Adaptive B-cell and T-cell responses to SARS-CoV-2 vaccination in patients with Multiple Sclerosis on disease modifying immunotherapy
Neurology
; 98(18 SUPPL), 2022.
Article
in English
| EMBASE | ID: covidwho-1925543
ABSTRACT
Objective:
To expand understanding of the human immunological response to SARS-CoV-2 vaccination in patients with Multiple Sclerosis (MS) treated with anti-CD20 monoclonal therapy and sphingosine-1-phosphate (S1P) modulators.Background:
Immunomodulatory therapy prescribed for patients with MS has been associated with decreased or absent anti-SARS-CoV-2 immunoglobulin production following COVID-19 vaccination. We investigate broader adaptive immune responses to SARS-CoV-2 vaccination measuring IgG immunoglobulin production and T-cell reactivity in a small cohort. Design/Methods:
We used the Stanford Research Repository database to identify 55 MS patients by ICD10 code who were tested for B-cell and T-cell responses via SARS-CoV-2-IgG and SARS-CoV-2 Interferon Gamma Release Assay (IGRA), respectively. 96% (53/55) of patients were fully vaccinated (98% mRNA/2% Janssen). A Chi-square test compared differences in vaccine response between 3 different disease modifying treatment (DMT) groups anti-CD20 therapy (n=24), S1P modulators (n=11), and off DMT/other MS therapies (n=20).Results:
In patients on anti-CD20 therapy, 71% (17/24) were positive for SARS-CoV-2 IGRA but negative for SARS-CoV-2 IgG, among which 65% (11/17) had low CD-19 levels (0-64 cells/uL, normal 100-500 cells/uL) with normal absolute lymphocyte count (ALC). Among patients who delayed vaccination by 4-6 months following anti-CD20 therapy, 13% (3/24) expressed SARS-CoV-2-IgG. 82% (9/11) of patients on S1P modulators showed absent SARS-CoV-2-IgG and SARS-CoV-2 IGRA responses, in association with low ALC (range 210-600 cells/uL, normal 1000-3000 cells/uL). 95% (19/20) of patients off DMT/on other MS therapies showed positive SARS-CoV-2-IgG and SARS-CoV-2 IRGA responses. All vaccinated patients were assessed between 4 weeks and 6 months post-vaccination. These differential responses between treatment groups were significant (p<0.05).Conclusions:
We demonstrate that among MS patients treated with anti-CD20 therapy, T-cell response was largely preserved despite greatly reduced B-cell response to SARS-CoV-2 vaccination. MS patients on S1P modulators demonstrated absence of both B-cell and T-cell response. The clinical correlation of this is to be determined.
CD19 antigen; CD20 antibody; endogenous compound; immunoglobulin G; messenger RNA; sphingosine 1 phosphate; vaccine; absolute lymphocyte count; adaptive immunity; adult; B lymphocyte; clinical assessment; conference abstract; controlled study; drug therapy; female; gene expression; human; ICD-10; immunoglobulin production; immunotherapy; interferon gamma release assay; major clinical study; male; multiple sclerosis; nonhuman; protein expression; SARS coronavirus 2 immunology test kit; Severe acute respiratory syndrome coronavirus 2; T lymphocyte; vaccination; vaccinee
Search on Google
Collection:
Databases of international organizations
Database:
EMBASE
Topics:
Vaccines
Language:
English
Journal:
Neurology
Year:
2022
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS