Booster dose of SARS-CoV-2 messenger RNA vaccines strengthens the specific immune response of patients with rheumatoid arthritis: A prospective multicenter longitudinal study. (December 2022)

• Record Type: Journal Article
• Authors: Farroni, Chiara; Aiello, Alessandra; Picchianti-Diamanti, Andrea; Laganà, Bruno; Petruccioli, Elisa; Agrati, Chiara; Garbuglia, Anna Rosa; Meschi, Silvia; Lapa, Daniele; Cuzzi, Gilda; Petrone, Linda; Vanini, Valentina; Salmi, Andrea; Altera, Anna Maria Gerarda; Repele, Federica; Grassi, Germana; Bettini, Aurora; Vita, Serena; Mariano, Andrea; Damiani, Arianna; Infantino, Maria; Grossi, Valentina; Manfredi, Mariangela; Niccoli, Laura; Puro, Vincenzo; Rosa, Roberta Di; Salemi, Simonetta; Sesti, Giorgio; Scolieri, Palma; Bruzzese, Vincenzo; Benucci, Maurizio; Cantini, Fabrizio; Nicastri, Emanuele; Goletti, Delia;
• Is Part Of: International journal of infectious diseases. Volume 125(2022)
• Page Start: 195
• Page End: 208
• Publication Date: 2022-12
• Subjects: COVID-19 vaccine -- SARS-CoV-2 -- Rheumatoid arthritis -- T-cell response -- Antibody response -- Immunosuppressive therapy; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2022.10.035
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: After receiving a COVID-19 booster, the antibody response increases in controls and rheumatoid arthritis (RA)-patients. After the booster, interferon-γ release assay-specific response remains stable in RA. After the booster, the spike-specific response is clusters of differentiation (CD)4-driven in health care workers and patients with RA. In RA, the booster is associated with low spike-CD4 response and interleukin-2 impairment. Abstract: Objectives: To characterize the kinetics of humoral and T-cell responses in rheumatoid arthritis (RA)-patients followed up to 4-6 weeks (T3) after the SARS-CoV-2 vaccine booster dose. Methods: Health care workers (HCWs, n = 38) and patients with RA (n = 52) completing the messenger RNA vaccination schedule were enrolled at T3. In each cohort, 25 subjects were sampled after 5 weeks (T1) and 6 months (T2) from the first vaccine dose. The humoral response was assessed by measuring anti-receptor-binding domain (RBD) and neutralizing antibodies, the T-cell response by interferon-γ-release assay (IGRA), T cell cytokine production, and B cell phenotype at T3 by flow cytometry. Results: Patients with RA showed a significant reduction of antibody titers from T1 to T2 and a significant increase at T3. T-cell response by IGRA persisted over time in patients with RA, whereas it increased in HCWs. Most patients with RA scored positive for anti-RBD, neutralizing antibody and T-cell responses, although the magnitude was lower than HCWs. The spike-specific-cytokine response was mainly clusters of differentiation (CD)4 + T cells restricted in both cohorts and significantly lower with reduced interleukin-2 response and CD4-antigen-responding naïve T cells in patients with RA. Unswitched memory B cells were reduced in patients with RA compared with HCWs independently of vaccination. Conclusion: COVID-19 vaccine booster strengthens the humoral immunity in patients with RA even with a reduced cytokine response.