Uea-Areewongsa Parichat, Pinpathomrat Nawamin, Ongarj Jomkwan, Sophonmanee Ratchanon, Seepathomnarong Purilap, Seeyankem Bunya, Surasombatpattana Smonrapat, Intapiboon Porntip
Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Asian Pac J Allergy Immunol. 2023 Jan 3. doi: 10.12932/AP-280722-1420.
Alongside vaccine hesitancy, impaired and waning immunity in autoimmune rheumatic diseases (ARDs) are barriers to immunization. The timeframe of immunity waning in ARD remains unclear.
We aimed to examine the waning of humoral immunogenicity in a cohort of ARD patients who received the heterologous inactivated vaccine followed by the adenoviral vector SAR-CoV-2 vaccine at a 3-month follow-up.
The levels of SARS-CoV-2 anti-RBD IgG were evaluated at 1 and 3 months in adults with ARDs (n = 29) and age- and sex-matched healthy controls (HC) that received the heterologous prime-boost CoronaVac vaccine followed by the ChAdOx1 nCoV-19 vaccine. Seropositivity was defined as anti-receptor binding domain (RBD) IgG levels of ≥ 7.15 binding antibody units (BAU)/mL. The kinetic properties of the vaccines were evaluated based on the ratio of anti-RBD IgG values obtained at each follow-up. Disease activity was evaluated.
The seropositivity rate was lower among patients with ARDs than among HCs (89.7% vs. 100%, p = 0.237). At 3 months, the median (IQR) anti-RBD IgG level was lower among patients with ARDs than among HCs (122.3 [30.6, 247.8] vs. 294.2 [127.4,605.7] BAU/mL, p = 0.006). Mean antibody levels in patients with ARDs decreased 3.5 (1.9)-fold within 3 months post-vaccination (122.3 [30.6, 247.8] vs. 279.9 [86,1076.5] BAU/mL, p < 0.001). Disease flare-ups occurred in three patients.
Our findings included changes to anti-RBD IgG levels and may inform vaccination strategies. SAR-CoV2 vaccine-induced immunity was lower in patients with ARDs than in HCs and decreased within 3 months, suggesting a need for booster vaccinations.
除了疫苗犹豫之外，自身免疫性风湿病（ARDs）中免疫功能受损和免疫力下降是免疫接种的障碍。ARDs中免疫力下降的时间框架仍不清楚。
我们旨在研究一组接受异源灭活疫苗后再接种腺病毒载体SARS-CoV-2疫苗的ARD患者在3个月随访时体液免疫原性的下降情况。
在接受异源初免-加强的科兴疫苗后再接种ChAdOx1 nCoV-19疫苗的成年ARD患者（n = 29）和年龄及性别匹配的健康对照（HC）中，于1个月和3个月时评估SARS-CoV-2抗RBD IgG水平。血清阳性定义为抗受体结合域（RBD）IgG水平≥7.15结合抗体单位（BAU）/mL。根据每次随访时获得的抗RBD IgG值的比值评估疫苗的动力学特性。评估疾病活动情况。
ARD患者的血清阳性率低于HC（89.7%对100%，p = 0.237）。在3个月时，ARD患者的抗RBD IgG水平中位数（IQR）低于HC（122.3 [30.6, 247.8]对294.2 [127.4, 605.7] BAU/mL，p = 0.006）。ARD患者的平均抗体水平在接种疫苗后3个月内下降了3.5（1.9）倍（122.3 [30.6, 247.8]对279.9 [86, 1076.5] BAU/mL，p < 0.001）。3名患者出现疾病复发。
我们的研究结果包括抗RBD IgG水平的变化，可能为疫苗接种策略提供参考。SARS-CoV2疫苗诱导的免疫力在ARD患者中低于HC，且在3个月内下降，提示需要加强接种。
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