Corbalan Paula María, Tomas-Grau Rodrigo Hernán, Pera Mariana, Ploper Diego, Espasa Gabriela Vanesa, Cazorla Silvia Inés, Leguizamón María Lilia, Pingitore Esteban Vera, Barbaglia Ana Lucía, Maldonado-Galdeano Carolina, Bertolaccini María Constanza, Soliz-Santander Silvana Estefanía, Lucero Luciana González, Ávila César Luis, Chehín Rosana Nieves, Sueldo Héctor Raúl, Socias Sergio Benjamín, Bellomio Verónica Inés
Servicio de Reumatología, Hospital Angel Cruz Padilla, Tucumán, Argentina.
Instituto de Investigación en Medicina Molecular y Celular Aplicada, Universidad Nacional de Tucumán, Consejo Nacional de Investigaciones Científicas y Técnicas, Sistema Provincial de Salud, Tucumán, Argentina.
Arch Med Res. 2025 Apr;56(3):103141. doi: 10.1016/j.arcmed.2024.103141. Epub 2025 Jan 6.
Patients with autoimmune rheumatic diseases (ARD) are at increased risk of infection due to their impaired immune response, which also reduces vaccination efficacy. Although several studies have evaluated the serological response to SARS-CoV-2 mRNA-based vaccines in patients with ARD, limited information on immune responses to other vaccination platforms is available.
This observational prospective study aims to investigate the humoral immune response to different SARS-CoV-2 vaccines in patients with ARD.
Total 66 patients with ARD who were scheduled to receive any SARS-CoV-2 vaccine (Gam-COVID-Vac; AZD1222; BBIBP-CorV; mRNA-1273; BNT162b2 and Ad5-nCoV) were enrolled in the study. We analyzed the humoral immune response elicited against the spike receptor-binding-domain (RBD) of SARS-CoV-2 at 0 and 14 ± 2 d after the first vaccine dose and at 0 ± 1, 21-45, and 180 d after the second one. Titers were also measured in patients who received an additional dose of vaccine.
After the second dose of the vaccine, 70.5% experienced seroconversion. The type of vaccine affected serological responses. BBIBP-CorV resulted in lower seroconversion rates, while mixed vaccinations increased anti-RBD titers. Other factors impacting seroconversion were higher prednisone doses, biological therapy, and hypertension. Patients treated with Rituximab had the lowest seroconversion rate. Regression analysis revealed an 89.0% lower probability of seroconversion for BBIBP-CorV recipients and an 88.0% lower probability for those with hypertension. An additional dose increased seroconversion to 85.7%.
Two-dose vaccination schemes exhibited a 70.5% seroconversion rate to the SARS-CoV-2 vaccine. An additional dose increased this rate to 85.0%. Reduced humoral immune responses were associated with BBIBP-CorV, prednisone higher doses, and biological therapy.
自身免疫性风湿病（ARD）患者由于免疫反应受损，感染风险增加，这也会降低疫苗接种效果。尽管多项研究评估了ARD患者对基于SARS-CoV-2 mRNA的疫苗的血清学反应，但关于对其他疫苗接种平台的免疫反应的信息有限。
这项观察性前瞻性研究旨在调查ARD患者对不同SARS-CoV-2疫苗的体液免疫反应。
共有66例计划接种任何SARS-CoV-2疫苗（Gam-COVID-Vac；AZD1222；BBIBP-CorV；mRNA-1273；BNT162b2和Ad5-nCoV）的ARD患者纳入研究。我们分析了在第一剂疫苗接种后0天和14±2天以及第二剂疫苗接种后0±1天、21 - 45天和180天时针对SARS-CoV-2刺突受体结合域（RBD）引发的体液免疫反应。还对接受额外一剂疫苗的患者进行了抗体滴度检测。
在第二剂疫苗接种后，70.5%的患者发生血清转化。疫苗类型影响血清学反应。BBIBP-CorV导致血清转化率较低，而混合接种增加了抗RBD滴度。影响血清转化的其他因素包括较高剂量的泼尼松、生物治疗和高血压。接受利妥昔单抗治疗的患者血清转化率最低。回归分析显示，接受BBIBP-CorV的患者血清转化概率降低89.0%，高血压患者降低88.0%。额外一剂疫苗使血清转化率提高到85.7%。
两剂疫苗接种方案对SARS-CoV-2疫苗的血清转化率为70.5%。额外一剂疫苗使该率提高到85.0%。体液免疫反应降低与BBIBP-CorV、较高剂量的泼尼松和生物治疗有关。
