Department of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
Department of Outpatient Clinics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
Front Immunol. 2022 Oct 31;13:1033804. doi: 10.3389/fimmu.2022.1033804. eCollection 2022.
Previous studies have shown a reduction in the effectiveness of primary COVID-19 vaccination in patients with rheumatic diseases. However, limited data is available regarding the effectiveness of the COVID-19 vaccine booster dose, especially on cellular response. The study aimed to assess the humoral and cellular immunogenicity of a booster dose in patients with inflammatory arthritis (IA).
49 IA and 47 age and sex-matched healthy controls (HC) were included in a prospective cohort study. Both groups completed primary COVID-19 vaccination and after more than 180 days received a BNT162b2 booster shot. Humoral responses (level of IgG antibodies) and cellular responses (IFN-γ production) were assessed before and after 4 weeks from the booster dose of the vaccine.
After the booster dose, all participants showed an increased humoral response, although significantly reduced antibody levels were observed in IA patients compared to HC (p=0.004). The cellular response was significantly lower both before (p<0.001) and after (p<0.001) the booster dose in IA patients as compared to HC. Among the immunomodulatory drugs, only biological and targeted synthetic drugs lowered the humoral response after booster vaccination. However, the cellular response was decreased after all immunomodulatory drugs except IL-17 inhibitors and sulfasalazine.
Our data indicate that patients with rheumatic diseases present lower humoral and cellular responses after the COVID-19 booster vaccine in comparison to HC. This may translate into a recommendation for subsequent booster doses of the COVID-19 vaccine for rheumatic patients.
先前的研究表明，风湿性疾病患者的 COVID-19 初级疫苗接种效果降低。然而，关于 COVID-19 疫苗加强针的有效性，尤其是在细胞反应方面的数据有限。本研究旨在评估炎症性关节炎（IA）患者加强针的体液和细胞免疫原性。
49 名 IA 患者和 47 名年龄和性别匹配的健康对照者（HC）被纳入前瞻性队列研究。两组均完成了 COVID-19 初级疫苗接种，180 天后接受了 BNT162b2 加强针。在加强针接种后 4 周，评估了体液反应（IgG 抗体水平）和细胞反应（IFN-γ产生）。
加强针后，所有参与者的体液反应均增加，但 IA 患者的抗体水平明显低于 HC（p=0.004）。与 HC 相比，IA 患者在加强针前（p<0.001）和后（p<0.001）的细胞反应均显著降低。在免疫调节剂中，只有生物和靶向合成药物在加强针接种后降低了体液反应。然而，除了白细胞介素 17 抑制剂和柳氮磺胺吡啶外，所有免疫调节剂均降低了细胞反应。
我们的数据表明，与 HC 相比，风湿性疾病患者在 COVID-19 加强疫苗后表现出较低的体液和细胞反应。这可能意味着风湿患者需要后续 COVID-19 疫苗加强针。
