Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Academic Medical Center, Amsterdam, Netherlands.
Amsterdam Institute for Infection and Immunity, Amsterdam, Netherlands.
Front Immunol. 2024 Feb 29;15:1314507. doi: 10.3389/fimmu.2024.1314507. eCollection 2024.
Rheumatoid factors (RFs) are autoantibodies that target the Fc region of IgG, and are found in patients with rheumatic diseases as well as in the healthy population. Many studies suggest that an immune trigger may (transiently) elicit RF responses. However, discrepancies between different studies make it difficult to determine if and to which degree RF reactivity can be triggered by vaccination or infection.
We quantitatively explored longitudinal RF responses after SARS-CoV-2 vaccination and infection in a well-defined, large cohort using a dual ELISA method that differentiates between true RF reactivity and background IgM reactivity. In addition, we reviewed existing literature on RF responses after vaccination and infection.
151 healthy participants and 30 RA patients were included to measure IgM-RF reactivity before and after SARS-CoV-2 vaccinations by ELISA. Additionally, IgM-RF responses after a SARS-CoV-2 breakthrough infection were studied in 51 healthy participants.
Published prevalence studies in subjects after infection report up to 85% IgM-RF seropositivity. However, seroconversion studies (both infection and vaccination) report much lower incidences of 2-33%, with a trend of lower percentages observed in larger studies. In the current study, SARS-CoV-2 vaccination triggered low-level IgM-RF responses in 5.5% (8/151) of cases, of which 1.5% (2/151) with a level above 10 AU/mL. Breakthrough infection was accompanied by development of an IgM-RF response in 2% (1/51) of cases.
Our study indicates that RF induction following vaccination or infection is an uncommon event, which does not lead to RF epitope spreading.
类风湿因子 (RFs) 是针对 IgG Fc 区域的自身抗体，在风湿性疾病患者以及健康人群中均有发现。许多研究表明，免疫触发因素可能（短暂地）引发 RF 反应。然而，不同研究之间的差异使得难以确定 RF 反应性是否以及在何种程度上可以通过接种疫苗或感染来引发。
我们使用双 ELISA 方法定量研究了 SARS-CoV-2 接种和感染后健康人群中 RF 反应的纵向变化，该方法可区分真正的 RF 反应性和背景 IgM 反应性。此外，我们还回顾了关于接种疫苗和感染后 RF 反应的现有文献。
纳入 151 名健康参与者和 30 名 RA 患者，通过 ELISA 测量 SARS-CoV-2 接种前后 IgM-RF 反应性。此外，还研究了 51 名健康参与者在 SARS-CoV-2 突破性感染后的 IgM-RF 反应。
已发表的感染后受试者的患病率研究报告称，高达 85%的 IgM-RF 呈阳性。然而，血清转化研究（感染和接种疫苗）报告的发生率要低得多，为 2-33%，且较大规模的研究中观察到的百分比较低。在本研究中，SARS-CoV-2 接种在 5.5%（8/151）的病例中引发低水平的 IgM-RF 反应，其中 1.5%（2/151）的水平高于 10 AU/mL。突破性感染伴有 IgM-RF 反应的发展，占 2%（1/51）的病例。
我们的研究表明，接种疫苗或感染后 RF 的诱导是一种罕见事件，不会导致 RF 表位扩散。
