Department of Immunology, Technion-Israel Institute of Technology.
Division of Allergy and Clinical Immunology, Bnai Zion Medical Center, Haifa, Rappaport Faculty of Medicine, Technion.
Rheumatology (Oxford). 2022 Aug 3;61(8):3439-3447. doi: 10.1093/rheumatology/keab879.
The mRNA-based COVID-19 vaccines are now employed globally and have shown high efficacy in preventing SARS-CoV-2 infection. However, less is known about the vaccine efficacy in immune-suppressed individuals. This study sought to explore whether humoral immunity to the COVID-19 vaccine BNT162b2 is altered in RA patients treated with Janus kinase inhibitors by analysing their antibodies titre, neutralization activity and B cell responses.
We collected plasma samples from 12 RA patients who were treated with Janus kinase inhibitors and received two doses of the BNT162b2 vaccine, as well as 26 healthy individuals who were vaccinated with the same vaccine. We analysed the quantity of the anti-spike IgG and IgA antibodies that were elicited following the BNT162b2 vaccination, the plasma neutralization capacity and the responsiveness of the B-lymphocytes. We used ELISA to quantify the antibody titres, and a plasma neutralization assay was used to determine the virus neutralization capacity. Alteration in expression of the genes that are associated with B cell activation and the germinal centre response were analysed by quantitative PCR.
Reduced levels of anti-spike IgG antibodies and neutralization capacity were seen in the RA patients who were treated with JAK inhibitors in comparison with healthy individuals. Furthermore, B cell responsiveness to the SARS-CoV-2 spike protein was reduced in the RA patients.
RA patients who are treated with JAK inhibitors show a suppressed humoral response following BNT162b2 vaccination, as revealed by the quantity and quality of the anti-spike antibodies.
基于 mRNA 的 COVID-19 疫苗现已在全球范围内使用，并已证明在预防 SARS-CoV-2 感染方面具有很高的功效。然而，对于免疫抑制个体的疫苗功效知之甚少。本研究旨在通过分析抗体滴度、中和活性和 B 细胞反应，探讨接受 Janus 激酶抑制剂治疗的类风湿关节炎患者对 COVID-19 疫苗 BNT162b2 的体液免疫是否发生改变。
我们收集了 12 名接受 Janus 激酶抑制剂治疗并接种了两剂 BNT162b2 疫苗的类风湿关节炎患者和 26 名接种了相同疫苗的健康个体的血浆样本。我们分析了 BNT162b2 疫苗接种后产生的抗刺突 IgG 和 IgA 抗体的数量、血浆中和能力以及 B 淋巴细胞的反应性。我们使用 ELISA 定量测定抗体滴度，使用血浆中和测定法测定病毒中和能力。通过定量 PCR 分析与 B 细胞激活和生发中心反应相关的基因表达的改变。
与健康个体相比，接受 JAK 抑制剂治疗的类风湿关节炎患者的抗刺突 IgG 抗体和中和能力水平降低。此外，RA 患者对 SARS-CoV-2 刺突蛋白的 B 细胞反应性降低。
接受 JAK 抑制剂治疗的类风湿关节炎患者在接种 BNT162b2 后表现出抑制的体液免疫反应，这表现在抗刺突抗体的数量和质量上。
