Lukaszuk Krzysztof, Woclawek-Potocka Izabela, Jakiel Grzegorz, Malinowska Paulina, Wdowiak Artur, Rozanska Karolina, Rabalski Lukasz
Department of Obstetrics and Gynecology Nursing, Medical University of Gdansk, 80-211 Gdansk, Poland.
Invicta Research and Development Center, 81-740 Sopot, Poland.
Vaccines (Basel). 2021 Oct 9;9(10):1151. doi: 10.3390/vaccines9101151.
We report a case of monitoring the antibody response to the BioNTech-Pfizer vaccine of a 50-year-old female diagnosed with rheumatoid arthritis undergoing treatment with methotrexate (MTX). Antibody levels were measured 21 days after dose 1 (i.e., on the day of dose 2) and then 8, 14 and 30 days after dose 2 with Elecsys Anti-SARS-CoV-2 S assay (Roche Diagnostics). Patient showed a negative result after dose 1 and had the serum sample retested using a LIAISON SARS-CoV-2 TrimericS IgG assay (DiaSorin), which showed a positive result. Subsequent samples were tested using both assays. Antibody levels kept increasing but at a much slower rate than in patients not receiving any immunomodulatory therapies. Other research indicates that among patients with autoimmune diseases, those receiving disease-modifying antirheumatic drugs (DMARDs) have higher COVID-19 mortality than those treated with tumor necrosis factor inhibitors (TNFis). These results indicate the need for people with autoimmune diseases to be carefully observed following vaccinations, including testing of antibody levels, and treated as potentially at risk until the effect of vaccination is confirmed. The different available vaccines should also be tested to verify their usefulness in the case of people with autoimmune diseases and those who take different immunomodulatory medications.
我们报告了一例对一名50岁类风湿关节炎女性患者进行监测的病例，该患者正在接受甲氨蝶呤（MTX）治疗，监测其对BioNTech -辉瑞疫苗的抗体反应。在第1剂接种后21天（即第2剂接种当天）测量抗体水平，然后在第2剂接种后8天、14天和30天使用Elecsys Anti - SARS-CoV-2 S检测法（罗氏诊断公司）进行测量。患者在第1剂接种后结果为阴性，随后使用LIAISON SARS-CoV-2 TrimericS IgG检测法（索林集团）对血清样本进行重新检测，结果呈阳性。后续样本同时使用这两种检测法进行检测。抗体水平持续上升，但上升速度比未接受任何免疫调节治疗的患者慢得多。其他研究表明，在自身免疫性疾病患者中，接受改善病情抗风湿药物（DMARDs）治疗的患者的COVID-19死亡率高于接受肿瘤坏死因子抑制剂（TNFis）治疗的患者。这些结果表明，自身免疫性疾病患者在接种疫苗后需要仔细观察，包括检测抗体水平，并且在疫苗接种效果得到确认之前应被视为潜在风险人群。还应测试不同的可用疫苗，以验证其在自身免疫性疾病患者和服用不同免疫调节药物的患者中的有效性。
