Classen Johanna Maria, Muzalyova Anna, Römmele Christoph, Nagl Sandra, Ebigbo Alanna, Schnoy Elisabeth
Internal Medicine III, University Hospital Augsburg, Augsburg, Germany.
Internal Medicine III, University Hospital Augsburg, Augsburg, Germany,
Dig Dis. 2025;43(1):19-27. doi: 10.1159/000542353. Epub 2024 Nov 30.
Patients with inflammatory bowel disease (IBD) receiving immunosuppressive therapy might have an increased risk of developing a severe course of SARS-CoV-2 infection. The aim of this study was to investigate the development of antibodies in immunosuppressed patients with IBD compared to a healthy control group and to determine the effect of immunomodulators on the level of anti-SARS-CoV-2 IgG antibody levels before and after a third vaccination against SARS-CoV-2.
This is a single-center study with a retrospective observational design. Seventy-one IBD patients matched by propensity score to 71 healthy employees (control group) were included. Blood was taken from both groups at predetermined times before and after the third booster vaccination.
All patients with IBD (n = 71, 100%) received immunomodulatory therapy. The mean antibody level before the third vaccination was 1,352.88 U/mL (SD = 1,011.489) in the IBD group and was not lower compared to the control group (p = 0.088). Gender, age, and disease duration had no significant impact on the development of antibody levels. Patients with TNF-alpha blockers had significantly lower antibody titers (p = 0.011) compared to the control group. Patients with integrin inhibitor therapy had significantly higher antibody titers (p = 0.003) than the controls. After the third vaccination, an increase in antibody titers was recorded in all patients in the IBD group.
We recorded an antibody titer in all patients with IBD that was not significantly lower compared to healthy controls despite immunomodulatory therapy. The booster vaccination led to an increase in antibody levels in all patients with IBD.
接受免疫抑制治疗的炎症性肠病（IBD）患者感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的风险可能会增加。本研究的目的是调查免疫抑制的IBD患者与健康对照组相比抗体的产生情况，并确定免疫调节剂对第三次接种SARS-CoV-2疫苗前后抗SARS-CoV-2 IgG抗体水平的影响。
这是一项采用回顾性观察设计的单中心研究。纳入了71例通过倾向评分匹配的IBD患者和71名健康员工（对照组）。在第三次加强疫苗接种前后的预定时间从两组采集血液。
所有IBD患者（n = 71，100%）均接受了免疫调节治疗。IBD组第三次接种前的平均抗体水平为1352.88 U/mL（标准差 = 1011.489），与对照组相比并不低（p = 0.088）。性别、年龄和病程对抗体水平的产生没有显著影响。与对照组相比，使用肿瘤坏死因子-α阻滞剂的患者抗体滴度显著较低（p = 0.011）。接受整合素抑制剂治疗的患者抗体滴度显著高于对照组（p = 0.003）。第三次接种后，IBD组所有患者的抗体滴度均有所升高。
我们发现所有IBD患者的抗体滴度尽管接受了免疫调节治疗，但与健康对照组相比并没有显著降低。加强疫苗接种使所有IBD患者的抗体水平升高。
