The Impact of Immune-Modifying Treatments for Skin Diseases on the Immune Response to COVID-19 Vaccines: a Narrative Review.

IF 2.4 Q2 DERMATOLOGY

Current Dermatology Reports Pub Date : 2022-01-01 Epub Date: 2022-10-25 DOI:10.1007/s13671-022-00376-3

Su-Yi Liew, Timothy Tree, Catherine H Smith, Satveer K Mahil

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Abstract

Purpose of review: SARS-CoV-2 has had a devastating global effect, with vaccinations being paramount in the public health strategy against COVID-19. Vaccinations have uncoupled infection from adverse COVID-19 outcomes worldwide. While immune-modifying therapies are effective for the management of skin diseases such as psoriasis and atopic dermatitis, these medications also impair protective immune responses. There has been longstanding uncertainty and concern over the impact of immune-modifying therapies on the effectiveness of vaccines; for example, it is well recognised that methotrexate impairs humoral responses to both influenza and pneumococcal vaccines. This narrative review aims to discuss the evidence to date on the impact of immune-modifying therapies on the immune response to COVID-19 vaccines, with a focus on the first two vaccine doses.

Recent findings: Individuals receiving immune-modifying therapy are more likely to have attenuated humoral responses to a single dose of COVID-19 vaccine compared to healthy controls; however, this may be improved by a complete course of vaccination. B cell targeted biologics such as rituximab markedly impair the humoral response to both the first and second COVID-19 vaccination. There remains a paucity of data on cellular immune responses, with the few available studies indicating lower responses to two vaccine doses in individuals receiving immune-modifying therapies compared to healthy controls, which may impact the durability of immune responses.

Summary: Inadequate humoral immune responses to a single dose of vaccine in the context of immune-modifying therapy are improved by a complete course of vaccination. Individuals receiving immune-modifying treatments should be encouraged to take up a complete vaccine course to mitigate their risk against COVID-19. Research in large patient populations on the longevity/kinetics of the complex humoral and cellular response to subsequent vaccine doses, including against newer variants of concern, is warranted, in addition to data on immune correlates of vaccine clinical effectiveness.

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皮肤病的免疫调节治疗对 COVID-19 疫苗免疫反应的影响：叙述性综述》（The Impact of Immune-Modifying Treaties for Skin Diseases on the Immune Response to COVID-19 Vaccines: a Narrative Review）。

审查目的：SARS-CoV-2 在全球造成了破坏性影响，而疫苗接种是针对 COVID-19 的公共卫生战略的重中之重。疫苗接种使感染与 COVID-19 在全球造成的不良后果脱钩。虽然免疫调节疗法能有效治疗牛皮癣和特应性皮炎等皮肤病，但这些药物也会损害保护性免疫反应。免疫调节疗法对疫苗效果的影响一直存在不确定性和担忧；例如，甲氨蝶呤会损害流感疫苗和肺炎球菌疫苗的体液反应，这一点已得到广泛认可。本综述旨在讨论迄今为止有关免疫调节疗法对 COVID-19 疫苗免疫反应影响的证据，重点是前两剂疫苗：最新研究结果：与健康对照组相比，接受免疫调节疗法的个体更有可能对单剂 COVID-19 疫苗产生减弱的体液反应；然而，完整的疫苗接种疗程可能会改善这种情况。B 细胞靶向生物制剂（如利妥昔单抗）会明显削弱对第一剂和第二剂 COVID-19 疫苗的体液反应。关于细胞免疫反应的数据仍然很少，现有的少数研究表明，与健康对照组相比，接受免疫调节疗法的个体对两剂疫苗的反应较低，这可能会影响免疫反应的持久性。应鼓励接受免疫调节治疗的患者接种完整的疫苗疗程，以降低他们感染COVID-19的风险。除了疫苗临床效果的免疫相关数据外，还需要在大量患者中研究对后续疫苗剂量（包括针对令人担忧的新变种）的复杂体液和细胞反应的寿命/动力学。

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来源期刊

Current Dermatology Reports DERMATOLOGY-

CiteScore

3.30

自引率

6.20%

发文量

期刊介绍： This journal intends to review the most significant recent developments in the field of dermatology. By providing clear, insightful, balanced contributions by expert international authors, the journal aims to serve all those involved in the diagnosis, treatment, management, and prevention of dermatologic conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas across the field, such as epidemiology, surgery, pharmacology, clinical trial design, and pediatrics. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known figures in the field, and an Editorial Board of more than 20 internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.