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[在体液反应受损的接受抗CD20治疗的患者中,是否可检测到针对严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的反应性T细胞并具有潜在保护作用?]

[Are SARS-CoV-2 reactive T cells detectable and potentially protective in patients under anti-CD20 treatment with an impaired humoral response?].

作者信息

Braun J, Westhoff T, Baraliakos X, Babel N

机构信息

Rheumazentrum Ruhrgebiet Herne, Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland.

Medizinische Klinik I, Marien Hospital Herne, University Hospital of the Ruhr-University Bochum, Herne, Deutschland.

出版信息

Z Rheumatol. 2021 Nov;80(9):879-883. doi: 10.1007/s00393-021-01083-3. Epub 2021 Sep 16.

Abstract

The pandemic attributable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has greatly changed life in most countries of the world for more than 1.5 years now. The spread could be more or less well-controlled and fatalities could partly be avoided by obligatory wearing of masks, contact restrictions and since the beginning of the year by vaccinations. Patients with chronic inflammatory diseases and organ transplant patients under immunosuppression, are somewhat more at risk to become ill with coronavirus disease 2019 (COVID-19). The probability and severity of an infection depends on the ability of the humoral and cellular immune systems to effectively combat the virus. This can be substantially improved by vaccination. The B cell depleting monoclonal antibody rituximab (RTX) is frequently employed in rheumatic diseases, whereby antibody formation against the new pathogen within the framework of vaccination is restricted. Recent study results in patients treated with RTX indicate that an effective cellular immune response can be developed despite the impaired humoral response.

摘要

由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的大流行,至今已在世界上大多数国家极大地改变了人们的生活,持续时间超过1.5年。通过强制佩戴口罩、限制接触,以及自今年年初以来的疫苗接种,疫情传播在一定程度上可以得到较好控制,死亡人数也能部分避免。患有慢性炎症性疾病的患者和免疫抑制状态下的器官移植患者,感染2019冠状病毒病(COVID-19)的风险相对更高一些。感染的可能性和严重程度取决于体液免疫系统和细胞免疫系统有效对抗病毒的能力。接种疫苗可大幅提高这种能力。B细胞耗竭性单克隆抗体利妥昔单抗(RTX)常用于治疗风湿性疾病,这会限制接种疫苗时针对新病原体的抗体形成。最近针对接受RTX治疗患者的研究结果表明,尽管体液免疫反应受损,但仍可产生有效的细胞免疫反应。

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