Frontiers in immunology · 2026
Humoral and cell mediated immune response to SARS-CoV-2 vaccination in patients with immune-mediated diseases.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Glenn Dorey A, Hu Yichun, Free Meghan E, Premkumar Lakshmanane, Narowski Tara M, Coleman Grayson M, Elmore Sandra, Collie Mary M, Culton Donna A, Orzechowski Nicole M, Wu Eveline Y, Falk Ronald J, Bunch Donna O, Derebail Vimal K
Аннотация
BACKGROUND: Vaccination against SARS-CoV-2 induces an immune response that is protective against severe disease in healthy populations. However, humoral and cellular immune responses in individuals with immune-mediated diseases receiving immunosuppressive medications are not well understood.
METHODS: We conducted a single-center, prospective observational cohort study of pediatric and adult patients with vasculitis, glomerular disease, or other immune-mediated diseases. Antibody response assessed by viral neutralization and, in a subset, cellular immunity to SARS-CoV-2 vaccination were assessed before and at time points following initial and booster vaccination.
RESULTS: Between March 2021 and June 2022, 80 individuals with immune-mediated diseases and 12 healthy controls were enrolled and followed for a median of 11.97 months (IQR 7.64, 14.05). Following vaccination, the median percent angiotensin-converting enzyme 2 (ACE2) neutralization at V1 (1-3 months post vaccination) for patients in the immune-mediated disease cohort and healthy controls were 46.9% (IQR 0.65, 95.6) and 95.9% (IQR 94.6, 96.5), respectively. Of 26 individuals with anti-CD20 therapy exposure or laboratory evidence of B cell depletion at time of vaccination, only 11.9% had protective neutralization titers at V1. After adjustment for age, sex, BMI, race, vaccine type, and number of comorbidities, anti-CD20 exposure at time of initial vaccination remained significantly associated with a lower odds of ACE2 neutralization ≥30% at V1. The median T-ELISpot counts (RBD) at V1 for patients with immune-mediated diseases and healthy controls were comparable (16 [IQR 12, 37] and 16 [IQR 4.5, 23], respectively).
CONCLUSIONS: Vaccination against SARS-CoV-2 during treatment with anti-CD20 antibody therapy was associated with impaired humoral immunity, but T cell responses were qualitatively preserved despite immunosuppressant exposure.
METHODS: We conducted a single-center, prospective observational cohort study of pediatric and adult patients with vasculitis, glomerular disease, or other immune-mediated diseases. Antibody response assessed by viral neutralization and, in a subset, cellular immunity to SARS-CoV-2 vaccination were assessed before and at time points following initial and booster vaccination.
RESULTS: Between March 2021 and June 2022, 80 individuals with immune-mediated diseases and 12 healthy controls were enrolled and followed for a median of 11.97 months (IQR 7.64, 14.05). Following vaccination, the median percent angiotensin-converting enzyme 2 (ACE2) neutralization at V1 (1-3 months post vaccination) for patients in the immune-mediated disease cohort and healthy controls were 46.9% (IQR 0.65, 95.6) and 95.9% (IQR 94.6, 96.5), respectively. Of 26 individuals with anti-CD20 therapy exposure or laboratory evidence of B cell depletion at time of vaccination, only 11.9% had protective neutralization titers at V1. After adjustment for age, sex, BMI, race, vaccine type, and number of comorbidities, anti-CD20 exposure at time of initial vaccination remained significantly associated with a lower odds of ACE2 neutralization ≥30% at V1. The median T-ELISpot counts (RBD) at V1 for patients with immune-mediated diseases and healthy controls were comparable (16 [IQR 12, 37] and 16 [IQR 4.5, 23], respectively).
CONCLUSIONS: Vaccination against SARS-CoV-2 during treatment with anti-CD20 antibody therapy was associated with impaired humoral immunity, but T cell responses were qualitatively preserved despite immunosuppressant exposure.