Kinetics of the B- and T-Cell Immune Responses After 6 Months From SARS-CoV-2 mRNA Vaccination in Patients With Rheumatoid Arthritis

ObjectiveTo assess the kinetics of the humoral and cell-mediated responses after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in rheumatoid arthritis (RA) patients treated with different immunosuppressive therapies.MethodsFollowing vaccine completed schedule, health care workers (HCWs, n = 49) and RA patients (n = 35) were enrolled at 5 weeks (T1) and 6 months (T6) after the first dose of BNT162b2-mRNA vaccination. Serological response was assessed by quantifying anti-receptor-binding domain (RBD)-specific immunoglobulin G (IgG) and SARS-CoV-2 neutralizing antibodies, while cell-mediated response was assessed by a whole-blood test quantifying the interferon (IFN)-γ response to spike peptides. B-cell phenotype and IFN-γ-specific T-cell responses were evaluated by flow cytometry.ResultsAfter 6 months, anti-RBD antibodies were still detectable in 91.4% of RA patients, although we observed a significant reduction of the titer in patients under Cytotoxic T-Lymphocyte Antigen 4 (CTLA-4)-Ig [median: 16.4 binding antibody units (BAU)/ml, interquartile range (IQR): 11.3–44.3, p < 0.0001] or tumor necrosis factor (TNF)-α inhibitors (median: 26.5 BAU/ml, IQR: 14.9–108.8, p = 0.0034) compared to controls (median: 152.7 BAU/ml, IQR: 89.3–260.3). All peripheral memory B-cell (MBC) subpopulations, in particular, the switched IgG+ MBCs (CD19+CD27+IgD-IgM-IgG+), were significantly reduced in RA subjects under CTLA-4-Ig compared to those in HCWs (p = 0.0012). In RA patients, a significantly reduced anti-RBD IgG titer was observed at T6 vs. T1, mainly in those treated with CTLA-4-Ig (p = 0.002), interleukin (IL)-6 inhibitors (p = 0.015), and disease-modifying antirheumatic drugs (DMARDs) ± corticosteroids (CCSs) (p = 0.015). In contrast, a weak nonsignificant reduction of the T-cell response was reported at T6 vs. T1. T-cell response was found in 65.7% of the RA patients at T6, with lower significant magnitude in patients under CTLA-4-Ig compared to HCWs (p < 0.0001). The SARS-CoV-2 IFN-γ-S-specific T-cell response was mainly detected in the CD4+ T-cell compartment.ConclusionsIn this study, in RA patients after 6 months from COVID-19 vaccination, we show the kinetics, waning, and impairment of the humoral and, to a less extent, of the T-cell response. Similarly, a reduction of the specific response was also observed in the controls. Therefore, based on these results, a booster dose of the vaccine is crucial to increase the specific immune response regardless of the immunosuppressive therapy..

Medienart:	E-Artikel

Erscheinungsjahr:	2022
Erschienen:	2022

Enthalten in:	Zur Gesamtaufnahme - volume:13
Enthalten in:	Frontiers in Immunology - 13(2022)

Sprache:	Englisch

Beteiligte Personen:

Chiara Farroni [VerfasserIn] Andrea Picchianti-Diamanti [VerfasserIn] Alessandra Aiello [VerfasserIn] Emanuele Nicastri [VerfasserIn] Bruno Laganà [VerfasserIn] Chiara Agrati [VerfasserIn] Concetta Castilletti [VerfasserIn] Silvia Meschi [VerfasserIn] Francesca Colavita [VerfasserIn] Gilda Cuzzi [VerfasserIn] Rita Casetti [VerfasserIn] Germana Grassi [VerfasserIn] Linda Petrone [VerfasserIn] Valentina Vanini [VerfasserIn] Valentina Vanini [VerfasserIn] Andrea Salmi [VerfasserIn] Federica Repele [VerfasserIn] Anna Maria Gerarda Altera [VerfasserIn] Gaetano Maffongelli [VerfasserIn] Angela Corpolongo [VerfasserIn] Simonetta Salemi [VerfasserIn] Roberta Di Rosa [VerfasserIn] Gabriele Nalli [VerfasserIn] Giorgio Sesti [VerfasserIn] Francesco Vaia [VerfasserIn] Vincenzo Puro [VerfasserIn] Delia Goletti [VerfasserIn]

Links:	doi.org [kostenfrei] doaj.org [kostenfrei] www.frontiersin.org [kostenfrei] Journal toc [kostenfrei]

Themen:	Antibody response COVID-19 Immunologic diseases. Allergy MRNA vaccine Rheumatoid arthritis T-cell response Whole blood

doi:	10.3389/fimmu.2022.846753

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PPN (Katalog-ID):	DOAJ035387106