Higher and Sustained Cell-Mediated Immune Responses After 3 Doses of mRNA COVID-19 Vaccine in Patients With Inflammatory Bowel Disease on Anti-Tumor Necrosis Factor Therapy.

IF 3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinical and Translational Gastroenterology Pub Date : 2024-04-01 DOI:10.14309/ctg.0000000000000688

Freddy Caldera, Stacey Rolak, Francis A Farraye, Brian M Necela, Davitte Cogen, Emily E Zona, Trevor L Schell, Oscar Ramirez Ramirez, Mazen Almasry, Kelly Chun, Mary S Hayney, Keith L Knutson

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引用次数: 0

Abstract

Introduction: Studies suggest that the generation of durable T-cell immunity following coronavirus disease 2019 (COVID-19) vaccination protects against severe disease. The aim of this study was to measure cell-mediated immune response (CMIR) 1-2 months and 6 months after a third dose of a COVID-19 mRNA vaccine.

Methods: This prospective study (HumoRal and CellULar initial and Sustained immunogenicity in patients with inflammatory bowel disease [IBD]) evaluated CMIR at 28-65 days (t 1 ) after dose 2, 28-65 days (t 2 ) (n = 183) and 6 months (±45 days) (t 3 ) (n = 167) after a third dose of an mRNA COVID-19 vaccine. A small cohort had blood sample available 28-65 days (t 4 ) (n = 55) after a fourth dose. Primary outcomes were CMIR at (t 2 ) and (t 3 ). Secondary outcomes included the effect of immunosuppressing IBD medications on CMIR and response at (t 4 ).

Results: All patients had measurable CMIR at all time points. CMIR increased at t 2 compared with that at t 1 (median 1,467 responding cells per million (interquartile range [IQR] 410-5,971) vs 313 (94-960) P < 0.001). There was no significant waning in t 2 vs t 3 or significant boosting at t 4 . Those on anti-tumor necrosis factor monotherapy had a higher CMIR compared with those not on this therapy at t 2 (4,132 [IQR 1,136-8,795] vs 869 [IQR 343-3,221] P < 0.001) and t 3 (2,843 [IQR 596-6,459] vs 654 [IQR 143-2,067] P < 0.001). In univariable analysis, anti-tumor necrosis factor monotherapy was associated with a higher CMIR at t 2 ( P < 0.001) and t 3 ( P < 0.001) and confirmed in a multivariable model ( P < 0.001).

Discussion: A third dose of a COVID-19 vaccine boosts CMIR, and the response is sustained in patients with IBD.

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接受抗肿瘤坏死因子治疗的炎症性肠病患者接种三次 mRNA COVID-19 疫苗后，细胞介导的免疫反应更强更持久

简介：研究表明，接种 COVID-19 疫苗后产生的持久 T 细胞免疫可预防严重疾病。本研究的目的是在接种第三剂 COVID-19 mRNA 疫苗一至两个月和六个月后测量细胞介导的免疫反应（CMIR）：这项前瞻性研究（HERCULES）评估了接种第二剂后28-65天（t1）、接种第三剂mRNA COVID-19疫苗后28-65天（t2）（约183人）和六个月（+/-45天）（t3）（约167人）的细胞介导免疫反应。一小部分人在接种第四剂疫苗后 28-65 天（t4）（55 人）可获得血液。主要结果是（t2）和（t3）的CMIR。次要结果包括免疫抑制 IBD 药物对 CMIR 的影响和（t4）时的反应：所有患者在所有时间点都有可测量的 CMIR。与 t1 时相比，t2 时的 CMIR 有所增加（中位数为每百万应答细胞 1467 个（四分位数间距（IQR）410-5971）vs 313 个（94-960）p< 0.001）。第2阶段与第3阶段相比，没有明显的减弱，第4阶段也没有明显的增强。与未接受抗肿瘤坏死因子单药治疗的患者相比，接受抗肿瘤坏死因子单药治疗的患者在第2个疗程时的CMIR更高（4132（IQR 1136-8795) vs. 869 (IQR 343-3221) p 结论：COVID治疗的第3个疗程应在第4个疗程时进行：第三剂COVID-19疫苗可提高CMIR，而且IBD患者的反应可持续。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Translational Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.00

自引率

0.00%

发文量

114

审稿时长

16 weeks

期刊介绍： Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease. Colon and small bowel Endoscopy and novel diagnostics Esophagus Functional GI disorders Immunology of the GI tract Microbiology of the GI tract Inflammatory bowel disease Pancreas and biliary tract Liver Pathology Pediatrics Preventative medicine Nutrition/obesity Stomach.