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Impact of multiple sclerosis disease-modifying therapies on SARS-CoV-2 vaccine-induced antibody and T cell immunity
medRxiv - Neurology Pub Date : 2021-09-20 , DOI: 10.1101/2021.09.10.21262933
Joseph J Sabatino 1 , Kristen Mittl 1 , William Rowles 1 , Kira Mcpolin 1 , Jayant V Rajan 2 , Colin R Zamecnik 1 , Ravi Dandekar 1 , Bonny D Alvarenga 1 , Rita P Loudermilk 1 , Chloe Gerungan 1 , Collin M Spencer 1 , Sharon A Sagan 1 , Danillo G Augusto 1, 3 , Jessa Alexander 1 , Jill A Hollenbach 1, 4 , Michael R Wilson 1 , Scott S Zamvil 1 , Riley Bove 1
Affiliation  

Vaccine-elicited adaptive immunity is an essential prerequisite for effective prevention and control of coronavirus 19 (COVID-19). Treatment of multiple sclerosis (MS) involves a diverse array of disease-modifying therapies (DMTs) that target antibody and cell-mediated immunity, yet a comprehensive understanding of how MS DMTs impact SARS-CoV-2 vaccine responses is lacking. We completed a detailed analysis of SARS-CoV-2 vaccine-elicited spike antigen-specific IgG and T cell responses in a cohort of healthy controls and MS participants in six different treatment categories. Two specific DMT types, sphingosine-1-phosphate (S1P) receptor modulators and anti-CD20 monoclonal antibodies (mAb), resulted in significantly reduced spike-specific IgG responses. Longer duration of anti-CD20 mAb treatment prior to SARS-CoV-2 vaccination were associated with absent antibody responses. Except for reduced CD4+ T cell responses in S1P-treated patients, spike-specific CD4+ and CD8+ T cell reactivity remained robust across all MS treatment types. These findings have important implications for clinical practice guidelines and vaccination recommendations in MS patients and other immunosuppressed populations.

中文翻译:

多发性硬化症疾病修饰疗法对 SARS-CoV-2 疫苗诱导的抗体和 T 细胞免疫的影响

疫苗引发的适应性免疫是有效预防和控制冠状病毒 19 (COVID-19) 的必要前提。多发性硬化症 (MS) 的治疗涉及多种针对抗体和细胞介导免疫的疾病改善疗法 (DMTs),但目前尚缺乏对 MS DMTs 如何影响 SARS-CoV-2 疫苗反应的全面了解。我们完成了对 SARS-CoV-2 疫苗引发的刺突抗原特异性 IgG 和 T 细胞反应的详细分析,这些反应是在一组健康对照和六种不同治疗类别的 MS 参与者中进行的。两种特定的 DMT 类型,即 1-磷酸鞘氨醇 (S1P) 受体调节剂和抗 CD20 单克隆抗体 (mAb),可显着降低尖峰特异性 IgG 反应。在 SARS-CoV-2 疫苗接种之前较长时间的抗 CD20 mAb 治疗与缺乏抗体反应有关。除了 S1P 治疗患者的 CD4+ T 细胞反应降低外,尖峰特异性 CD4+ 和 CD8+ T 细胞反应性在所有 MS 治疗类型中保持强劲。这些发现对 MS 患者和其他免疫抑制人群的临床实践指南和疫苗接种建议具有重要意义。
更新日期:2021-09-22
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