SARS-CoV-2 vaccination in rituximab-treated patients: B cells promote humoral immune responses in the presence of T-cell-mediated immunity
SARS-CoV-2 vaccination in rituximab-treated patients: B cells promote humoral immune responses in the presence of T-cell-mediated immunity
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DOI：
10.1136/annrheumdis-2021-220781
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发表时间：
2021-10-01
影响因子：
27.4
通讯作者：
Bonelli, Michael
中科院分区：
文献类型：
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作者：
Mrak, Daniel;Tobudic, Selma;Bonelli, Michael
目的有证据表明利妥昔单抗（rituximab，RTX）去除B细胞治疗影响疫苗接种后的体液免疫应答。目前尚不清楚RTX治疗的患者是否可以在immunosefication.Methods免疫后产生针对SARS-CoV-2的体液和T细胞介导的免疫应答。RTX治疗的患者（n=74）接种两次mRNA-1273或BNT 162 b2。使用Elecsys抗SARS-CoV-2 S免疫测定法对刺突蛋白的受体结合结构域（RBD）和中和试验定量抗体。SARS-CoV-2特异性T细胞反应通过IFN-γ酶联免疫吸附斑点试验进行定量。结果所有健康对照者均产生了针对SARS-CoV-2刺突蛋白RBD的抗体，但RTX治疗组中只有39%的患者发生了血清转化。抗SARS-CoV-2 RBD抗体与中和抗体显著相关（tau=0.74，p
ObjectivesEvidence suggests that B cell-depleting therapy with rituximab (RTX) affects humoral immune response after vaccination. It remains unclear whether RTX-treated patients can develop a humoral and T-cell-mediated immune response against SARS-CoV-2 after immunisation.Methods Patients under RTX treatment (n=74) were vaccinated twice with either mRNA-1273 or BNT162b2. Antibodies were quantified using the Elecsys Anti-SARS-CoV-2 S immunoassay against the receptor-binding domain (RBD) of the spike protein and neutralisation tests. SARS-CoV-2-specific T-cell responses were quantified by IFN-gamma enzyme-linked immunosorbent spot assays. Prepandemic healthy individuals (n=5), as well as healthy individuals (n=10) vaccinated with BNT162b2, served as controls.Results All healthy controls developed antibodies against the SARS-CoV-2 RBD of the spike protein, but only 39% of the patients under RTX treatment seroconverted. Antibodies against SARS-CoV-2 RBD significantly correlated with neutralising antibodies (tau=0.74, p