Anft Moritz, Wiemers Lea, Rosiewicz Kamil S, Doevelaar Adrian, Skrzypczyk Sarah, Kurek Julia, Kaliszczyk Sviatlana, Seidel Maximilian, Stervbo Ulrik, Seibert Felix S, Westhoff Timm H, Babel Nina
Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, University Hospital of the Ruhr-University Bochum, Hölkeskampring 40, 44625 Herne, Germany.
Berlin Institute of Health, Berlin-Brandenburg Center for Regenerative Therapies, and Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin Augustenburger Platz 1, 13353 Berlin, Germany.
Mol Ther. 2025 Jun 4;33(6):2886-2899. doi: 10.1016/j.ymthe.2025.01.007. Epub 2025 Jan 10.
Autoantibodies (AABs) are currently being investigated as causative or aggravating factors during post-COVID. In this study, we analyze the effect of immunoadsorption therapy on symptom improvement and the relationship with immunological parameters in post-COVID patients exhibiting symptoms of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) induced or aggravated by an SARS-CoV-2 infection. This observational study includes 12 post-COVID patients exhibiting a predominance of ME/CFS symptoms alongside increased concentrations of autonomic nervous system receptor (ANSR) autoantibodies and neurological impairments. We found that following immunoadsorption therapy, the ANSR AABs were nearly eliminated from the patients' blood. The removal of immunoglobulin G antibodies was accompanied by a decrease of pro-inflammatory cytokines including interleukin (IL)-4, IL-2, IL-1β, tumor necrosis factor, and IL-17A serum levels, and a significant reduction of soluble spike protein. Notably, a strong positive correlation between pro-inflammatory cytokines and ASNR-AABs β1, β2, M3, and M4 was observed in spike protein-positive patients, whereas no such correlation was evident in spike protein-negative patients. Thirty days post-immunoadsorption therapy, patients exhibited notable improvement in neuropsychological function and a modest but statistically significant amelioration of hand grip strength was observed. However, neither self-reported symptoms nor scores on ME/CFS questionnaires showed a significant improvement and a rebound of the removed proteins occurring within a month.
自身抗体（AABs）目前正作为新冠后致病或加重因素进行研究。在本研究中，我们分析了免疫吸附疗法对新冠后出现由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染诱发或加重的肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）症状的患者症状改善的影响以及与免疫参数的关系。这项观察性研究纳入了12名新冠后患者，这些患者以ME/CFS症状为主，同时自主神经系统受体（ANSR）自身抗体浓度升高且存在神经功能障碍。我们发现，免疫吸附治疗后，患者血液中的ANSR AABs几乎被清除。免疫球蛋白G抗体的清除伴随着促炎细胞因子水平下降，包括白细胞介素（IL）-4、IL-2、IL-1β、肿瘤坏死因子和IL-17A血清水平，以及可溶性刺突蛋白的显著降低。值得注意的是，在刺突蛋白阳性患者中，促炎细胞因子与ASNR-AABs β1、β2、M3和M4之间存在强正相关，而在刺突蛋白阴性患者中则无明显相关性。免疫吸附治疗30天后，患者神经心理功能有显著改善，握力有适度但具有统计学意义的改善。然而，自我报告的症状和ME/CFS问卷得分均未显示出显著改善，且在一个月内出现了已清除蛋白的反弹。
