The T-Cell Response to SARS-CoV-2 Vaccination in Inflammatory Bowel Disease is Augmented with Anti-TNF Therapy

Li, Dalin; Xu, Alexander M.; Mengesha, Emebet; Elyanow, Rebecca; Gittelman, Rachel; Chapman, Heidi; Prostko, John; Frias, Edwin C.; Stewart, James L.; Pozdnyakova, Valeriya; Debbas, Philip; Mujukian, Angela; Horizon, Arash; Merin, Noah; Joung, Sandy; Botwin, Gregory J.; Figueiredo, Jane C.; Cheng, Susan; Kaplan, Ian M.; McGovern, Dermot; Merchant, Akil; Melmed, Gil Y.; Braun, Jonathan

doi:10.1093/ibd/izac071

Cited by 27 publications

(32 citation statements)

References 16 publications

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“…These data are in line with observations from CLARITY-IBD, in which T-cell responses were not significantly different between patients treated with infliximab and patients treated with vedolizumab following two doses of vaccine, 6 but we have not recapitulated the findings of the CORALE study, which showed augmentation of T-cell response in recipients of anti-TNF. 32 In the current study, we observed that patients treated with thiopurine, infliximab, thiopurine plus infliximab, ustekinumab, or vedolizumab did not differ significantly from healthy controls in terms of T-cell response. However, tofacitinib treatment was associated with reduced T-cell immunity against spike protein, suggesting that this treatment impairs humoral and cellmediated response to COVID-19 vaccination, which might mark out patients on this treatment as particularly susceptible during future waves of SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 43%

COVID-19 vaccine-induced antibody and T-cell responses in immunosuppressed patients with inflammatory bowel disease after the third vaccine dose (VIP): a multicentre, prospective, case-control study

Alexander

Liu

Sandoval

et al. 2022

The Lancet Gastroenterology & Hepatology

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Section: Discussionmentioning

confidence: 43%

COVID-19 vaccine-induced antibody and T-cell responses in immunosuppressed patients with inflammatory bowel disease after the third vaccine dose (VIP): a multicentre, prospective, case-control study

Alexander

Liu

Sandoval

et al. 2022

The Lancet Gastroenterology & Hepatology

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“…Specifically, B cell responses were reduced in response to the anti-TNFα treatment in patients with rheumatoid arthritis, following the seasonal influenza vaccination [ 47 ]. In contrast to the decreased B cell responses by the TNFa blockade, T cell activity was unaffected [ 38 , 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

Anti-TNFα Treatment Impairs Long-Term Immune Responses to COVID-19 mRNA Vaccine in Patients with Inflammatory Bowel Diseases

et al. 2022

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Patients with inflammatory bowel disease (IBD) treated with anti-tumor-necrosis factor-alpha (TNFα) exhibited lower serologic responses one-month following the second dose of the COVID-19 BNT162b2 vaccine compared to those not treated with anti-TNFα (non-anti-TNFα) or to healthy controls (HCs). We comprehensively analyzed long-term humoral responses, including anti-spike (S) antibodies, serum inhibition, neutralization, cross-reactivity and circulating B cell six months post BNT162b2, in patients with IBD stratified by therapy compared to HCs. Subjects enrolled in a prospective, controlled, multi-center Israeli study received two BNT162b2 doses. Anti-S levels, functional activity, specific B cells, antigen cross-reactivity, anti-nucleocapsid levels, adverse events and IBD disease score were detected longitudinally. In total, 240 subjects, 151 with IBD (94 not treated with anti-TNFα and 57 treated with anti-TNFα) and 89 HCs participated. Six months after vaccination, patients with IBD treated with anti-TNFα had significantly impaired BNT162b2 responses, specifically, more seronegativity, decreased specific circulating B cells and cross-reactivity compared to patients untreated with anti-TNFα. Importantly, all seronegative subjects were patients with IBD; of those, >90% were treated with anti-TNFα. Finally, IBD activity was unaffected by BNT162b2. Altogether these data support the earlier booster dose administration in these patients.

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“… 16 We did find that anti-TNF therapy was associated with a higher CMIR, as was seen in a previous study. 24 …”

Section: Discussionmentioning

confidence: 99%

“…Those on anti-TNF therapy had an augmented response compared with those on no therapy. 24 These differences among studies may be at least partly explained by differences in the COVID-19 vaccine preparations and the immunization schedules among studies. For example, UK health authorities allowed for an extended dosing interval at the beginning of the pandemic so that the second dose of a COVID-19 vaccine could be administered up to 12 weeks later instead of 3 to 4 weeks after the first dose.…”

Section: Discussionmentioning

confidence: 99%

Higher Cell-Mediated Immune Responses in Patients With Inflammatory Bowel Disease on Anti-TNF Therapy After COVID-19 Vaccination

Caldera

Farraye

Necela

et al. 2022

Inflammatory Bowel Diseases

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Background Some patients with inflammatory bowel disease (IBD) on immunosuppressive therapies may have a blunted response to certain vaccines, including the messenger RNA (mRNA) coronavirus disease 2019 (COVID-19) vaccines. However, few studies have evaluated the cell-mediated immune response (CMIR), which is critical to host defense after COVID-19 infection. The aim of this study was to evaluate the humoral immune response and CMIR after mRNA COVID-19 vaccination in patients with IBD. Methods This prospective study (HERCULES [HumoRal and CellULar initial and Sustained immunogenicity in patients with IBD] study) evaluated humoral immune response and CMIR after completion of 2 doses of mRNA COVID-19 vaccines in 158 IBD patients and 20 healthy control (HC) subjects. The primary outcome was the CMIR to mRNA COVID-19 vaccines in patients with IBD. The secondary outcomes were a comparison of (1) the CMIR in patients with IBD and HC subjects, (2) CMIR and humoral immune response in all participants, and (3) correlation between CMIR and humoral immune response. Results The majority (89%) of patients with IBD developed a CMIR, which was not different vs HC subjects (94%) (P = .6667). There was no significant difference (P = .5488) in CMIR between immunocompetent (median 255 [interquartile range, 146-958] spike T cells per million peripheral blood mononuclear cells) and immunosuppressed patients (median 377 [interquartile range, 123-1440]). There was no correlation between humoral and cell-mediated immunity after vaccination (P = .5215). In univariable analysis, anti-tumor necrosis factor therapy was associated with a higher CMIRs (P = .02) and confirmed in a multivariable model (P = .02). No other variables were associated with CMIR. Conclusions Most patients with IBD achieved CMIR to a COVID-19 vaccine. Future studies are needed evaluating sustained CMIR and clinical outcomes.

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The T-Cell Response to SARS-CoV-2 Vaccination in Inflammatory Bowel Disease is Augmented with Anti-TNF Therapy

Cited by 27 publications

References 16 publications

COVID-19 vaccine-induced antibody and T-cell responses in immunosuppressed patients with inflammatory bowel disease after the third vaccine dose (VIP): a multicentre, prospective, case-control study

COVID-19 vaccine-induced antibody and T-cell responses in immunosuppressed patients with inflammatory bowel disease after the third vaccine dose (VIP): a multicentre, prospective, case-control study

Anti-TNFα Treatment Impairs Long-Term Immune Responses to COVID-19 mRNA Vaccine in Patients with Inflammatory Bowel Diseases

Higher Cell-Mediated Immune Responses in Patients With Inflammatory Bowel Disease on Anti-TNF Therapy After COVID-19 Vaccination

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