Kälin Tobias, Passarin Katia, Filipowic-Sinnreich Magdalena, Semela David, Seifert Tanja, Sallusto Federica, Vergani Diego, Cerny Andreas, Mieli-Vergani Giorgina, Terziroli Beretta-Piccoli Benedetta
Università della Svizzera Italiana, Facoltà di Scienze Biomediche, Lugano, Switzerland.
Independent biostatistician, Switzerland.
J Autoimmun. 2024 Dec;149:103325. doi: 10.1016/j.jaut.2024.103325. Epub 2024 Oct 15.
mRNA vaccines against Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) infection have been associated with immune-related adverse reactions. We aimed at investigating whether SARS-CoV-2 vaccines may worsen autoimmune reactions in patients with autoimmune liver diseases.
We centrally tested a large panel of liver- and non-liver-related autoantibodies in patients with primary biliary cholangitis (PBC), autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC), and in healthcare workers (HW) before and after SARS-CoV-2 mRNA vaccines.
49 PBC, 35 AIH, 9 PSC and 38 HW were included. The proportion of subjects with at least one autoantibody positivization after vaccination was 11 % for HW, 37 % for AIH, 35 % for PBC and 56 % for PSC patients, patients having a significantly higher frequency of positivization as compared to HW. The proportion of seropositive subjects before vaccination who had at least one autoantibody negativization was 25 % for HW, 57 % for AIH, 40 % for PBC and 50 % for PSC, AIH patients having a significantly higher frequency of negativization as compared to HW. In the AIH group, the number of autoantibody negativizations was higher than the number of positivizations. The BNT162b2 vaccine was associated with a higher risk of developing new autoantibodies as compared to the mRNA-1273 vaccine. No new-onset autoimmune disease was observed after one year. One AIH patient had a relapse after vaccination.
mRNA SARS-CoV-2 vaccines do not induce short-term worsening of autoimmunity in patients with autoimmune liver diseases.
针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的信使核糖核酸（mRNA）疫苗与免疫相关不良反应有关。我们旨在研究SARS-CoV-2疫苗是否会使自身免疫性肝病患者的自身免疫反应恶化。
我们集中检测了原发性胆汁性胆管炎（PBC）、自身免疫性肝炎（AIH）、原发性硬化性胆管炎（PSC）患者以及医护人员（HW）在接种SARS-CoV-2 mRNA疫苗前后的大量肝脏相关和非肝脏相关自身抗体。
纳入了49例PBC患者、35例AIH患者、9例PSC患者和38名HW。接种疫苗后至少有一种自身抗体呈阳性的受试者比例，HW为11%，AIH为37%，PBC为35%，PSC患者为56%，这些患者的阳性率显著高于HW。接种疫苗前血清阳性的受试者中至少有一种自身抗体转阴的比例，HW为25%，AIH为57%，PBC为40%，PSC为50%，AIH患者的转阴率显著高于HW。在AIH组中，自身抗体转阴的数量高于阳性的数量。与mRNA-1273疫苗相比，BNT162b2疫苗产生新自身抗体的风险更高。一年后未观察到新发自身免疫性疾病。一名AIH患者在接种疫苗后复发。
mRNA SARS-CoV-2疫苗不会导致自身免疫性肝病患者的自身免疫在短期内恶化。
