1. Immunosuppressive treatments selectively affect the humoral and cellular response to SARS-CoV-2 in vaccinated patients with vasculitis.
- Author
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Monti, Sara, Fornara, Chiara, Delvino, Paolo, Bartoletti, Alice, Bergami, Federica, Comolli, Giuditta, Sammartino, Josè Camilla, Biglia, Alessandro, Cassione, Emanuele Bozzalla, Cassaniti, Irene, Baldanti, Fausto, Lilleri, Daniele, and Montecucco, Carlomaurizio
- Subjects
GIANT cell arteritis diagnosis ,COVID-19 ,IMMUNIZATION ,IMMUNOGLOBULINS ,COVID-19 vaccines ,GIANT cell arteritis ,IMMUNOSUPPRESSION ,ANTIBODY formation ,MESSENGER RNA ,ENZYME-linked immunosorbent assay ,DESCRIPTIVE statistics ,RESEARCH funding ,CELLULAR immunity ,T cells - Abstract
Objectives To analyse humoral and cellular immune response to mRNA COVID-19 vaccines in patients with GCA. Methods Consecutive patients with a diagnosis of GCA receiving two doses of BNT162b2 vaccine were assessed at baseline and 3 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 neutralizing antibodies (NtAb). Specific T cell response was assessed by enzyme linked immunosorbent spot (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, but this was significantly lower than HCs (100%); P < 0.0001. Neutralizing activity was not detected in 16% of patients with GCA. Antibody titres (S-IgG and NtAb) were significantly lower compared with HCs. Humoral response (S-IgG and NtAb) was significantly hampered by treatment with MTX. Cellular response was lacking in 30% of patients with GCA (vs 0% in HCs; 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 neutralizing 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. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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