Pokryszka Jagoda, Wagner Angelika, Wiedermann Ursula, Tobudic Selma, Herkner Harald, Winkler Stefan, Brehovsky Sonja, Reinisch Walter, Novacek Gottfried
Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, 1090 Vienna, Austria.
Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, 1090 Vienna, Austria.
Vaccines (Basel). 2022 May 11;10(5):759. doi: 10.3390/vaccines10050759.
Two years into the pandemic, vaccination remains the most effective option to prevent coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Preliminary studies suggest vaccination efficacy in patients with inflammatory bowel diseases (IBD), but little is known about its impact on chronic intestinal inflammation. Here we assessed the mucosal inflammatory activity in patients with IBD before and after immunization with the mRNA-1273 (Moderna) vaccine by measurement of fecal calprotectin (fCP).
In 42 patients with IBD, the baseline fCP levels obtained prior to the first vaccine were compared with the highest levels measured during and after two doses of vaccination. Patients' sera were collected after the second dose to evaluate anti-SARS-CoV-2 antibodies' titers.
We observed a significant fCP elevation in 31% of patients after any dose. Vedolizumab was identified as the only agent associated with an fCP increase (OR 12.4, 95% CI [1.6; 120.2], = 0.0171). Gastrointestinal adverse events were reported in 9.5% of all subjects and in 75% of cases accompanied by an fCP increase. Anti-SARS-CoV-2 antibodies associated only weakly with the fCP increase after the first dose ( = 0.04).
Our findings support possible collinearity in pathways of SARS-CoV-2 antigen expression and the pathogenesis of IBD.
在新冠疫情爆发两年后，接种疫苗仍然是预防由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的2019冠状病毒病（COVID-19）的最有效选择。初步研究表明疫苗对炎症性肠病（IBD）患者有效，但对其对慢性肠道炎症的影响知之甚少。在此，我们通过测量粪便钙卫蛋白（fCP）评估了IBD患者在接种mRNA-1273（Moderna）疫苗前后的黏膜炎症活性。
在42例IBD患者中，将首次接种疫苗前测得的基线fCP水平与两剂疫苗接种期间及之后测得的最高水平进行比较。在第二剂疫苗接种后收集患者血清，以评估抗SARS-CoV-2抗体的滴度。
我们观察到31%的患者在接种任何一剂疫苗后fCP显著升高。维多珠单抗被确定为唯一与fCP升高相关的药物（比值比12.4，95%置信区间[1.6；120.2]，P = 0.0171）。9.5%的受试者报告了胃肠道不良事件，其中75%的病例伴有fCP升高。第一剂疫苗接种后，抗SARS-CoV-2抗体与fCP升高的相关性较弱（P = 0.04）。
我们的研究结果支持SARS-CoV-2抗原表达途径与IBD发病机制之间可能存在共线性。
