NYU Multiple Sclerosis Comprehensive Care Center, Department of Neurology, New York University Grossman School of Medicine, New York, New York, 10016, USA.
Laura and Isaac Perlmutter Cancer Center and Department of Pathology, New York University Grossman School of Medicine, New York, New York, 10016, USA.
Ann Clin Transl Neurol. 2022 Oct;9(10):1643-1659. doi: 10.1002/acn3.51664. Epub 2022 Sep 27.
To compare "hybrid immunity" (prior COVID-19 infection plus vaccination) and post-vaccination immunity to SARS CoV-2 in MS patients on different disease-modifying therapies (DMTs) and to assess the impact of vaccine product and race/ethnicity on post-vaccination immune responses.
Consecutive MS patients from NYU MS Care Center (New York, NY), aged 18-60, who completed primary COVID-19 vaccination series ≥6 weeks previously were evaluated for SARS CoV-2-specific antibody responses with electro-chemiluminescence and multiepitope bead-based immunoassays and, in a subset, live virus immunofluorescence-based microneutralization assay. SARS CoV-2-specific cellular responses were assessed with cellular stimulation TruCulture IFNγ and IL-2 assay and, in a subset, with IFNγ and IL-2 ELISpot assays. Multivariate analyses examined associations between immunologic responses and prior COVID-19 infection while controlling for age, sex, DMT at vaccination, time-to-vaccine, and vaccine product.
Between 6/01/2021 and 11/11/2021, 370 MS patients were recruited (mean age 40.6 years; 76% female; 53% non-White; 22% with prior infection; common DMT classes: ocrelizumab 40%; natalizumab 15%, sphingosine-1-phosphate receptor modulators 13%; and no DMT 8%). Vaccine-to-collection time was 18.7 (±7.7) weeks and 95% of patients received mRNA vaccines. In multivariate analyses, patients with laboratory-confirmed prior COVID-19 infection had significantly increased antibody and cellular post-vaccination responses compared to those without prior infection. Vaccine product and DMT class were independent predictors of antibody and cellular responses, while race/ethnicity was not.
Prior COVID-19 infection is associated with enhanced antibody and cellular post-vaccine responses independent of DMT class and vaccine type. There were no differences in immune responses across race/ethnic groups.
比较患有不同疾病修正治疗（DMT）药物的多发性硬化症（MS）患者的“混合免疫”（既往 COVID-19 感染加疫苗接种）和 SARS-CoV-2 疫苗接种后免疫，并评估疫苗产品和种族/民族对疫苗接种后免疫反应的影响。
来自纽约大学 MS 护理中心（纽约，NY）的连续 MS 患者，年龄在 18-60 岁之间，在完成初级 COVID-19 疫苗接种系列≥6 周后，通过电化学发光和多表位珠免疫分析评估 SARS-CoV-2 特异性抗体反应，在亚组中，还通过活病毒免疫荧光微量中和测定评估 SARS-CoV-2 特异性细胞反应。使用细胞刺激 TruCulture IFNγ和 IL-2 测定以及亚组中的 IFNγ和 IL-2 ELISA 斑点测定评估 SARS-CoV-2 特异性细胞反应。多变量分析检查了免疫反应与既往 COVID-19 感染之间的关联，同时控制了年龄、性别、接种疫苗时的 DMT、疫苗接种时间和疫苗产品。
在 2021 年 6 月 1 日至 2021 年 11 月 11 日期间，共招募了 370 名 MS 患者（平均年龄 40.6 岁；76%为女性；53%为非白人；22%有既往感染；常见的 DMT 类别：奥瑞珠单抗 40%；那他珠单抗 15%，鞘氨醇-1-磷酸受体调节剂 13%；无 DMT 8%）。疫苗接种到采集时间为 18.7（±7.7）周，95%的患者接受了 mRNA 疫苗。在多变量分析中，与无既往感染的患者相比，实验室确诊的既往 COVID-19 感染患者的疫苗接种后抗体和细胞反应显著增加。疫苗产品和 DMT 类别是抗体和细胞反应的独立预测因素，而种族/民族不是。
既往 COVID-19 感染与疫苗接种后抗体和细胞反应增强有关，与 DMT 类别和疫苗类型无关。不同种族/民族之间的免疫反应没有差异。
