Booster dose of SARS-CoV-2 messenger RNA vaccines strengthens the specific immune response of patients with rheumatoid arthritis: A prospective multicenter longitudinal study

Farroni, Chiara; Aiello, Alessandra; Picchianti-Diamanti, Andrea; Laganà, Bruno; Petruccioli, Elisa; Agrati, Chiara; Garbuglia, Anna Rosa; Meschi, Silvia; Lapa, Daniele; Cuzzi, Gilda; Petrone, Linda; Vanini, Valentina; Salmi, Andrea; Altera, Anna Maria Gerarda; Repele, Federica; Grassi, Germana; Bettini, Aurora; Vita, Serena; Mariano, Andrea; Damiani, Arianna; Infantino, María; Grossi, Valentina; Manfredi, Mariangela; Niccoli, Laura; Puro, Vincenzo; Rosa, Roberta; Salemi, Simonetta; Sesti, Giorgio; Scolieri, Palma; Bruzzese, Vincenzo; Benucci, Maurizio; Cantini, Fabrizio; Nicastri, Emanuele; Goletti, Delia

doi:10.1016/j.ijid.2022.10.035

Cited by 24 publications

(26 citation statements)

References 51 publications

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“…For flow cytometry, fresh whole blood (600 µL) was overnight stimulated with spike protein or SEB together with a-CD28 and a-CD49d (1 µg/mL each). Cells were then stained for intracellular cytokines and T-cell phenotype as previously described12 23 (online supplemental table 1 and figure 1).…”

Section: Methodsmentioning

confidence: 99%

Longitudinal characterisation of B and T-cell immune responses after the booster dose of COVID-19 mRNA-vaccine in people with multiple sclerosis using different disease-modifying therapies

Aiello

Coppola

Ruggieri

et al. 2022

J Neurol Neurosurg Psychiatry

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BackgroundThe decline of humoral response to COVID-19 vaccine led to authorise a booster dose. Here, we characterised the kinetics of B-cell and T-cell immune responses in patients with multiple sclerosis (PwMS) after the booster dose.MethodsWe enrolled 22 PwMS and 40 healthcare workers (HCWs) after 4–6 weeks from the booster dose (T3). Thirty HCWs and 19 PwMS were also recruited 6 months (T2) after the first dose. Antibody response was measured by anti-receptor-binding domain (RBD)-IgG detection, cell-mediated response by an interferon (IFN)-γ release assay (IGRA), Th1 cytokines and T-cell memory profile by flow cytometry.ResultsBooster dose increased anti-RBD-IgG titers in fingolimod-treated, cladribine-treated and IFN-β-treated patients, but not in ocrelizumab-treated patients, although antibody titres were lower than HCWs. A higher number of fingolimod-treated patients seroconverted at T3. Differently, T-cell response evaluated by IGRA remained stable in PwMS independently of therapy. Spike-specific Th1-cytokine response was mainly CD4+T-cell-mediated, and in PwMS was significantly reduced (p<0.0001) with impaired IL-2 production compared with HCWs at T3. In PwMS, total Th1 and IFN-γ CD4+T-cell responders to spike protein were increased from T2 to T3.Compared with HCWs, PwMS presented a higher frequency of CD4+and CD8+terminally differentiated effector memory cells and of CD4+effector memory (TEM) cells, independently of the stimulus suggesting the association of this phenotype with MS status. CD4+and CD8+TEMcell frequency was further increased at T3 compared with T2.ConclusionsCOVID-19 vaccine booster strengthens humoral and Th1-cell responses and increases TEMcells in PwMS.

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Section: Methodsmentioning

confidence: 99%

Longitudinal characterisation of B and T-cell immune responses after the booster dose of COVID-19 mRNA-vaccine in people with multiple sclerosis using different disease-modifying therapies

Aiello

Coppola

Ruggieri

et al. 2022

J Neurol Neurosurg Psychiatry

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“…These findings are in line with rheumatological studies, demonstrating sufficient antibody response rate to influenza/pneumococcal and SARS-CoV-2 vaccinations during TCZ treatment. 3 , 7 …”

