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Humoral and T-Cell Response to SARS-CoV-2 Vaccination in Patients With Multiple Sclerosis Treated With Ocrelizumab.
Brill, Livnat; Rechtman, Ariel; Zveik, Omri; Haham, Nitzan; Oiknine-Djian, Esther; Wolf, Dana G; Levin, Netta; Raposo, Catarina; Vaknin-Dembinsky, Adi.
  • Brill L; Faculty of Medicine, Hebrew University of Jerusalem, Department of Neurology and Laboratory of Neuroimmunology and the Agnes-Ginges Center for Neurogenetics, Hadassah Medical Center, Ein-Kerem, Jerusalem, Israel.
  • Rechtman A; Faculty of Medicine, Hebrew University of Jerusalem, Department of Neurology and Laboratory of Neuroimmunology and the Agnes-Ginges Center for Neurogenetics, Hadassah Medical Center, Ein-Kerem, Jerusalem, Israel.
  • Zveik O; Faculty of Medicine, Hebrew University of Jerusalem, Department of Neurology and Laboratory of Neuroimmunology and the Agnes-Ginges Center for Neurogenetics, Hadassah Medical Center, Ein-Kerem, Jerusalem, Israel.
  • Haham N; Faculty of Medicine, Hebrew University of Jerusalem, Department of Neurology and Laboratory of Neuroimmunology and the Agnes-Ginges Center for Neurogenetics, Hadassah Medical Center, Ein-Kerem, Jerusalem, Israel.
  • Oiknine-Djian E; Clinical Virology Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
  • Wolf DG; Lautenberg Center for General and Tumor Immunology, The Hebrew University Faculty of Medicine, Jerusalem, Israel.
  • Levin N; Clinical Virology Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
  • Raposo C; Lautenberg Center for General and Tumor Immunology, The Hebrew University Faculty of Medicine, Jerusalem, Israel.
  • Vaknin-Dembinsky A; Faculty of Medicine, Hebrew University of Jerusalem, Department of Neurology and Laboratory of Neuroimmunology and the Agnes-Ginges Center for Neurogenetics, Hadassah Medical Center, Ein-Kerem, Jerusalem, Israel.
JAMA Neurol ; 78(12): 1510-1514, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1432341
ABSTRACT
Importance B-cell-depleting therapies may affect the development of a protective immune response following vaccination. Understanding the ability to develop vaccine-specific immunity to COVID-19 in patients with multiple sclerosis (MS) treated with B-cell-depleting therapy is of importance for clinical decisions.

Objective:

To assess SARS-CoV-2 vaccine-specific humoral and cellular responses in patients treated with ocrelizumab compared with healthy controls. Design, Setting, and

Participants:

This single-center study performed at Hadassah Medical Center in Jerusalem, Israel, included patients with MS treated with ocrelizumab, healthy controls, and untreated patients with MS. Vaccination occurred between December 2020 and April 2021. Participants donated blood 2 to 4 and 2 to 8 weeks after the second vaccine dose for antibody and T-cell assessments, respectively. Exposures All participants received 2 doses of BNT162b2 vaccine (Pfizer/BioNTech) and completed the study. Main Outcomes and

Measures:

Proportion of patients treated with ocrelizumab with SARS-CoV-2-specific serology and/or T-cell responses following vaccination. All participants underwent SARS-CoV-2 antibody testing; 29 patients treated with ocrelizumab and 15 healthy controls had evaluation of SARS-CoV-2-specific T-cell responses.

Results:

Of 112 participants, 49 (43.8%) had MS and were treated with ocrelizumab (33 [67.3%] female; mean [SD] age, 47.9 [13.3] years), 23 (20.5%) had MS and were not treated with disease-modifying therapies (18 [78.3%] female; mean [SD] age, 49 [13.4] years), and 40 (35.7%) were healthy controls (25 [62.5%] female; mean [SD] age, 45.3 [16] years). Twenty-six of 29 patients (89.7%) treated with ocrelizumab and 15 of 15 healthy controls (100%) had SARS-CoV-2-specific T cells following vaccination at similar levels (mean [SD], 15.4 [7.6] and 14.3 [6.3] spot-forming cells, respectively). Mean antibody titers and positive serology rate were lower in the group of patients treated with ocrelizumab (mean [SD] antibody titers and positive serology rate, 26.2 [49.2] and 376.5 [907.6] AU/mL; 10 of 40 [25%] and 20 of 49 [40.8%] for S1/S2 and receptor-binding domain, respectively) compared with healthy controls (mean [SD] antibody titers and positive serology rate, 283 [100] and 12 712 [9114] AU/mL; 100% S1/S2 and receptor-binding domain) and untreated patients (mean [SD] antibody titers and positive serology rate, 288.3 [113.8] and 10 877 [9476] AU/mL; 100% S1/S2 and receptor-binding domain), with positive association to time from ocrelizumab infusion (S1/S2 r = 0.7, P < .001; receptor-binding domain r = 0.4, P = .04). Conclusion and Relevance In this study, patients with MS who were treated with ocrelizumab generated comparable SARS-CoV-2-specific T-cell responses with healthy controls and had lower antibody response following vaccination. Given the potential role of T cells in protection from severe disease, this is reassuring and will help physicians develop consensus guidelines regarding MS treatment in the era of the COVID-19 pandemic.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: T-Lymphocytes / Immunity, Humoral / Antibodies, Monoclonal, Humanized / COVID-19 Vaccines / Immunologic Factors / Multiple Sclerosis Type of study: Experimental Studies / Prognostic study Topics: Vaccines / Variants Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: JAMA Neurol Year: 2021 Document Type: Article Affiliation country: Jamaneurol.2021.3599

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Full text: Available Collection: International databases Database: MEDLINE Main subject: T-Lymphocytes / Immunity, Humoral / Antibodies, Monoclonal, Humanized / COVID-19 Vaccines / Immunologic Factors / Multiple Sclerosis Type of study: Experimental Studies / Prognostic study Topics: Vaccines / Variants Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: JAMA Neurol Year: 2021 Document Type: Article Affiliation country: Jamaneurol.2021.3599