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B- and T-Cell Responses After SARS-CoV-2 Vaccination in Patients With Multiple Sclerosis Receiving Disease Modifying Therapies: Immunological Patterns and Clinical Implications.
Iannetta, Marco; Landi, Doriana; Cola, Gaia; Campogiani, Laura; Malagnino, Vincenzo; Teti, Elisabetta; Coppola, Luigi; Di Lorenzo, Andrea; Fraboni, Daniela; Buccisano, Francesco; Grelli, Sandro; Mozzani, Marcello; Zingaropoli, Maria Antonella; Ciardi, Maria Rosa; Nisini, Roberto; Bernardini, Sergio; Andreoni, Massimo; Marfia, Girolama Alessandra; Sarmati, Loredana.
  • Iannetta M; Infectious Disease Unit, Department of System Medicine, Tor Vergata University and Hospital, Rome, Italy.
  • Landi D; Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University and Hospital, Rome, Italy.
  • Cola G; Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University and Hospital, Rome, Italy.
  • Campogiani L; Infectious Disease Unit, Department of System Medicine, Tor Vergata University and Hospital, Rome, Italy.
  • Malagnino V; Infectious Disease Unit, Department of System Medicine, Tor Vergata University and Hospital, Rome, Italy.
  • Teti E; Infectious Disease Unit, Department of System Medicine, Tor Vergata University and Hospital, Rome, Italy.
  • Coppola L; Infectious Disease Unit, Department of System Medicine, Tor Vergata University and Hospital, Rome, Italy.
  • Di Lorenzo A; Infectious Disease Unit, Department of System Medicine, Tor Vergata University and Hospital, Rome, Italy.
  • Fraboni D; Department of Biomedicine and Prevention, Tor Vergata University and Hospital, Rome, Italy.
  • Buccisano F; Department of Biomedicine and Prevention, Tor Vergata University and Hospital, Rome, Italy.
  • Grelli S; Department of Experimental Medicine, Tor Vergata University and Hospital, Rome, Italy.
  • Mozzani M; Department of Experimental Medicine, Tor Vergata University and Hospital, Rome, Italy.
  • Zingaropoli MA; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Ciardi MR; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Nisini R; Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Roma, Italy.
  • Bernardini S; Department of Experimental Medicine, Tor Vergata University and Hospital, Rome, Italy.
  • Andreoni M; Infectious Disease Unit, Department of System Medicine, Tor Vergata University and Hospital, Rome, Italy.
  • Marfia GA; Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University and Hospital, Rome, Italy.
  • Sarmati L; Unit of Neurology, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy.
Front Immunol ; 12: 796482, 2021.
Article in English | MEDLINE | ID: covidwho-2123406
ABSTRACT

Background:

Vaccination campaign to contrast the spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has raised the issue of vaccine immunogenicity in special populations such as people with multiple sclerosis (PwMS) on highly effective disease modifying treatments (DMTs). While humoral responses to SARS-CoV-2 mRNA vaccines have been well characterized in the general population and in PwMS, very little is known about cell-mediated responses in conferring protection from SARS-CoV-2 infection and severe coronavirus disease-2019 (COVID-19).

Methods:

PwMS on ocrelizumab, fingolimod or natalizumab, vaccinated with two doses of mRNABNT162b2 (Comirnaty®) vaccine were enrolled. Anti-Spike (S) and anti-Nucleoprotein (N) antibody titers, IFN-gamma production upon S and N peptide libraries stimulation, peripheral blood lymphocyte absolute counts were assessed after at least 1 month and within 4 months from vaccine second dose administration. A group of age and sex matched healthy donors (HD) were included as reference group. Statistical analysis was performed using GraphPad Prism 8.2.1.

Results:

Thirty PwMS and 9 HDs were enrolled. All the patients were negative for anti-N antibody detection, nor reported previous symptoms of COVID-19. Peripheral blood lymphocyte counts were assessed in PwMS showing (i) reduction of circulating B-lymphocytes in PwMS on ocrelizumab; (ii) reduction of peripheral blood B- and T-lymphocyte absolute counts in PwMS on fingolimod and (iii) normal B- and T-lymphocyte absolute counts with an increase in circulating CD16+CD56+ NK-cells in PwMS on natalizumab. Three patterns of immunological responses were identified in PwMS. In patients on ocrelizumab, anti-S antibody were lacking or reduced, while T-cell responses were normal. In patients on fingolimod both anti-S titers and T-cell mediated responses were impaired. In patients on natalizumab both anti-S titers and T-cell responses were present and comparable to those observed in HD.

Conclusions:

The evaluation of T-cell responses, anti-S titers and peripheral blood lymphocyte absolute count in PwMS on DMTs can help to better characterize the immunological response after SARS-CoV-2 vaccination. The evaluation of T-cell responses in longitudinal cohorts of PwMS will help to clarify their protective role in preventing SARS-CoV-2 infection and severe COVID-19. The correlation between DMT treatment and immunological responses to SARS-CoV-2 vaccines could help to better evaluate vaccination strategies in PwMS.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: B-Lymphocytes / T-Lymphocytes / Vaccination / SARS-CoV-2 / COVID-19 / BNT162 Vaccine / Multiple Sclerosis Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Front Immunol Year: 2021 Document Type: Article Affiliation country: Fimmu.2021.796482

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Full text: Available Collection: International databases Database: MEDLINE Main subject: B-Lymphocytes / T-Lymphocytes / Vaccination / SARS-CoV-2 / COVID-19 / BNT162 Vaccine / Multiple Sclerosis Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Front Immunol Year: 2021 Document Type: Article Affiliation country: Fimmu.2021.796482