COVID-19 Vaccine Booster Shot Preserves T Cells Immune Response Based on Interferon-Gamma Release Assay in Inflammatory Bowel Disease (IBD) Patients on Anti-TNFα Treatment

Abstract

Immune-modifying treatment in inflammatory bowel disease (IBD) impairs the humoral response. The role of T lymphocytes in this setting is still unclear. This study aims to assess if a booster shot (third dose) of BNT162b2 mRNA COVID-19 vaccine enhanced the humoral response and elicited cellular immunity in IBD patients on different immuno-therapy regimens compared to healthy controls (HCs). Five months after a booster dose, serological and T-cell responses were assessed. The measurements were described using geometric means with 95% confidence intervals. The differences between study groups were assessed by Mann–Whitney tests. Seventy-seven subjects (n = 53 IBD patients and n = 24 HCs), who were fully vaccinated and not previously SARS-CoV-2 infected, were recruited. Regarding the IBD patients, 19 were affected by Crohn’s disease and 34 by ulcerative colitis. During the vaccination cycle, half of the patients (53%) were on stable treatment with aminosalicylates, and 32% were on biological therapy. No differences in antibody concentrations between IBD patients and HCs, nor T-cell responses, were found. Stratifying IBD patients based on the type of treatment (anti-TNFα agents vs. other treatment regimens), a decrease only in antibody titer (p = 0.008), but not in cellular response, was observed. Even after the COVID-19 vaccine booster dose, the TNFα inhibitors selectively decreased the humoral immune response compared to patients on other treatment regimens. The T-cell response was preserved in all study groups. These findings highlight the importance of evaluating T-cell immune responses following COVID-19 vaccination in a routine diagnostic setting, particularly for immunocompromised cohorts.

Antibody Kinetics after Three Doses of SARS-CoV-2 mRNA Vaccination in Patients with Inflammatory Bowel Disease

“…A multicenter prospective study involving the University of Wisconsin-Madison (Madison, WI, USA) and Mayo Clinic (Jacksonville, FL, USA) demonstrated that all IBD patients who received a third SARS-CoV-2 mRNA vaccine dose exhibited a humoral immune response [ 14 ]. Additionally, another study showed that IBD patients on similar treatment regimens to those in our study were able to mount a serological response comparable to a control group following the administration of a third dose [ 15 ]. A study focusing on patients with autoinflammatory rheumatic and musculoskeletal diseases also showed an increased humoral response in the majority of participants following the administration of a third SARS-CoV-2 mRNA vaccine dose [ 16 ].…”

“…Ultimately, our findings are consistent with other studies that have examined anti-RBD kinetics after both two and three doses of mRNA vaccination in IBD patients, as well as patients with other autoinflammatory diseases. These studies demonstrate that mRNA vaccines are safe for use in the IBD population [ 5 , 14 , 15 , 16 ].…”

Does the Human Gut Virome Contribute to Host Health or Disease?

“…In this view of our metagenome, variations in the systemic virome may contribute to phenotypic variation by regulating immunophenotype rather than acting as pathogens. In several chronic, progressive immune-mediated conditions, such as IBD, it is well known that environmental factors, gut microbiota composition, genetic predisposition, and biological treatments contribute to the impaired immune response and disease evolution [112][113][114][115][116]. However, how the gut virome behaves in this condition is not yet well understood.…”