Woelfel, Simon; Dütschler, Joel; König, Marius; Graf, Nicole; Oikonomou, Vasileios; Krieger, Claudia; Truniger, Samuel; Franke, Annett; Eckhold, Annika; Forsch, Kristina; Wyss, Jacqueline; Krupka, Niklas; Albrich, Werner; Frei, Nicola; Geissler, Nora; Schaub, Peter; Friedrich, Matthias; Misselwitz, Benjamin; Korte, Wolfgang; Bürgi, Justus J; ... (2023). Systemic and T cell-associated responses to SARS-CoV-2 immunisation in gut inflammation (STAR SIGN study): effects of biologics on vaccination efficacy of the third dose of mRNA vaccines against SARS-CoV-2. Alimentary pharmacology & therapeutics, 57(1), pp. 103-116. Wiley-Blackwell 10.1111/apt.17264
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Aliment_Pharmacol_Ther_-_2022_-_Woelfel_-_Systemic_and_T_cell_associated_responses_to_SARS_CoV_2_immunisation_in_gut.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (3MB) |
BACKGROUND
Immunosuppressed patients with inflammatory bowel disease (IBD) experience increased risk of vaccine-preventable diseases such as COVID-19.
AIMS
To assess humoral and cellular immune responses following SARS-CoV-2 booster vaccination in immunosuppressed IBD patients and healthy controls.
METHODS
In this prospective, multicentre, case-control study, 139 IBD patients treated with biologics and 110 healthy controls were recruited. Serum anti-SARS-CoV-2 spike IgG concentrations were measured 2-16 weeks after receiving a third mRNA vaccine dose. The primary outcome was to determine if humoral immune responses towards booster vaccines differ in IBD patients under anti-TNF versus non-anti-TNF therapy and healthy controls. Secondary outcomes were antibody decline, impact of previous infection and SARS-CoV-2-targeted T cell responses.
RESULTS
Anti-TNF-treated IBD patients showed reduced anti-spike IgG concentrations (geometric mean 2357.4 BAU/ml [geometric SD 3.3]) when compared to non-anti-TNF-treated patients (5935.7 BAU/ml [3.9]; p < 0.0001) and healthy controls (5481.7 BAU/ml [2.4]; p < 0.0001), respectively. In multivariable modelling, prior infection (geometric mean ratio 2.00 [95% CI 1.34-2.90]) and vaccination with mRNA-1273 (1.53 [1.01-2.27]) increased antibody concentrations, while anti-TNF treatment (0.39 [0.28-0.54]) and prolonged time between vaccination and antibody measurement (0.72 [0.58-0.90]) decreased anti-SARS-CoV-2 spike antibodies. Antibody decline was comparable in IBD patients independent of anti-TNF treatment and antibody concentrations could not predict breakthrough infections. Cellular and humoral immune responses were uncoupled, and more anti-TNF-treated patients than healthy controls developed inadequate T cell responses (15/73 [20.5%] vs 2/100 [2.0%]; p = 0.00031).
CONCLUSIONS
Anti-TNF-treated IBD patients have impaired humoral and cellular immunogenicity following SARS-CoV-2 booster vaccination. Fourth dose administration may be beneficial for these patients.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery 04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Gastroenterology 04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine |
UniBE Contributor: |
Oikonomou, Vasileios, Wyss, Jacqueline, Krupka, Niklas, Misselwitz, Benjamin |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0269-2813 |
Publisher: |
Wiley-Blackwell |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
31 Oct 2022 11:12 |
Last Modified: |
10 Dec 2022 00:14 |
Publisher DOI: |
10.1111/apt.17264 |
PubMed ID: |
36307899 |
BORIS DOI: |
10.48350/174278 |
URI: |
https://boris.unibe.ch/id/eprint/174278 |
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