吸烟对用于预防多发性硬化症患者感染COVID-19的灭活疫苗和mRNA疫苗反应的影响
The Effect of Smoking on Inactivated and mRNA Vaccine Responses Applied to Prevent COVİD-19 in Multiple Sclerosis.
作者信息
Şen Sedat, Arslan Gökhan, Tütüncü Melih, Demir Serkan, Dinç Öykü, Gündüz Tuncay, Uzunköprü Cihat, Gümüş Haluk, Tütüncü Mesude, Akçin Ruveyda, Özakbaş Serkan, Köseoğlu Mesrure, Bünül Sena Destan, Gezer Ozan, Tezer Damla Çetinkaya, Baba Cavid, Özen Pınar Acar, Koç Rabia, Elverdi Tuğrul, Uygunoğlu Uğur, Kürtüncü Murat, Beckmann Yeşim, Doğan İpek Güngör, Turan Ömer Faruk, Boz Cavit, Terzi Murat, Tuncer Aslı, Saip Sabahattin, Karabudak Rana, Kocazeybek Bekir, Efendi Hüsnü, Bilge Uğur, Siva Aksel
机构信息
Faculty of Medicine, Department of Neurology, Ondokuz Mayıs University, Samsun, Turkey.
Faculty of Medicine, Department of Physiology, Ondokuz Mayıs University, Samsun, Turkey.
出版信息
Noro Psikiyatr Ars. 2023 Aug 10;60(3):252-256. doi: 10.29399/npa.28503. eCollection 2023.
INTRODUCTION
Coronavirus disease 2019 (COVID-19) is the biggest health challenge of recent times. Studies so far reveal that vaccination is the only way to prevent this pandemic. There may be factors that decrease or increase vaccine effectiveness. In multiple sclerosis (MS), some of these factors may cause changes in the effectiveness of the vaccine, depending on the nature of the disease and disease-modifying treatments (DMT). In this study, we aimed to investigate the relationship between antibody titer and smoking in non-treated and DMT-treated MS patients who received inactivated vaccine (Sinovac) and messenger RNA BNT162b2 (BioNTech) mRNA vaccines.
METHOD
Vaccine antibody responses were measured between 4-12 weeks after two doses of inactivated vaccine and mRNA vaccines. Patients were separated into 6 groups as: patients with MS without treatment PwMS w/o T, ocrelizumab, fingolimod, interferons (interferon beta-1a and interferon beta-1b), dimethyl fumarate, and teriflunomide. Antibody titers of smokers and non-smokers were compared for both vaccines and for each group.
RESULTS
The study included 798 patients. In the mRNA vaccine group, smokers (n=148; 2982±326 AU/mL) had lower antibody titers compared to the non-smokers (n=244; 5903±545 AU/mL) in total (p=0.020). In the inactivated vaccine group, no significant difference was detected between smokers (n=136; 383±51 AU/mL) and non-smokers (n=270; 388±49 AU/mL) in total (p=0.149). In both vaccine groups, patients receiving ocrelizumab and fingolimod had lower antibody titers than those receiving other DMTs or PwMS w/o T. In untreated MS patients, antibody levels in smokers were lower than in non-smokers in the mRNA vaccine group. No difference was found between antibody levels of smokers and non-smokers in any of the inactivated vaccine groups.
CONCLUSION
Ocrelizumab and fingolimod have lower antibody levels than PwMS w/o T or other DMTs in both mRNA and inactivated vaccine groups. Smoking decreases antibody levels in the mRNA vaccine group, while it has no effect in the inactivated vaccine group.
引言
2019年冠状病毒病（COVID-19）是近期最大的健康挑战。迄今为止的研究表明，接种疫苗是预防这一疫情的唯一途径。可能存在降低或提高疫苗效力的因素。在多发性硬化症（MS）中，其中一些因素可能会根据疾病的性质和疾病修饰治疗（DMT）导致疫苗效力发生变化。在本研究中，我们旨在调查接受灭活疫苗（科兴）和信使核糖核酸BNT162b2（辉瑞/BioNTech）mRNA疫苗的未接受治疗和接受DMT治疗的MS患者中抗体滴度与吸烟之间的关系。
方法
在接种两剂灭活疫苗和mRNA疫苗后的4至12周内测量疫苗抗体反应。患者被分为6组：未接受治疗的MS患者（PwMS w/o T）、奥瑞珠单抗、芬戈莫德、干扰素（干扰素β-1a和干扰素β-1b）、富马酸二甲酯和特立氟胺。比较了两种疫苗以及每组中吸烟者和非吸烟者的抗体滴度。
结果
该研究纳入了798名患者。在mRNA疫苗组中，吸烟者（n = 148；2982±326 AU/mL）的总体抗体滴度低于非吸烟者（n = 244；5903±545 AU/mL）（p = 0.020）。在灭活疫苗组中，吸烟者（n = 136；383±51 AU/mL）和非吸烟者（n = 270；388±49 AU/mL）的总体抗体滴度未检测到显著差异（p = 0.149）。在两个疫苗组中，接受奥瑞珠单抗和芬戈莫德治疗的患者的抗体滴度低于接受其他DMTs治疗的患者或未接受治疗的PwMS患者。在未接受治疗的MS患者中，mRNA疫苗组中吸烟者的抗体水平低于非吸烟者。在任何灭活疫苗组中，吸烟者和非吸烟者的抗体水平均未发现差异。
结论
在mRNA疫苗组和灭活疫苗组中，奥瑞珠单抗和芬戈莫德的抗体水平均低于未接受治疗的PwMS患者或其他DMTs治疗的患者。吸烟会降低mRNA疫苗组中的抗体水平，而在灭活疫苗组中则无影响。
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