tetano
Editor, Senior Moderator
Lancet Reg Health West Pac
. 2022 Dec 20;100661.
doi: 10.1016/j.lanwpc.2022.100661. Online ahead of print.
Persistence of SARS-CoV-2 neutralizing antibodies and anti-Omicron IgG induced by BNT162b2 mRNA vaccine in patients with autoimmune inflammatory rheumatic disease: An explanatory study in Japan
Yuta Yamaguchi[SUP] 1 2 [/SUP], Shinichiro Nameki[SUP] 1 2 [/SUP], Yasuhiro Kato[SUP] 1 2 [/SUP], Ryotaro Saita[SUP] 3 [/SUP], Tomoharu Sato[SUP] 4 [/SUP], Sayaka Nagao[SUP] 5 [/SUP], Teruaki Murakami[SUP] 1 2 [/SUP], Yuko Yoshimine[SUP] 1 2 [/SUP], Saori Amiya[SUP] 1 2 [/SUP], Takayoshi Morita[SUP] 1 2 [/SUP], Yasutaka Okita[SUP] 1 2 [/SUP], Takahiro Kawasaki[SUP] 1 2 [/SUP], Jun Fujimoto[SUP] 1 2 [/SUP], Yasutaka Ueda[SUP] 6 [/SUP], Yuichi Maeda[SUP] 1 7 [/SUP], Akane Watanabe[SUP] 1 8 [/SUP], Hyota Takamatsu[SUP] 1 2 [/SUP], Sumiyuki Nishida[SUP] 1 [/SUP], Yoshihito Shima[SUP] 1 8 [/SUP], Masashi Narazaki[SUP] 1 9 [/SUP], Atsushi Kumanogoh[SUP] 1 2 5 7 10 11 [/SUP]
Affiliations
Abstract
Background: Autoimmune inflammatory rheumatic disease (AIRD) patients are at high risk of the coronavirus disease 2019 (COVID-19), but the medium-term effects of immunosuppressants on vaccine efficacy are unknown. We investigated the duration of humoral responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) wild-type and Omicron variant in AIRD patients administered with two doses of the BNT162b2 (Pfizer-BioNTech) vaccine.
Methods: Serum-neutralizing antibody (NAb) and anti-receptor-binding domain (RBD)/spike antibody levels were measured. Short- and medium-term effects of immunosuppressants were analyzed pre-vaccination (Term 1) and 14-42 days (Term 2) and 100-200 days (Term 3) after the second vaccination.
Findings: From Feb 1, 2021, to Feb 28, 2022, 439 AIRD patients and 146 healthy controls were investigated. The seropositivity rate and log[SUB]10[/SUB]-NAb titers were significantly lower in AIRD patients than in controls at Terms 2 and 3. In rheumatoid arthritis patients, tumor necrosis factor-α inhibitors (TNFis) at Term 3, and older age, glucocorticoids, and abatacept at Terms 2 and 3 were risk factors for reduced responses. Anti-Omicron RBD/spike IgG levels strongly correlated with NAb titers.
Interpretation: Glucocorticoids, TNFis, and abatacept treatments negatively affect the longevity of humoral responses to SARS-CoV-2, including Omicron, after two vaccine doses. These findings may inform the timing of additional vaccination for AIRD patients.
Funding: Cloud Funding of Peace Winds Japan; Center of Innovation Program from the Ministry of Education, Culture, Sports, Science and Technology of Japan; Japan Society for the Promotion of Science KAKENHI; Japan Agency for Medical Research and Development; Kansai Economic Federation; Mitsubishi Zaidan; and Research Grant from Japan Agency for Medical Research and Development-Core Research for Evolutional Science and Technology.
Keywords: Autoimmune inflammatory rheumatic disease; BNT162b2 mRNA vaccine; Humoral response; SARS-CoV-2; SARS-CoV-2 Omicron variant.
