Humoral immune response to COVID-19 mRNA vaccine in patients with multiple sclerosis treated with high-efficacy disease-modifying therapies.
Humoral immune response to COVID-19 mRNA vaccine in patients with multiple sclerosis treated with high-efficacy disease-modifying therapies.
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DOI：
10.1177/17562864211012835
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发表时间：
2021
影响因子：
5.9
通讯作者：
Gurevich M
中科院分区：
文献类型：
--
作者：
Achiron A;Mandel M;Dreyer-Alster S;Harari G;Magalashvili D;Sonis P;Dolev M;Menascu S;Flechter S;Falb R;Gurevich M
美国国家多发性硬化症协会和其他专家组织建议，所有多发性硬化症（MS）患者都应接种COVID-19疫苗。然而，疾病修饰疗法（DMT）对产生适当免疫应答的疗效的影响尚不清楚。我们的目的是表征接受高效DMT治疗的mRNA-COVID-19 MS疫苗接种者的体液免疫。我们使用基于抗刺突蛋白的血清学（EUROIMMUN）在125名接种BNT 162 b2-COVID-19疫苗的MS患者中测量了第二剂疫苗接种后1个月的SARS-CoV-2 IgG应答。患者未接受治疗或正在接受芬戈莫德、克拉屈滨或ocrelizumab治疗。一组同样接种疫苗的健康受试者作为对照。评价产生保护性抗体的受试者百分比、滴度和距末次给药的时间。在接种COVID-19疫苗的健康受试者（N = 47）、未经治疗的MS患者（N = 32）和接受克拉屈滨（N = 23）、ocrelizumab（N = 44）和fingolimod（N = 26）治疗的MS患者中，分别观察到97.9%、100%、100%、22.7%和3.8%的保护性体液免疫。SARS-CoV-2 IgG抗体滴度在健康受试者、未经治疗的MS患者和克拉屈滨治疗的MS患者中在第二次疫苗接种后29.5-55天内较高。仅22.7%的ocrelizumab治疗患者出现体液IgG应答，与正常绝对淋巴细胞计数无关。大多数芬戈莫德治疗的MS患者淋巴细胞计数非常低，未能产生SARS-COV-2抗体。年龄、疾病持续时间和距末次给药的时间不影响COVID-19疫苗接种的体液反应。克拉屈滨治疗不会损害对COVID-19疫苗接种的体液反应。我们建议在愿意接种疫苗的MS患者中推迟ocrelizumab治疗，因为仅在某些情况下可以预期保护性体液应答。我们不建议给接受芬戈莫德治疗的MS患者接种疫苗，因为预计不会产生保护性体液应答。
The National Multiple Sclerosis Society and other expert organizations recommended that all patients with multiple sclerosis (MS) should be vaccinated against COVID-19. However, the effect of disease-modifying therapies (DMTs) on the efficacy to mount an appropriate immune response is unknown. We aimed to characterize humoral immunity in mRNA-COVID-19 MS vaccinees treated with high-efficacy DMTs. We measured SARS-CoV-2 IgG response using anti-spike protein-based serology (EUROIMMUN) in 125 MS patients vaccinated with BNT162b2-COVID-19 vaccine 1 month after the second dose. Patients were either untreated or under treatment with fingolimod, cladribine, or ocrelizumab. A group of healthy subjects similarly vaccinated served as control. The percent of subjects that developed protective antibodies, the titer, and the time from the last dosing were evaluated. Protective humoral immunity of 97.9%, 100%, 100%, 22.7%, and 3.8%, was observed in COVID-19 vaccinated healthy subjects (N = 47), untreated MS patients (N = 32), and MS patients treated with cladribine (N = 23), ocrelizumab (N = 44), and fingolimod (N = 26), respectively. SARS-CoV-2 IgG antibody titer was high in healthy subjects, untreated MS patients, and MS patients under cladribine treatment, within 29.5–55 days after the second vaccine dose. Only 22.7% of patients treated with ocrelizumab developed humoral IgG response irrespective to normal absolute lymphocyte count. Most fingolimod-treated MS patients had very low lymphocyte count and failed to develop SARS-COV-2 antibodies. Age, disease duration, and time from the last dosing did not affect humoral response to COVID-19 vaccination. Cladribine treatment does not impair humoral response to COVID-19 vaccination. We recommend postponing ocrelizumab treatment in MS patients willing to be vaccinated as a protective humoral response can be expected only in some. We do not recommend vaccinating MS patients treated with fingolimod as a protective humoral response is not expected.
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BNT162B2 mRNA COVID-19疫苗的安全性和功效。
DOI：
10.1056/nejmoa2034577
发表时间：
2020-12-31
期刊：
The New England journal of medicine
影响因子：
--
作者：
Polack FP;Thomas SJ;Kitchin N;Absalon J;Gurtman A;Lockhart S;Perez JL;Pérez Marc G;Moreira ED;Zerbini C;Bailey R;Swanson KA;Roychoudhury S;Koury K;Li P;Kalina WV;Cooper D;Frenck RW Jr;Hammitt LL;Türeci Ö;Nell H;Schaefer A;Ünal S;Tresnan DB;Mather S;Dormitzer PR;Şahin U;Jansen KU;Gruber WC;C4591001 Clinical Trial Group
通讯作者：
C4591001 Clinical Trial Group
影响因子：
3.7
作者：
Nayak K;Gottimukkala K;Kumar S;Reddy ES;Edara VV;Kauffman R;Floyd K;Mantus G;Savargaonkar D;Goel PK;Arora S;Rahi M;Davis CW;Linderman S;Wrammert J;Suthar MS;Ahmed R;Sharma A;Murali-Krishna K;Chandele A
通讯作者：
Chandele A
DOI：
10.1177/13524585211003476
发表时间：
2021-05
期刊：
Multiple sclerosis (Houndmills, Basingstoke, England)
影响因子：
--
作者：
Achiron A;Dolev M;Menascu S;Zohar DN;Dreyer-Alster S;Miron S;Shirbint E;Magalashvili D;Flechter S;Givon U;Guber D;Stern Y;Polliack M;Falb R;Gurevich M
通讯作者：
Gurevich M
影响因子：
2.9
作者：
Mendrone-Junior, Alfredo;Dinardo, Carla Luana;Sabino, Ester Cerdeira
通讯作者：
Sabino, Ester Cerdeira
影响因子：
8.6
作者：
Miyazaki, Yusei;Niino, Masaaki;Kikuchi, Seiji
通讯作者：
Kikuchi, Seiji