Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN, United States.
Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China.
Front Immunol. 2023 Jul 31;14:1224702. doi: 10.3389/fimmu.2023.1224702. eCollection 2023.
The longitudinal responses towards multiple doses of COVID-19 mRNA vaccines in patients with systemic autoimmune diseases remain incompletely understood. While observational studies suggested the safety of COVID-19 mRNA vaccines in rheumatic disease patients, laboratory evidence is lacking.
Here we evaluated seroreactivity, clinical manifestions, and multiple disease biomarkers after 2 or 3 doses of COVID-19 mRNA vaccines in a cohort of patients with rheumatic diseases.
Most patients generated high SARS-CoV-2 spike-specific neutralizing antibodies comparable to those in healthy controls after 2 doses of mRNA vaccines. The antibody level declined over time but recovered after the third dose of the vaccine. Patients with systemic lupus erythematosus (SLE) or psoriatic arthritis (PsA) remained without significant flares post-vaccination. The changes in anti-dsDNA antibody concentration and expression of type I interferon (IFN) signature genes were highly variable but did not show consistent or significant increases. Frequency of double negative 2 (DN2) B cells remained largely stable.
Our data provide experimental evidences indicating the efficacy and safety of repeated COVID-19 mRNA vaccination in rheumatic disease patients.
患有自身免疫性疾病的患者多次接种 COVID-19 mRNA 疫苗的纵向反应仍不完全清楚。虽然观察性研究表明 COVID-19 mRNA 疫苗在风湿性疾病患者中的安全性，但缺乏实验室证据。
在这里，我们评估了风湿性疾病患者队列中接受 2 或 3 剂 COVID-19 mRNA 疫苗后的血清反应性、临床表现和多种疾病生物标志物。
大多数患者在接受 2 剂 mRNA 疫苗后产生了与健康对照组相当的高 SARS-CoV-2 刺突特异性中和抗体。抗体水平随时间下降，但在接种第三剂疫苗后恢复。接种疫苗后，红斑狼疮（SLE）或银屑病关节炎（PsA）患者没有明显的发作。抗 dsDNA 抗体浓度和 I 型干扰素（IFN）特征基因表达的变化高度可变，但没有表现出一致或显著增加。双阴性 2 型（DN2）B 细胞的频率基本保持稳定。
我们的数据提供了实验证据，表明 COVID-19 mRNA 疫苗在风湿性疾病患者中的重复接种具有疗效和安全性。
