Humoral immune response in convalescent COVID-19 people with multiple sclerosis treated with high-efficacy disease-modifying therapies: A multicenter, case-control study,Journal of Neuroimmunology

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Humoral immune response in convalescent COVID-19 people with multiple sclerosis treated with high-efficacy disease-modifying therapies: A multicenter, case-control study
Journal of Neuroimmunology ( IF 3.3 ) Pub Date : 2021-08-16 , DOI: 10.1016/j.jneuroim.2021.577696
Mario Habek ₁ , Gregor Jakob Brecl ₂ , Vanja Bašić Kes ₃ , Dunja Rogić ₄ , Barbara Barun ₁ , Tereza Gabelić ₁ , Andreja Emeršič ₂ , Alenka Horvat Ledinek ₂ , Nevena Grbić ₃ , Ivana Lapić ₄ , Dragana Šegulja ₄ , Koraljka Đurić ₅ , Ivan Adamec ₆ , Magdalena Krbot Skorić ₇

Affiliation

Aim

To determine the influence of high-efficacy disease modifying therapy (DMT) on the development of IgG SARS-CoV-2 antibody response in COVID-19 convalescent people with multiple sclerosis (pwMS).

Methods

Seventy-four pwMS taking high-efficacy DMTs (specifically natalizumab, fingolimod, alemtuzumab, ocrelizumab, cladribine and ublituximab) and diagnosed with COVID-19 and 44 healthy persons (HC) were enrolled. SARS-CoV2 antibodies were tested with Elecsys® Anti-SARSCoV-2 S assay.

Results

pwMS taking high-efficacy DMTs had a significantly higher chance of having negative titer of SARS-CoV2 antibodies compared to healthy controls (33 negative pwMS [44.6%] compared to one negative HC [2.3%], p < 0.001). pwMS taking B-cell depleting therapy (ocrelizumab and ublituximab) had a significantly higher chance of having negative titer of SARS-CoV2 antibodies compared to pwMS on all other DMTs (29 negative pwMS on B-cell therapy [64.4%] compared to four negative pwMS on all other DMTs [13.8%], p < 0.001). Out of other DMTs, two (33.3%) pwMS taking fingolimod and two (16.7%) pwMS taking cladribine failed to develop IgG SARS-COV-2 antibodies. B-cell depleting therapy independently predicted negative titer of IgG SARS-CoV-2 antibody (Exp[B] =0.014, 95%CI 0.002–0.110, p < 0.001).

Conclusions

A significant proportion of convalescent COVID-19 pwMS on high-efficacy DMTs will not develop IgG SARS-CoV-2 antibodies. B-cell depleting therapies independently predict negative and low titer of IgG SARS-CoV-2 antibody.

中文翻译：

接受高效疾病改善疗法治疗的多发性硬化症恢复期 COVID-19 患者的体液免疫反应：一项多中心、病例对照研究

目的

确定高效疾病修正疗法 (DMT) 对 COVID-19 多发性硬化症康复者 (pwMS) IgG SARS-CoV-2 抗体反应发展的影响。

方法

74 名服用高效 DMT（特别是那他珠单抗、芬戈莫德、阿仑单抗、ocrelizumab、克拉屈滨和 ublituximab）并被诊断患有 COVID-19 的 pwMS 和 44 名健康人 (HC) 被纳入研究。SARS-CoV2 抗体已通过 Elecsys® Anti-SARSCoV-2 S 检测进行了测试。

结果

与健康对照相比，服用高效 DMT 的 pwMS 具有显着更高的 SARS-CoV2 抗体滴度阴性的机会（33 个阴性 pwMS [44.6%] 与一个阴性 HC [2.3%] 相比，p < 0.001）。与所有其他 DMT 上的 pwMS 相比，接受 B 细胞耗竭疗法（ocrelizumab 和 ublituximab）的 pwMS 具有显着更高的 SARS-CoV2 抗体滴度阴性的机会（B 细胞疗法的 29 个阴性 pwMS [64.4%] 与四个阴性相比所有其他 DMT 上的 pwMS [13.8%]，p < 0.001)。在其他 DMT 中，两名 (33.3%) 服用芬戈莫德的 pwMS 和两名 (16.7%) 服用克拉屈滨的 pwMS 未能产生 IgG SARS-COV-2抗体。B 细胞耗竭疗法可独立预测 IgG SARS-CoV-2 抗体的阴性滴度（Exp[B] =0.014，95%CI 0.002–0.110，p < 0.001)。