University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
Center for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Zagreb, Croatia.
Mult Scler Relat Disord. 2022 Mar;59:103682. doi: 10.1016/j.msard.2022.103682. Epub 2022 Feb 8.
To determine anti-SARS-Cov2 antibodies and T-cell immunity in convalescent people with multiple sclerosis (pwMS) and/or pwMS vaccinated against Covid-19, depending on the disease modifying therapy, and in comparison to healthy controls (HC).
75 participants were enrolled: Group 1-29 (38.7%) COVID-19 convalescent participants; Group 2-34 (45.3%) COVID-19 vaccinated; Group 3-12 (16.0%) COVID-19 convalescent participants who were later vaccinated against COVID-19. Cellular immunity was evaluated by determination of number of CD4+ and CD8+ cells secreting TNFα, IFNγ, and IL2 after stimulation with SARS-CoV-2 peptides.
pwMS treated with ocrelizumab were less likely to develop humoral immunity after COVID-19 recovery or vaccination. No difference was observed in the cellular immunity in all studied parameters between pwMS treated with ocrelizumab compared to HC or pwMS who were treatment naïve or on first line therapies. These findings were consistent in convalescent, vaccinated, and convalescent+vaccinated participants. COVID-19 vaccinated convalescent pwMS on ocrelizumab compared to COVID-19 convalescent HC who were vaccinated did not show statistically difference in the rate of seroconversion nor titers of SARS-CoV-2 antibodies.
Presence of cellular immunity in pwMS on B-cell depleting therapies is reassuring, as at least partial protection from more severe COVID-19 outcomes can be expected.
确定患有多发性硬化症（pwMS）和/或已接种 COVID-19 疫苗的 pwMS 康复者中的抗 SARS-CoV2 抗体和 T 细胞免疫情况，具体取决于疾病修正治疗，并与健康对照（HC）进行比较。
共纳入 75 名参与者：第 1 组-29 名（38.7%）COVID-19 康复参与者；第 2 组-34 名（45.3%）COVID-19 疫苗接种者；第 3 组-12 名（16.0%）COVID-19 康复参与者，他们后来接种了 COVID-19 疫苗。通过测定 SARS-CoV-2 肽刺激后 TNFα、IFNγ 和 IL2 分泌的 CD4+和 CD8+细胞数量来评估细胞免疫。
接受奥瑞珠单抗治疗的 pwMS 在 COVID-19 康复或接种疫苗后产生体液免疫的可能性较低。与 HC 或未接受治疗、接受一线治疗的 pwMS 相比，接受奥瑞珠单抗治疗的 pwMS 在所有研究参数的细胞免疫方面没有差异。在康复、接种疫苗和康复+接种疫苗的参与者中，这些发现是一致的。与 COVID-19 康复的 HC 相比，接受奥瑞珠单抗治疗的 COVID-19 康复 pwMS 接种疫苗后，血清转化率和 SARS-CoV-2 抗体滴度均无统计学差异。
在接受 B 细胞耗竭治疗的 pwMS 中存在细胞免疫令人放心，因为至少可以预期对更严重的 COVID-19 结局有部分保护。