. 2022 Dec 20;100661.
doi: 10.1016/j.lanwpc.2022.100661. Online ahead of print.
Persistence of SARS-CoV-2 neutralizing antibodies and anti-Omicron IgG induced by BNT162b2 mRNA vaccine in patients with autoimmune inflammatory rheumatic disease: An explanatory study in Japan
Yuta Yamaguchi[SUP] 1 2 [/SUP], Shinichiro Nameki[SUP] 1 2 [/SUP], Yasuhiro Kato[SUP] 1 2 [/SUP], Ryotaro Saita[SUP] 3 [/SUP], Tomoharu Sato[SUP] 4 [/SUP], Sayaka Nagao[SUP] 5 [/SUP], Teruaki Murakami[SUP] 1 2 [/SUP], Yuko Yoshimine[SUP] 1 2 [/SUP], Saori Amiya[SUP] 1 2 [/SUP], Takayoshi Morita[SUP] 1 2 [/SUP], Yasutaka Okita[SUP] 1 2 [/SUP], Takahiro Kawasaki[SUP] 1 2 [/SUP], Jun Fujimoto[SUP] 1 2 [/SUP], Yasutaka Ueda[SUP] 6 [/SUP], Yuichi Maeda[SUP] 1 7 [/SUP], Akane Watanabe[SUP] 1 8 [/SUP], Hyota Takamatsu[SUP] 1 2 [/SUP], Sumiyuki Nishida[SUP] 1 [/SUP], Yoshihito Shima[SUP] 1 8 [/SUP], Masashi Narazaki[SUP] 1 9 [/SUP], Atsushi Kumanogoh[SUP] 1 2 5 7 10 11 [/SUP]
Affiliations
- PMID: 36569794
- PMCID: PMC9763057
- DOI: 10.1016/j.lanwpc.2022.100661
Abstract
Background: Autoimmune inflammatory rheumatic disease (AIRD) patients are at high risk of the coronavirus disease 2019 (COVID-19), but the medium-term effects of immunosuppressants on vaccine efficacy are unknown. We investigated the duration of humoral responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) wild-type and Omicron variant in AIRD patients administered with two doses of the BNT162b2 (Pfizer-BioNTech) vaccine.
Methods: Serum-neutralizing antibody (NAb) and anti-receptor-binding domain (RBD)/spike antibody levels were measured. Short- and medium-term effects of immunosuppressants were analyzed pre-vaccination (Term 1) and 14-42 days (Term 2) and 100-200 days (Term 3) after the second vaccination.
Findings: From Feb 1, 2021, to Feb 28, 2022, 439 AIRD patients and 146 healthy controls were investigated. The seropositivity rate and log[SUB]10[/SUB]-NAb titers were significantly lower in AIRD patients than in controls at Terms 2 and 3. In rheumatoid arthritis patients, tumor necrosis factor-α inhibitors (TNFis) at Term 3, and older age, glucocorticoids, and abatacept at Terms 2 and 3 were risk factors for reduced responses. Anti-Omicron RBD/spike IgG levels strongly correlated with NAb titers.
Interpretation: Glucocorticoids, TNFis, and abatacept treatments negatively affect the longevity of humoral responses to SARS-CoV-2, including Omicron, after two vaccine doses. These findings may inform the timing of additional vaccination for AIRD patients.
Funding: Cloud Funding of Peace Winds Japan; Center of Innovation Program from the Ministry of Education, Culture, Sports, Science and Technology of Japan; Japan Society for the Promotion of Science KAKENHI; Japan Agency for Medical Research and Development; Kansai Economic Federation; Mitsubishi Zaidan; and Research Grant from Japan Agency for Medical Research and Development-Core Research for Evolutional Science and Technology.
Keywords: Autoimmune inflammatory rheumatic disease; BNT162b2 mRNA vaccine; Humoral response; SARS-CoV-2; SARS-CoV-2 Omicron variant.