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B cell numbers predict humoral and cellular response upon SARS-CoV-2 vaccination among patients treated with rituximab.
Stefanski, Ana L; Rincon-Arevalo, Hector; Schrezenmeier, Eva; Karberg, Kirsten; Szelinski, Franziska; Ritter, Jacob; Jahrsdörfer, Bernd; Schrezenmeier, Hubert; Ludwig, Carolin; Sattler, Arne; Kotsch, Katja; Chen, Yidan; Claußnitzer, Anne; Haibel, Hildrun; Proft, Fabian; Guerra, Gabriela; Durek, Pawel; Heinrich, Frederik; Ferreira-Gomes, Marta; Burmester, Gerd R; Radbruch, Andreas; Mashreghi, Mir F; Lino, Andreia C; Dörner, Thomas.
  • Stefanski AL; Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin; Berlin, Germany.
  • Rincon-Arevalo H; Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany.
  • Schrezenmeier E; Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin; Berlin, Germany.
  • Karberg K; Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany.
  • Szelinski F; Department of Nephrology and Medical Intensive Care, Charité Universitätsmedizin Berlin, Berlin, Germany.
  • Ritter J; Grupo de Inmunología Celular e Inmunogenética, Facultad de Medicina, Instituto de Investigaciones Médicas, Universidad de Antioquia UdeA, Medellín, Colombia.
  • Jahrsdörfer B; Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany.
  • Schrezenmeier H; Department of Nephrology and Medical Intensive Care, Charité Universitätsmedizin Berlin, Berlin, Germany.
  • Ludwig C; Berlin Institute of Health Charité Universitätsmedizin Berlin, BIH Academy, Berlin, Germany.
  • Sattler A; Rheumatology outpatient office RheumaPraxis Steglitz, Berlin, Germany.
  • Kotsch K; Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin; Berlin, Germany.
  • Chen Y; Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany.
  • Claußnitzer A; Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin; Berlin, Germany.
  • Haibel H; Berlin Institute of Health Charité Universitätsmedizin Berlin, BIH Academy, Berlin, Germany.
  • Proft F; Institute of Transfusion Medicine, Ulm University, Ulm, Germany and Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg - Hessen and University Hospital Ulm, Ulm, Germany.
  • Guerra G; Institute of Transfusion Medicine, Ulm University, Ulm, Germany and Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg - Hessen and University Hospital Ulm, Ulm, Germany.
  • Durek P; Institute of Transfusion Medicine, Ulm University, Ulm, Germany and Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg - Hessen and University Hospital Ulm, Ulm, Germany.
  • Heinrich F; Department for General, Visceral and Vascular Surgery, Charité Universitätsmedizin Berlin, Berlin, Germany.
  • Ferreira-Gomes M; Department for General, Visceral and Vascular Surgery, Charité Universitätsmedizin Berlin, Berlin, Germany.
  • Burmester GR; Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin; Berlin, Germany.
  • Radbruch A; Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany.
  • Mashreghi MF; Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin; Berlin, Germany.
  • Lino AC; Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitätsmedizin Berlin, Berlin, Germany.
  • Dörner T; Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitätsmedizin Berlin, Berlin, Germany.
Arthritis Rheumatol ; 2021 Dec 28.
Article in English | MEDLINE | ID: covidwho-1589171
Preprint
This scientific journal article is probably based on a previously available preprint. It has been identified through a machine matching algorithm, human confirmation is still pending.
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ABSTRACT

OBJECTIVES:

Patients with autoimmune inflammatory rheumatic diseases receiving rituximab (RTX) therapy are at higher risk for poor COVID-19 outcomes and show substantially impaired humoral anti-SARS-CoV-2 vaccine responses. However, the complex relationship between antigen-specific B and T cells and the level of B cell repopulation necessary to achieve anti-vaccine responses remain largely unknown.

METHODS:

Antibody responses to SARS-CoV-2 vaccines and induction of antigen-specific B and CD4/CD8 T cell subsets were studied in 19 rheumatoid arthritis (RA) and ANCA-associated vasculitis (AAV) patients receiving RTX, 12 RA patients on other therapies and 30 healthy controls after SARS-CoV-2 vaccination with either mRNA or vector based vaccines.

RESULTS:

A minimum of 10 B cells/µL (0,4% of lymphocytes) in the peripheral circulation appeared to be required in RTX patients to mount seroconversion to anti-S1 IgG upon SARS-CoV-2 vaccination. RTX patients lacking IgG seroconversion showed reduced RBD+ B cells, lower frequency of TfH-like cells as well as less activated CD4 and CD8 T cells compared to IgG seroconverted RTX patients. Functionally relevant B cell depletion resulted in impaired IFNγ secretion by spike-specific CD4 T cells. In contrast, antigen-specific CD8 T cells were reduced in patients, independently of IgG formation.

CONCLUSIONS:

In patients receiving RTX, a minimum of 10 B cells/µl in the peripheral circulation candidates as biomarker for a high likelihood of an appropriate cellular and humoral response after SARS-CoV-2 vaccination. Mechanistically, the data emphasize the crucial role of co-stimulatory B cell functions for the proper induction of CD4 responses propagating vaccine-specific B and plasma cell differentiation.

Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study / Risk factors Language: English Year: 2021 Document Type: Article Affiliation country: Art.42060

Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study / Risk factors Language: English Year: 2021 Document Type: Article Affiliation country: Art.42060