Department of Rheumatology, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Department of Clinical Medicine, Aarhus University, and Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark.
Clin Exp Rheumatol. 2024 Jan;42(1):157-165. doi: 10.55563/clinexprheumatol/orpp04. Epub 2023 Oct 23.
To investigate the effect of COVID-19 mRNA revaccination (two doses) on the antibody response in patients with rheumatic diseases (RD) who were initial vaccine non-responders. Further, to examine if B-cell levels or T-cell responses before revaccination predicted seroconversion.
From a RD cohort vaccinated with the standard two-dose COVID-19 vaccinations, we enrolled cases without detectable antibody responses (n=17) and controls with detectable antibody response (n=29). Blood donors (n=32) were included as additional controls. Samples were collected before and six weeks after completed revaccination. Total antibodies and specific IgG, IgA, and IgM against SARS-CoV-2 spike protein, SARS-CoV-2 neutralising antibodies, and SARS-CoV-2 reacting CD4+ and CD8+ T-cells were measured before and after revaccination. B-cells (CD19+CD45+) were quantified before revaccination.
Forty-seven percent of cases had detectable neutralising antibodies after revaccination. However, antibody levels were significantly lower than in controls and blood donors. Revaccination induced an antibody class switch in cases with a decrease in IgM and increase in IgG. No significant difference was observed in T-cell responses before and after revaccination between the three groups. Only 29% of cases had measurable B-cells compared to 100% of controls and blood donors. Fifty percent of revaccinated cases who seroconverted had measurable B-cells before revaccination.
Forty-seven percent of initial non-responders seroconverted after two-dose revaccination but still had lower levels of SARS-CoV-2 antibodies compared with controls and blood donors. RD patients without a detectable serological response after the initial COVID-19 mRNA vaccine had a T-cell response similar to immunocompetent controls and blood donors.
研究 COVID-19 mRNA 加强针（两剂）对初始疫苗无反应的风湿病患者（RD）抗体反应的影响。此外，还研究了加强针前 B 细胞水平或 T 细胞反应是否预测血清转化率。
从接受标准两剂 COVID-19 疫苗接种的 RD 队列中，我们招募了未检测到抗体反应的病例（n=17）和检测到抗体反应的对照组（n=29）。还纳入了血液捐献者（n=32）作为额外对照。在完成加强针接种前后采集样本。在加强针前后测量总抗体和针对 SARS-CoV-2 刺突蛋白的特异性 IgG、IgA 和 IgM、SARS-CoV-2 中和抗体以及 SARS-CoV-2 反应性 CD4+和 CD8+T 细胞。在加强针前量化 B 细胞（CD19+CD45+）。
47%的病例在加强针后可检测到中和抗体。然而，抗体水平明显低于对照组和血液捐献者。加强针诱导了病例的抗体类别转换，IgM 减少，IgG 增加。三组之间加强针前后 T 细胞反应无显著差异。与对照组和血液捐献者的 100%相比，只有 29%的病例可检测到 B 细胞。50%的血清转化率病例在加强针前可检测到 B 细胞。
47%的初始无反应者在两剂加强针后血清转化率，但与对照组和血液捐献者相比，SARS-CoV-2 抗体水平仍较低。初始 COVID-19 mRNA 疫苗后未检测到血清学反应的 RD 患者的 T 细胞反应与免疫功能正常的对照组和血液捐献者相似。
