Immunosuppressive treatments selectively affect the humoral and cellular response to SARS-CoV-2 in vaccinated patients with vasculitis.
Rheumatology (Oxford)
; 2022 Jun 23.
Article
in English
| MEDLINE | ID: covidwho-2233444
ABSTRACT
OBJECTIVES:
To analyse humoral and cellular immune response to messenger RNA (mRNA) COVID-19 vaccines in patients with giant cell arteritis (GCA).METHODS:
Consecutive patients with a diagnosis of GCA receiving two doses of BNT162b2 vaccine were assessed at baseline and three weeks from the second vaccine dose. Healthy subjects (n = 51) were included as controls (HC). Humoral response was assessed with Spike-specific IgG antibody response (S-IgG) and neutralising antibodies (NtAb). Specific T cell response was assessed by Enzyme linked immunospot (ELISpot).RESULTS:
Of 56 included patients with GCA, 44 were eligible after exclusion of previous evidence of COVID-19 and incomplete follow-up. A significant proportion of patients with GCA (91%) demonstrated antibody (S-IgG) response, however this was significantly lower than HC (100%); p< 0.0001. Neutralising activity was not detected in 16% of patients with GCA. Antibody titres (S-IgG and NtAb) were significantly lower compared with HC. Humoral response (S-IgG and NtAb) was significantly hampered by treatment with methotrexate (MTX). Cellular response was lacking in 30% of patients with GCA (vs 0% in HC); p< 0.0001. Cellular response was significantly influenced by the levels of baseline peripheral T-lymphocytes and by glucocorticoid treatment. Treatment with tocilizumab did not affect any level of the immune response elicited by vaccination.CONCLUSIONS:
Although patients with GCA apparently achieve a robust antibody seroconversion, there is a significant impairment of the neutralising activity. MTX significantly reduced all levels of the humoral response. Up to one third of patients do not develop a cellular immune protection in response to COVID-19 vaccination.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Cohort study
/
Prognostic study
Topics:
Vaccines
Language:
English
Journal subject:
Rheumatology
Year:
2022
Document Type:
Article
Affiliation country:
Rheumatology
Similar
MEDLINE
...
LILACS
LIS