Department of Rheumatology, Fujian Medical University Union Hospital, Fuzhou, China.
Sci Rep. 2022 Oct 26;12(1):17955. doi: 10.1038/s41598-022-22839-0.
Progress has been made in COVID-19 vaccine development, with encouraging safety and efficacy data. The purpose of this study was to investigate the immunogenicity of inactivated COVID-19 vaccine in patients with autoimmune inflammatory rheumatic diseases (AIIRD). Patients with AIIRD (n = 101) were included in this study. All patients received 2 doses of inactivated COVID-19 vaccine. Serum anti-S1/RBD protein IgG was detected 2-16 weeks after the second vaccination. Seropositivity was defined as IgG ≥ 1.00 bound antibody unit S/CO. Immunogenicity of inactivated COVID-19 vaccine was assessed by seropositivity rate and the levels of serum IgG antibody against anti-S1/RBD protein, compared with the general population (n = 46). There was no difference by statistical significance in the seropositivity rate between patients with AIIRD (82.2%) and SLE (86.1%) and the control group (93.5%), p > 0.05. The level of anti-S1/RBD protein IgG antibodies in patients with AIIRD (median [IQR], 8.8 [2.2-17.3]) and SLE (median [IQR], 9.6 [2.4-20.4]) was comparable to that in the control group (median [IQR], 7.2 [3.1-14.2]), p > 0.05. Patients treated with glucocorticoids(GCs) (median dose, [IQR]: 2.5 mg/day [IQR 2.5-5.0]) or hydroxychloroquine(HCQ) or GCs + HCQ without other immunomodulatory medications, had an appropriate immunogenic response(88.1%) with high levels of anti-S1/RBD protein IgG(median [IQR], 12.1 [6.5-20.4]). Neither of patients treated with rituximab had positive serum antibodies, which was statistically significant, compared with the control group (p < 0.01). Compared with the control group, methotrexate(MTX) and iguratimod(IGU) was significantly reduced the level of anti-S1/RBD protein IgG antibodies. Inactivated COVID-19 vaccine had appropriate immunogenicity in patients with AIIRD. Immunogenicity of inactivated COVID-19 vaccine was severely impaired by rituximab, and also suppressed by MTX and IGU, while low doses of GC and HCQ had negligible effect.
在 COVID-19 疫苗开发方面已经取得了进展，安全性和有效性数据令人鼓舞。本研究旨在探讨灭活 COVID-19 疫苗在自身免疫性炎症性风湿病（AIIRD）患者中的免疫原性。纳入了 101 例 AIIRD 患者。所有患者均接种了 2 剂灭活 COVID-19 疫苗。在第二次接种后 2-16 周检测血清抗 S1/RBD 蛋白 IgG。定义 IgG≥1.00 结合抗体单位 S/CO 为血清阳性。通过血清阳性率和血清抗 S1/RBD 蛋白 IgG 抗体水平评估灭活 COVID-19 疫苗的免疫原性，并与一般人群（n=46）进行比较。AIIRD 患者（82.2%）、SLE 患者（86.1%）和对照组（93.5%）的血清阳性率无统计学差异，p＞0.05。AIIRD 患者（中位数 [IQR]，8.8 [2.2-17.3]）和 SLE 患者（中位数 [IQR]，9.6 [2.4-20.4]）的抗 S1/RBD 蛋白 IgG 抗体水平与对照组（中位数 [IQR]，7.2 [3.1-14.2]）相当，p＞0.05。接受糖皮质激素（GCs）（中位剂量，[IQR]：2.5mg/天 [IQR 2.5-5.0]）或羟氯喹（HCQ）或 GCs+HCQ 而无其他免疫调节药物治疗的患者具有适当的免疫应答（88.1%），且抗 S1/RBD 蛋白 IgG 水平较高（中位数 [IQR]，12.1 [6.5-20.4]）。与对照组相比，接受利妥昔单抗治疗的患者均未产生血清抗体，差异有统计学意义（p＜0.01）。与对照组相比，甲氨蝶呤（MTX）和依那西普（IGU）显著降低了抗 S1/RBD 蛋白 IgG 抗体水平。灭活 COVID-19 疫苗在 AIIRD 患者中具有适当的免疫原性。利妥昔单抗严重损害了灭活 COVID-19 疫苗的免疫原性，而 MTX 和 IGU 也抑制了其免疫原性，而低剂量的 GC 和 HCQ 则无显著影响。
