Pavia Grazia, Spagnuolo Rocco, Quirino Angela, Marascio Nadia, Giancotti Aida, Simeone Silvio, Cosco Cristina, Tino Elena, Carrabetta Federico, Di Gennaro Gianfranco, Nobile Carmelo, Bianco Aida, Matera Giovanni, Doldo Patrizia
Unit of Clinical Microbiology, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy.
Unit of Gastroenterology, Department of Clinical and Experimental Medicine, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy.
Vaccines (Basel). 2023 Mar 3;11(3):591. doi: 10.3390/vaccines11030591.
Immune-modifying treatment in inflammatory bowel disease (IBD) impairs the humoral response. The role of T lymphocytes in this setting is still unclear. This study aims to assess if a booster shot (third dose) of BNT162b2 mRNA COVID-19 vaccine enhanced the humoral response and elicited cellular immunity in IBD patients on different immuno-therapy regimens compared to healthy controls (HCs). Five months after a booster dose, serological and T-cell responses were assessed. The measurements were described using geometric means with 95% confidence intervals. The differences between study groups were assessed by Mann-Whitney tests. Seventy-seven subjects ( = 53 IBD patients and = 24 HCs), who were fully vaccinated and not previously SARS-CoV-2 infected, were recruited. Regarding the IBD patients, 19 were affected by Crohn's disease and 34 by ulcerative colitis. During the vaccination cycle, half of the patients (53%) were on stable treatment with aminosalicylates, and 32% were on biological therapy. No differences in antibody concentrations between IBD patients and HCs, nor T-cell responses, were found. Stratifying IBD patients based on the type of treatment (anti-TNFα agents vs. other treatment regimens), a decrease only in antibody titer ( = 0.008), but not in cellular response, was observed. Even after the COVID-19 vaccine booster dose, the TNFα inhibitors selectively decreased the humoral immune response compared to patients on other treatment regimens. The T-cell response was preserved in all study groups. These findings highlight the importance of evaluating T-cell immune responses following COVID-19 vaccination in a routine diagnostic setting, particularly for immunocompromised cohorts.
炎症性肠病（IBD）中的免疫调节治疗会损害体液免疫反应。T淋巴细胞在这种情况下的作用仍不清楚。本研究旨在评估BNT162b2 mRNA新冠疫苗的加强针（第三剂）是否能增强体液免疫反应，并在接受不同免疫治疗方案的IBD患者中引发细胞免疫，与健康对照（HCs）进行比较。加强剂量五个月后，评估血清学和T细胞反应。测量结果用几何平均数和95%置信区间进行描述。研究组之间的差异通过Mann-Whitney检验进行评估。招募了77名受试者（n = 53名IBD患者和n = 24名HCs），他们均已全程接种疫苗且此前未感染过SARS-CoV-2。关于IBD患者，19例患有克罗恩病，34例患有溃疡性结肠炎。在疫苗接种周期中，一半的患者（53%）接受氨基水杨酸类药物稳定治疗，32%接受生物治疗。未发现IBD患者和HCs之间在抗体浓度或T细胞反应方面存在差异。根据治疗类型（抗TNFα药物与其他治疗方案）对IBD患者进行分层，仅观察到抗体滴度下降（P = 0.008），但细胞反应未下降。即使在新冠疫苗加强剂量后，与接受其他治疗方案的患者相比，TNFα抑制剂仍选择性地降低了体液免疫反应。所有研究组的T细胞反应均得以保留。这些发现凸显了在常规诊断环境中评估新冠疫苗接种后T细胞免疫反应的重要性，特别是对于免疫功能低下的人群。
