Lu Liangjian, Chan Chang Yien, Lim Yi Yang, Than Mya, Teo Sharon, Lau Perry Y W, Ng Kar Hui, Yap Hui Kim
Department of Paediatrics, Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore 119228, Singapore.
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117549, Singapore.
Vaccines (Basel). 2023 Dec 18;11(12):1864. doi: 10.3390/vaccines11121864.
Long-term humoral immunity is mediated by short-lived plasma cells (replenished by memory B cells) and long-lived plasma cells. Their relative contributions are uncertain for immunity to SARS-CoV-2, especially given the widespread use of novel mRNA vaccines. Yet, this has far-reaching implications in terms of the need for regular booster doses in the general population and perhaps even revaccination in patients receiving B cell-depleting therapy. We aimed to characterise anti-SARS-CoV-2 antibody titres in patients receiving Rituximab following previous SARS-CoV-2 vaccination. We recruited 10 fully vaccinated patients (age: 16.9 ± 2.52 years) with childhood-onset nephrotic syndrome, not in relapse, receiving Rituximab for their steroid/calcineurin-inhibitor sparing effect. Antibodies to SARS-CoV-2 spike (S) and nucleocapsid (N) proteins were measured immediately prior to Rituximab and again ~6 months later, using the Roche Elecys Anti-SARS-CoV-2 (S) assay. All ten patients were positive for anti-S antibodies prior to Rituximab, with six patients (60%) having titres above the upper limit of detection (>12,500 U/mL). Following Rituximab therapy, there was a reduction in anti-S titres ( = 0.043), but all patients remained positive for anti-S antibodies, with five patients (50%) continuing to have titres >12,500 U/mL. Six patients (60%) were positive for anti-N antibodies prior to Rituximab. Following Rituximab therapy, only three of these six patients remained positive for anti-N antibodies ( = 0.036 compared to anti-S seroreversion). Humoral immunity to SARS-CoV-2 is likely to be mediated in part by long-lived plasma cells.
长期体液免疫由短命浆细胞（由记忆B细胞补充）和长寿浆细胞介导。对于新冠病毒免疫，它们的相对贡献尚不确定，尤其是考虑到新型mRNA疫苗的广泛使用。然而，这对于普通人群定期接种加强针的必要性，甚至对于接受B细胞耗竭疗法的患者再次接种疫苗而言，都具有深远意义。我们旨在描述先前接种新冠病毒疫苗后接受利妥昔单抗治疗的患者体内抗新冠病毒抗体滴度。我们招募了10名完全接种疫苗的患者（年龄：16.9±2.52岁），他们患有儿童期起病的肾病综合征，且未复发，因利妥昔单抗具有节省类固醇/钙调神经磷酸酶抑制剂的作用而接受该治疗。在使用罗氏Elecys抗新冠病毒（S）检测法在利妥昔单抗治疗前及约6个月后再次检测针对新冠病毒刺突（S）蛋白和核衣壳（N）蛋白的抗体。所有10名患者在利妥昔单抗治疗前抗S抗体均为阳性，其中6名患者（60%）的滴度高于检测上限（>12,500 U/mL）。利妥昔单抗治疗后，抗S滴度降低（P = 0.043），但所有患者抗S抗体仍为阳性，5名患者（50%）的滴度持续>12,500 U/mL。6名患者（60%）在利妥昔单抗治疗前抗N抗体为阳性。利妥昔单抗治疗后，这6名患者中只有3名抗N抗体仍为阳性（与抗S血清逆转相比，P = 0.036）。对新冠病毒的体液免疫可能部分由长寿浆细胞介导。
