Impaired immunogenicity to COVID-19 vaccines in autoimmune systemic diseases. High prevalence of non-response in different patients' subgroups.
Impaired immunogenicity to COVID-19 vaccines in autoimmune systemic diseases. High prevalence of non-response in different patients' subgroups.
复制标题
DOI：
10.1016/j.jaut.2021.102744
复制
发表时间：
2021-12
影响因子：
12.8
通讯作者：
Antonelli A
中科院分区：
文献类型：
--
作者：
Ferri C;Ursini F;Gragnani L;Raimondo V;Giuggioli D;Foti R;Caminiti M;Olivo D;Cuomo G;Visentini M;Cacciapaglia F;Pellegrini R;Pigatto E;Urraro T;Naclerio C;Tavoni A;Puccetti L;Varcasia G;Cavazzana I;L'Andolina M;Ruscitti P;Vadacca M;Gigliotti P;La Gualana F;Cozzi F;Spinella A;Visalli E;Dal Bosco Y;Amato G;Masini F;Pagano Mariano G;Brittelli R;Aiello V;Caminiti R;Scorpiniti D;Rechichi G;Ferrari T;Monti M;Elia G;Franceschini F;Meliconi R;Casato M;Iannone F;Giacomelli R;Fallahi P;Santini SA;Zignego AL;Antonelli A
自身免疫系统性疾病（ASD）可能对COVID-19疫苗的免疫原性受损。我们的前瞻性观察性多中心研究旨在评估疫苗接种周期后和6-12个月随访时的血清转换，以及疫苗预防COVID-19的安全性和有效性。该研究包括478例ASD患者（平均年龄59 ± 15岁），即101例类风湿性关节炎（RA），38例系统性红斑狼疮（SLE），265例系统性硬化症（SSc），61例冷球蛋白血症性血管炎（CV）和13例系统性血管炎的混合症。对照组包括502名来自普通人群的个体（平均年龄59 ± 14 SD岁）。通过测量接种周期后3周内获得的样本的血清IgG中和抗体（NAb）（SARS-CoV-2 IgG II Quant抗体检测试剂盒; Abbott Laboratories，芝加哥，IL），评价mRNA COVID-19疫苗（BNT 162 b2和mRNA-1273）的免疫原性。我们的前瞻性研究的短期结果显示，与对照组相比，ASD系列中的NAb水平显著较低[286（53-1203）vs 825（451-1542）BAU/mL，p < 0.0001]，单个ASD亚组和对照组之间也是如此。更有趣的是，与对照组相比，ASD患者中记录的对疫苗无应答者的百分比更高[13.2%（63/478）vs 2.8%（14/502）; p < 0.0001]。在不同的ASD亚组、ASD相关间质性肺病患者（p = 0.009）以及接受糖皮质激素（p = 0.002）、麦考酚酸酯（p < 0.0001）或利妥昔单抗（p <0.0001）治疗的患者中，也观察到对疫苗无反应的患病率增加。在应答者和非应答者ASD患者中记录了疫苗相关不良反应的百分比。弱/无血清转换的患者，被认为对SARS-CoV-2感染具有免疫力，具有发展COVID-19的高风险。疫苗接种周期后血清NAb的早期测定可允许鉴定ASD患者的三个主要组：应答者、具有次优应答的受试者、无应答者。应答欠佳的患者应优先接种加强剂量的疫苗，而非应答者可接种不同类型的疫苗。
Autoimmune systemic diseases (ASD) may show impaired immunogenicity to COVID-19 vaccines. Our prospective observational multicenter study aimed to evaluate the seroconversion after the vaccination cycle and at 6-12-month follow-up, as well the safety and efficacy of vaccines in preventing COVID-19. The study included 478 unselected ASD patients (mean age 59 ± 15 years), namely 101 rheumatoid arthritis (RA), 38 systemic lupus erythematosus (SLE), 265 systemic sclerosis (SSc), 61 cryoglobulinemic vasculitis (CV), and a miscellanea of 13 systemic vasculitis. The control group included 502 individuals from the general population (mean age 59 ± 14SD years). The immunogenicity of mRNA COVID-19 vaccines (BNT162b2 and mRNA-1273) was evaluated by measuring serum IgG-neutralizing antibody (NAb) (SARS-CoV-2 IgG II Quant antibody test kit; Abbott Laboratories, Chicago, IL) on samples obtained within 3 weeks after vaccination cycle. The short-term results of our prospective study revealed significantly lower NAb levels in ASD series compared to controls [286 (53–1203) vs 825 (451–1542) BAU/mL, p < 0.0001], as well as between single ASD subgroups and controls. More interestingly, higher percentage of non-responders to vaccine was recorded in ASD patients compared to controls [13.2% (63/478), vs 2.8% (14/502); p < 0.0001]. Increased prevalence of non-response to vaccine was also observed in different ASD subgroups, in patients with ASD-related interstitial lung disease (p = 0.009), and in those treated with glucocorticoids (p = 0.002), mycophenolate-mofetil (p < 0.0001), or rituximab (p < 0.0001). Comparable percentages of vaccine-related adverse effects were recorded among responder and non-responder ASD patients. Patients with weak/absent seroconversion, believed to be immune to SARS-CoV-2 infection, are at high risk to develop COVID-19. Early determination of serum NAb after vaccination cycle may allow to identify three main groups of ASD patients: responders, subjects with suboptimal response, non-responders. Patients with suboptimal response should be prioritized for a booster-dose of vaccine, while a different type of vaccine could be administered to non-responder individuals.
登录
查看更多内容
DOI：
10.1002/art.41914
发表时间：
2022-01
期刊：
Arthritis & rheumatology (Hoboken, N.J.)
影响因子：
--
作者：
Simon D;Tascilar K;Schmidt K;Manger B;Weckwerth L;Sokolova M;Bucci L;Fagni F;Manger K;Schuch F;Ronneberger M;Hueber A;Steffen U;Mielenz D;Herrmann M;Harrer T;Kleyer A;Krönke G;Schett G
通讯作者：
Schett G
影响因子：
3.4
作者：
Bixio R;Bertelle D;Masia M;Pistillo F;Carletto A;Rossini M
通讯作者：
Rossini M
影响因子：
6.2
作者：
Hasseli R;Mueller-Ladner U;Hoyer BF;Krause A;Lorenz HM;Pfeil A;Richter J;Schäfer M;Schmeiser T;Strangfeld A;Schulze-Koops H;Voll RE;Specker C;Regierer AC
通讯作者：
Regierer AC
影响因子：
3.4
作者：
Ammitzbøll C;Bartels LE;Bøgh Andersen J;Risbøl Vils S;Elbaek Mistegård C;Dahl Johannsen A;From Hermansen ML;Kragh Thomsen M;Erikstrup C;Hauge EM;Troldborg A
通讯作者：
Troldborg A
DOI：
10.1002/art.41619
发表时间：
2021-06
期刊：
Arthritis & rheumatology (Hoboken, N.J.)
影响因子：
--
作者：
D'Silva KM;Jorge A;Cohen A;McCormick N;Zhang Y;Wallace ZS;Choi HK
通讯作者：
Choi HK