Department of Rheumatology, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.
Department of Immunology, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.
Semin Arthritis Rheum. 2021 Dec;51(6):1258-1262. doi: 10.1016/j.semarthrit.2021.10.006. Epub 2021 Nov 7.
In patients with immune-mediated rheumatic diseases (RMD), the development of T-cell responses against SARS-CoV-2 may be impaired by either the immune disturbances associated with the disease, or by the effects of immunosuppressive therapies. We aimed at determining the magnitude of SARS-CoV-2-specific interferon (IFN)-γ-producing T-cell response after COVID-19 recovery in a cohort of patients with RMD on different immunosuppressive therapies.
53 adult patients with inflammatory or autoimmune RMD and 61 sex and age-matched non-RMD patients with confirmed COVID-19 were included. Peripheral blood mononuclear cells were obtained and T-cell-IFN-γ antigen-specific responses against the S1 domain of the spike glycoprotein, the nucleoprotein (N) and the membrane (M) protein from SARS-CoV-2 were assessed by FluoroSpot assay.
Patients with RMD and COVID-19 showed positive T-cells-IFN-γ responses to SARS-COV-2 antigens, in a similar proportion and magnitude as non-RMD patients at a median of 298 [151-316] and 165 [162-167] days after COVID-19 respectively. Among RMD patients 83%, 87% and 90%, and among non-RMD patients, 95%, 87% and 93% responded to S1, N and M protein respectively. Similar responses were observed in the different diagnostic and therapeutic groups, including conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), TNF-α inhibitors, IL-17 inhibitors, rituximab, JAK inhibitors or other immunosuppressants.
T-cell responses to the main SARS-CoV-2 antigens are present after COVID-19 recovery in most patients with RMD and are not impaired by immunosuppressive therapies.
在患有免疫介导的风湿性疾病（RMD）的患者中，针对 SARS-CoV-2 的 T 细胞反应的发展可能会受到疾病相关的免疫紊乱或免疫抑制治疗的影响而受损。我们旨在确定在接受不同免疫抑制治疗的 RMD 患者队列中，从 COVID-19 康复后 SARS-CoV-2 特异性干扰素（IFN）-γ产生 T 细胞反应的程度。
纳入了 53 名成年炎症性或自身免疫性 RMD 患者和 61 名性别和年龄匹配的 COVID-19 确诊的非 RMD 患者。采集外周血单核细胞，并通过 FluoroSpot 分析评估针对 SARS-CoV-2 刺突糖蛋白 S1 结构域、核蛋白（N）和膜（M）蛋白的 T 细胞-IFN-γ 抗原特异性反应。
RMD 和 COVID-19 患者对 SARS-COV-2 抗原表现出阳性的 T 细胞-IFN-γ 反应，在 COVID-19 后中位数为 298 [151-316] 和 165 [162-167] 天时，其比例和程度与非 RMD 患者相似。在 RMD 患者中，83%、87%和 90%，以及在非 RMD 患者中，95%、87%和 93%分别对 S1、N 和 M 蛋白有反应。在不同的诊断和治疗组中观察到相似的反应，包括常规合成的疾病修饰抗风湿药物（csDMARDs）、TNF-α 抑制剂、IL-17 抑制剂、利妥昔单抗、JAK 抑制剂或其他免疫抑制剂。
在大多数 RMD 患者从 COVID-19 康复后，针对 SARS-CoV-2 主要抗原的 T 细胞反应存在，并且不会受到免疫抑制治疗的影响。