Section: Discussionmentioning

confidence: 99%

Humoral COVID-19 vaccine response in patients with NMOSD/MOGAD during anti-IL-6 receptor therapy compared to other immunotherapies

et al. 2023

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Background: Data on the humoral vaccine response in patients on anti-interleukin-6 (IL-6) receptor therapy remain scarce. Objective: The main objective of our study was to investigate the humoral response after vaccination against SARS-CoV-2 in neuromyelitis optica spectrum disorder (NMOSD)/myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) patients treated with anti-IL-6 receptor therapy. Secondarily, we analyzed relapse activity timely associated with vaccination. Methods: In this retrospective cross-sectional multicenter study, we included 15 healthy controls and 48 adult NMOSD/MOGAD patients without previous COVID-19 infection. SARS-CoV-2 spike protein antibody titers during anti-IL-6 receptor therapy were compared to anti-CD20 antibody therapy, oral immunosuppressants, and to nonimmunosuppressed individuals. Results: We observed 100% seroconversion in the anti-IL-6 receptor treatment group. Titers of SARS-CoV-2 spike protein antibodies were lower compared to healthy controls (720 vs 2500 binding antibody units (BAU)/mL, p = 0.004), but higher than in the anti-CD20 (720 vs 0.4 BAU/mL, p < 0.001) and comparable to the oral immunosuppressant group (720 vs 795 BAU/mL, p = 1.0). We found no association between mRNA-based vaccines and relapse activity in patients with or without immunotherapy. Conclusions: Despite being lower than in healthy controls, the humoral vaccine response during anti-IL-6 receptor therapy was evident in all patients and substantially stronger compared to anti-CD20 treatment. No relevant disease activity occurred after mRNA vaccination against SARS-CoV-2.

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“…However, in the last two years, vaccination was demonstrated to be a successful strategy to control COVID-19 pandemic both in the general population and in ARDs. Several real-life studies showed that some immunosuppressive agents decrease the titer of specific anti-RBD antibodies, but the large majority of patients can still develop a good immune response [ 8 , 10 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

“…This hypothesis is corroborated by the overall good immunogenicity of the original SARS-CoV-2 strain, emerged by our previous studies conducted on a part of these patients. Indeed, we already showed that the antibody specific response was present in almost all subjects after the first cycle and was significantly strengthened after the third dose of BNT162b2 mRNA vaccine [ 10 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

The Third Dose of BNT162b2 COVID-19 Vaccine Does Not “Boost” Disease Flares and Adverse Events in Patients with Rheumatoid Arthritis

et al. 2023

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Data on the risk of adverse events (AEs) and disease flares in autoimmune rheumatic diseases (ARDs) after the third dose of COVID-19 vaccine are scarce. The aim of this multicenter, prospective study is to analyze the clinical and immunological safety of BNT162b2 vaccine in a cohort of rheumatoid arthritis (RA) patients followed-up from the first vaccine cycle to the third dose. The vaccine showed an overall good safety profile with no patient reporting serious AEs, and a low percentage of total AEs at both doses (40/78 (51.3%) and 13/47 (27.7%) patients after the second and third dose, respectively (p < 0.002). Flares were observed in 10.3% of patients after the end of the vaccination cycle and 12.8% after the third dose. Being vaccinated for influenza was inversely associated with the onset of AEs after the second dose, at both univariable (p = 0.013) and multivariable analysis (p = 0.027). This result could allow identification of a predictive factor of vaccine tolerance, if confirmed in larger patient populations. A higher disease activity at baseline was not associated with a higher incidence of AEs or disease flares. Effectiveness was excellent after the second dose, with only 1/78 (1.3%) mild breakthrough infection (BI) and worsened after the third dose, with 9/47 (19.2%) BI (p < 0.002), as a probable expression of the higher capacity of the Omicron variants to escape vaccine recognition.

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Booster dose of SARS-CoV-2 messenger RNA vaccines strengthens the specific immune response of patients with rheumatoid arthritis: A prospective multicenter longitudinal study

Cited by 24 publications

References 51 publications

Longitudinal characterisation of B and T-cell immune responses after the booster dose of COVID-19 mRNA-vaccine in people with multiple sclerosis using different disease-modifying therapies

Longitudinal characterisation of B and T-cell immune responses after the booster dose of COVID-19 mRNA-vaccine in people with multiple sclerosis using different disease-modifying therapies

Humoral COVID-19 vaccine response in patients with NMOSD/MOGAD during anti-IL-6 receptor therapy compared to other immunotherapies

The Third Dose of BNT162b2 COVID-19 Vaccine Does Not “Boost” Disease Flares and Adverse Events in Patients with Rheumatoid Arthritis

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