Evaluation of Humoral and Cellular Immune Responses to the SARS-CoV-2 Vaccine in Patients With Common Variable Immunodeficiency Phenotype and Patient Receiving B-Cell Depletion Therapy

Frontiers in Immunology

Cristina Masuet-Aumatell¹  Raúl Rigo-Bonnin²  Gemma Rocamora-Blanch³  Carla Bermudez³  Arnau Antolí³  Xavier Solanich³  Luis Humberto Hernández-Benítez⁵  Nadia Garcia-Muñoz⁵  Laura Calatayud⁶  Eva Dopico⁷  Jordi Bas⁸  Virgínia Mas-Bosch⁸  Francisco Morandeira⁸  Mario Framil⁸  Sergio Navarro⁸  Sergio Martinez-Yelamos^1,11  Antoni Riera-Mestre^1,11 

[1] 0Department of Preventive Medicine, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain;1Department of Clinical Laboratory, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain;Adults Primary Immunodeficiency Unit (UFIPA), Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain;Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain;Blood Bank Department - Banc de Sang i Teixits (BST), Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain;CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain;Deparment of Microbiology, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain;Department of Immunology, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain;Department of Internal Medicine, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain;Department of Neurology, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain;Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain;

关键词: SARS-CoV-2;    vaccine;    COVID-19;    multiple sclerosis;    anti-CD20 therapies;    CVID;   

DOI  :  10.3389/fimmu.2022.895209

来源: DOAJ

【 摘 要 】

IntroductionSARS-CoV-2 vaccines’ effectiveness is not yet clearly known in immunocompromised patients. This study aims to assess the humoral and cellular specific immune response to SARS-CoV-2 vaccines and the predictors of poor response in patients with common variable immunodeficiency (CVID) phenotype and in patients treated with B-cell depletion therapies (BCDT), as well as the safety of these vaccines.MethodsFrom March to September 2021, we performed a prospective study of all adult patients who would receive the SARS-CoV-2 vaccination and were previously diagnosed with (i) a CVID syndrome (CVID phenotype group; n=28) or (ii) multiple sclerosis (MS) treated with B-cell depleting therapies three to six months before vaccination (BCD group; n=24). Participants with prior SARS-CoV-2 infection; or prior SARS-CoV-2 vaccine administration; or use of any immunosuppressant (except BCDT in MS group) were excluded. A group of subjects without any medical condition that confers immunosuppression and who met all study criteria was also assessed (control group; n=14). A chemiluminescence immunoassay was used to determine pre- and post-SARS-CoV-2 vaccine anti-S IgG antibodies. T-cell specific response was assessed by analysis of pre- and post-SARS-CoV-2 vaccination blood samples with an interferon-gamma release assay. The baseline blood sample also included several biochemical, haematological and immunological analyses.ResultsSARS-CoV-2 vaccines are safe in immunocompromised patients, although their effectiveness was lower than in healthy individuals. CVID phenotype patients showed impaired humoral (29%) and cellular (29%) response, while BCD patients fundamentally presented humoral failure (54%). Low IgA values, low CD19+ peripheral B cells, low switched memory B cells, and a low CD4+/CD8+ ratio were predictors of inadequate specific antibody response in CVID phenotype patients. No factor was found to predict poor cellular response in CVID phenotype patients, nor a defective humoral or cellular response in BCD patients.ConclusionThe effectiveness of SARS-CoV-2 vaccines in CVID phenotype and BCD patients is lower than in healthy individuals. Knowledge of predictive factors of humoral and cellular response failure in immunocompromised patients could be very useful in clinical practice, and thus, studies in this regard are clearly needed.

【 授权许可】

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