Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.
Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.
Ann Rheum Dis. 2021 Oct;80(10):1312-1316. doi: 10.1136/annrheumdis-2021-220461. Epub 2021 May 6.
To better understand the factors that influence the humoral immune response to vaccination against SARS-CoV-2 in patients with immune-mediated inflammatory diseases (IMIDs).
Patients and controls from a large COVID-19 study, with (1) no previous history of COVID-19, (2) negative baseline anti-SARS-CoV-2 IgG test and (3) SARS-CoV-2 vaccination at least 10 days before serum collection were measured for anti-SARS-CoV-2 IgG. Demographic, disease-specific and vaccination-specific data were recorded.
Vaccination responses from 84 patients with IMID and 182 controls were analysed. While all controls developed anti-SARS-CoV-2 IgG, five patients with IMID failed to develop a response (p=0.003). Moreover, 99.5% of controls but only 90.5% of patients with IMID developed neutralising antibody activity (p=0.0008). Overall responses were delayed and reduced in patients (mean (SD): 6.47 (3.14)) compared with controls (9.36 (1.85); p<0.001). Estimated marginal means (95% CI) adjusted for age, sex and time from first vaccination to sampling were 8.48 (8.12-8.85) for controls and 6.90 (6.45-7.35) for IMIDs. Significantly reduced vaccination responses pertained to untreated, conventionally and anticytokine treated patients with IMID.
Immune responses against the SARS-CoV-2 are delayed and reduced in patients with IMID. This effect is based on the disease itself rather than concomitant treatment.
更好地了解影响免疫介导的炎症性疾病（IMID）患者对 SARS-CoV-2 疫苗接种产生体液免疫反应的因素。
这项大型 COVID-19 研究中的患者和对照者（1）无 COVID-19 既往史，（2）基线抗 SARS-CoV-2 IgG 检测阴性，（3）在采集血清前至少 10 天接种 SARS-CoV-2 疫苗，检测抗 SARS-CoV-2 IgG。记录人口统计学、疾病特异性和疫苗特异性数据。
分析了 84 例 IMID 患者和 182 例对照者的疫苗接种反应。虽然所有对照者均产生了抗 SARS-CoV-2 IgG，但 5 例 IMID 患者未能产生应答（p=0.003）。此外，99.5%的对照者但只有 90.5%的 IMID 患者产生了中和抗体活性（p=0.0008）。与对照者（9.36（1.85）相比，患者的总体反应延迟且减少（平均值（SD）：6.47（3.14））（p<0.001）。经年龄、性别和首次接种至采样时间调整后的估计边缘平均值（95%CI），对照者为 8.48（8.12-8.85），IMID 患者为 6.90（6.45-7.35）。未经治疗、常规治疗和抗细胞因子治疗的 IMID 患者的疫苗接种反应显著降低。
IMID 患者对 SARS-CoV-2 的免疫反应延迟且减少。这种效应是基于疾病本身，而不是伴随的治疗。
