Department of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland.
Department of Outpatient Clinics, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland.
Viruses. 2023 Feb 24;15(3):620. doi: 10.3390/v15030620.
Impaired immunogenicity of COVID-19 vaccinations in inflammatory arthritis (IA) patients results in diminished immunity. However, optimal booster vaccination regimens are still unknown. Therefore, this study aimed to assess the kinetics of humoral and cellular responses in IA patients after the COVID-19 booster. In 29 IA patients and 16 healthy controls (HC), humoral responses (level of IgG antibodies) and cellular responses (IFN-γ production) were assessed before (T0), after 4 weeks (T1), and after more than 6 months (T2) from the booster vaccination with BNT162b2. IA patients, but not HC, showed lower anti-S-IgG concentration and IGRA fold change at T2 compared to T1 ( = 0.026 and = 0.031). Furthermore, in IA patients the level of cellular response at T2 returned to the pre-booster level (T0). All immunomodulatory drugs, except IL-6 and IL-17 inhibitors for the humoral and IL-17 inhibitors for the cellular response, impaired the immunogenicity of the booster dose at T2. Our study showed impaired kinetics of both humoral and cellular responses after the booster dose of the COVID-19 vaccine in IA patients, which, in the case of cellular response, did not allow the vaccination effect to be maintained for more than 6 months. Repetitive vaccination with subsequent booster doses seems to be necessary for IA patients.
COVID-19 疫苗在炎症性关节炎 (IA) 患者中的免疫原性受损导致免疫力下降。然而,最佳的加强免疫接种方案仍不清楚。因此,本研究旨在评估 COVID-19 加强免疫后 IA 患者的体液和细胞反应动力学。在 29 名 IA 患者和 16 名健康对照者 (HC) 中,在加强免疫接种 BNT162b2 前 (T0)、4 周后 (T1) 和 6 个月后 (T2) 评估了体液反应 (IgG 抗体水平) 和细胞反应 (IFN-γ 产生)。与 T1 相比,IA 患者 (而非 HC) 在 T2 时的抗-S-IgG 浓度和 IGRA 倍数变化较低 ( = 0.026 和 = 0.031)。此外,IA 患者的细胞反应水平在 T2 时恢复到加强免疫前水平 (T0)。除了白细胞介素 6 和白细胞介素 17 抑制剂对体液反应,以及白细胞介素 17 抑制剂对细胞反应的免疫原性外,所有免疫调节剂均在 T2 时削弱了加强剂量的免疫原性。我们的研究表明,IA 患者在 COVID-19 疫苗加强剂量后,体液和细胞反应的动力学均受损,而在细胞反应的情况下,接种效果无法维持 6 个月以上。对于 IA 患者,重复接种并随后加强剂量似乎是必要的。