SARS-CoV-2 mRNA 疫苗不会加重自身免疫性肝病患者的自身免疫力

IF 7.9 1区医学 Q1 IMMUNOLOGY

Journal of autoimmunity Pub Date : 2024-10-15 DOI:10.1016/j.jaut.2024.103325

Tobias Kälin , Katia Passarin , Magdalena Filipowic-Sinnreich , David Semela , Tanja Seifert , Federica Sallusto , Diego Vergani , Andreas Cerny , Giorgina Mieli-Vergani , Benedetta Terziroli Beretta-Piccoli , The Swiss Autoimmune Hepatitis Cohort Study, The Swiss Primary Biliary Cholangitis Cohort Study, The Swiss Primary Sclerosing Cholangitis Study

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引用次数: 0

摘要

引言和目的针对严重急性呼吸道冠状病毒 2（SARS-CoV-2）感染的smRNA 疫苗与免疫相关的不良反应有关。我们旨在研究 SARS-CoV-2 疫苗是否会加重自身免疫性肝病患者的自身免疫反应。方法我们对原发性胆汁性胆管炎（PBC）、自身免疫性肝炎（AIH）、原发性硬化性胆管炎（PSC）患者以及医护人员（HW）在接种 SARS-CoV-2 mRNA 疫苗前后的大量肝脏和非肝脏相关自身抗体进行了集中检测。接种疫苗后至少有一种自身抗体呈阳性的受试者比例为：HW 11%、AIH 37%、PBC 35%、PSC 56%，与 HW 相比，PBC 患者的阳性频率明显更高。接种前血清阳性但至少有一次自身抗体阴性的受试者比例为：HW 25%、AIH 57%、PBC 40%、PSC 50%，AIH 患者的阴性率明显高于 HW。在 AIH 组中，自身抗体阴性率高于阳性率。与 mRNA-1273 疫苗相比，BNT162b2 疫苗产生新自身抗体的风险更高。一年后未观察到新发自身免疫性疾病。结论mRNA SARS-CoV-2 疫苗不会诱发自身免疫性肝病患者的自身免疫性短期恶化。

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SARS-CoV-2 mRNA vaccines do not worsen autoimmunity in patients with autoimmune liver diseases

Introduction and aims

mRNA vaccines against Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) infection have been associated with immune-related adverse reactions. We aimed at investigating whether SARS-CoV-2 vaccines may worsen autoimmune reactions in patients with autoimmune liver diseases.

Methods

We centrally tested a large panel of liver- and non-liver-related autoantibodies in patients with primary biliary cholangitis (PBC), autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC), and in healthcare workers (HW) before and after SARS-CoV-2 mRNA vaccines.

Results

49 PBC, 35 AIH, 9 PSC and 38 HW were included. The proportion of subjects with at least one autoantibody positivization after vaccination was 11 % for HW, 37 % for AIH, 35 % for PBC and 56 % for PSC patients, patients having a significantly higher frequency of positivization as compared to HW. The proportion of seropositive subjects before vaccination who had at least one autoantibody negativization was 25 % for HW, 57 % for AIH, 40 % for PBC and 50 % for PSC, AIH patients having a significantly higher frequency of negativization as compared to HW. In the AIH group, the number of autoantibody negativizations was higher than the number of positivizations. The BNT162b2 vaccine was associated with a higher risk of developing new autoantibodies as compared to the mRNA-1273 vaccine. No new-onset autoimmune disease was observed after one year. One AIH patient had a relapse after vaccination.

Conclusion

mRNA SARS-CoV-2 vaccines do not induce short-term worsening of autoimmunity in patients with autoimmune liver diseases.

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来源期刊

Journal of autoimmunity 医学-免疫学

CiteScore

27.90

自引率

1.60%

发文量

117

审稿时长

17 days

期刊介绍： The Journal of Autoimmunity serves as the primary publication for research on various facets of autoimmunity. These include topics such as the mechanism of self-recognition, regulation of autoimmune responses, experimental autoimmune diseases, diagnostic tests for autoantibodies, as well as the epidemiology, pathophysiology, and treatment of autoimmune diseases. While the journal covers a wide range of subjects, it emphasizes papers exploring the genetic, molecular biology, and cellular aspects of the field. The Journal of Translational Autoimmunity, on the other hand, is a subsidiary journal of the Journal of Autoimmunity. It focuses specifically on translating scientific discoveries in autoimmunity into clinical applications and practical solutions. By highlighting research that bridges the gap between basic science and clinical practice, the Journal of Translational Autoimmunity aims to advance the understanding and treatment of autoimmune diseases.