department of Immunology, Oslo University Hospital, Oslo, Norway.
  • Goll GL; Precision Immunotherapy Alliance, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
  • Munthe LA; ImmunoLingo Convergence Center, University of Oslo, Oslo, Norway.
Front Immunol ; 15: 1296273, 2024.
Article en En | MEDLINE | ID: mdl-38455062
ABSTRACT

Background:

SARS-CoV-2 vaccination in rheumatoid arthritis (RA) patients treated with B cell-depleting drugs induced limited seroconversion but robust cellular response. We aimed to document specific T and B cell immunity in response to vaccine booster doses and breakthrough infection (BTI).

Methods:

We included 76 RA patients treated with rituximab who received up to four SARS-CoV-2 vaccine doses or three doses plus BTI, in addition to vaccinated healthy donors (HD) and control patients treated with tumor necrosis factor inhibitor (TNFi). We quantified anti-SARS-CoV-2 receptor-binding domain (RBD) Spike IgG, anti-nucleocapsid (NC) IgG, 92 circulating inflammatory proteins, Spike-binding B cells, and Spike-specific T cells along with comprehensive high-dimensional phenotyping and functional assays.

Findings:

The time since the last rituximab infusion, persistent inflammation, and age were associated with the anti-SARS-CoV-2 RBD IgG seroconversion. The vaccine-elicited serological response was accompanied by an incomplete induction of peripheral Spike-specific memory B cells but occurred independently of T cell responses. Vaccine- and BTI-elicited cellular immunity was similar between RA and HD ex vivo in terms of frequency or phenotype of Spike-specific cytotoxic T cells and in vitro in terms of the functionality and differentiation profile of Spike-specific T cells.

Interpretation:

SARS-CoV-2 vaccination in RA can induce persistent effector T-cell responses that are reactivated by BTI. Paused rituximab medication allowed serological responses after a booster dose (D4), especially in RA with lower inflammation, enabling efficient humoral and cellular immunity after BTI, and contributed overall to the development of potential durable immunity.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Reumatoide / COVID-19 Límite: Humans Idioma: En Revista: Front Immunol Año: 2024 Tipo del documento: Article País de afiliación: Noruega Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Reumatoide / COVID-19 Límite: Humans Idioma: En Revista: Front Immunol Año: 2024 Tipo del documento: Article País de afiliación: Noruega Pais de publicación: Suiza