Feige Julia, Berek Klaus, Seiberl Michael, Hilpold Patrick, Hitzl Wolfgang, Di Pauli Franziska, Hegen Harald, Deisenhammer Florian, Trinka Eugen, Harrer Andrea, Wipfler Peter, Moser Tobias
Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University and Center for Cognitive Neuroscience, European Reference Network EpiCARE, 5020 Salzburg, Austria.
Department of Neurology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Neurol Int. 2022 Nov 16;14(4):943-951. doi: 10.3390/neurolint14040075.
Anti-CD20 therapies decrease the humoral response to SARS-CoV-2 immunization. We aimed to determine the extent of the humoral response to SARS-CoV-2 antigens in correlation with peripheral B-cell dynamics among patients with central nervous system inflammatory disorders treated with anti-CD20 medications. We retrospectively included patients receiving anti-CD20 therapy after antigen contact who were divided into responders (>7 binding antibody units (BAU)/mL) and non-responders (<7 BAU/mL). In participants with first antigen contact prior to therapy, we investigated the recall response elicited once under treatment. We included 80 patients (responders n = 34, non-responders n = 37, recall cohort n = 9). The B-cell counts among responders were significantly higher compared to non-responders (mean 1012 cells/µL ± SD 105 vs. mean 17 cells/µL ± SD 47; p < 0.001). Despite very low B-cell counts (mean 9 cells/µL ± SD 20), humoral response was preserved among the recall cohort (mean 1653 BAU/mL ± SD 2250.1) and did not differ significantly from responders (mean 735 BAU/mL ± SD 1529.9; p = 0.14). Our data suggest that peripheral B cells are required to generate antibodies to neo-antigens but not for a recall response during anti-CD20 therapy. Evaluation of B-cell counts and pre-existing SARS-CoV-2 antibodies might serve as biomarkers for estimating the immune competence to mount a humoral response to SARS-CoV-2 antigens.
抗CD20疗法会降低对SARS-CoV-2免疫接种的体液反应。我们旨在确定接受抗CD20药物治疗的中枢神经系统炎性疾病患者中，与外周B细胞动态相关的对SARS-CoV-2抗原的体液反应程度。我们回顾性纳入了抗原接触后接受抗CD20治疗的患者，这些患者被分为反应者（>7结合抗体单位（BAU）/mL）和无反应者（<7 BAU/mL）。在治疗前首次接触抗原的参与者中，我们研究了治疗期间引发的回忆反应。我们纳入了80名患者（反应者n = 34，无反应者n = 37，回忆队列n = 9）。与无反应者相比，反应者的B细胞计数显著更高（平均1012个细胞/µL±标准差105 vs.平均17个细胞/µL±标准差47；p < 0.001）。尽管B细胞计数非常低（平均9个细胞/µL±标准差20），回忆队列中的体液反应仍得以保留（平均1653 BAU/mL±标准差2250.1），且与反应者相比无显著差异（平均735 BAU/mL±标准差1529.9；p = 0.14）。我们的数据表明，外周B细胞是产生针对新抗原的抗体所必需的，但在抗CD20治疗期间并非回忆反应所必需。评估B细胞计数和预先存在的SARS-CoV-2抗体可能作为生物标志物，用于估计对SARS-CoV-2抗原产生体液反应的免疫能力。
