Jayne Doherty, Neil O'Morain, Roisin Stack, Miriam Tosetto, Rosanna Inzitiari, Sophie O'Reilly, Lili Gu, Juliette Sheridan, Garret Cullen, Edel Mc Dermott, Maire Buckley, Gareth Horgan, Hugh Mulcahy, Margaret Walshe, Elizabeth J Ryan, Virginie Gautier, John Prostko, Edwin Frias, David Daghfal, Peter Doran, Colm O'Morain, Glen A Doherty
{"title":"新冠肺炎加强疫苗的血清学反应降低与炎症性肠病患者B细胞记忆降低有关；变异[IBD AgainsT严重急性呼吸系统综合征冠状病毒2型免疫应答的变异性]。","authors":"Jayne Doherty, Neil O'Morain, Roisin Stack, Miriam Tosetto, Rosanna Inzitiari, Sophie O'Reilly, Lili Gu, Juliette Sheridan, Garret Cullen, Edel Mc Dermott, Maire Buckley, Gareth Horgan, Hugh Mulcahy, Margaret Walshe, Elizabeth J Ryan, Virginie Gautier, John Prostko, Edwin Frias, David Daghfal, Peter Doran, Colm O'Morain, Glen A Doherty","doi":"10.1093/ecco-jcc/jjad065","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>Patients with inflammatory bowel disease [IBD] have an attenuated response to initial COVID-19 vaccination. We sought to characterize the impact of IBD and its treatment on responses after the third vaccine against SARS-CoV-2.</p><p><strong>Methods: </strong>This was a prospective multicentre observational study of patients with IBD [n = 202] and healthy controls [HC, n = 92]. Serological response to vaccination was assessed by quantification of anti-spike protein [SP] immunoglobulin [Ig]G levels [anti-SPIgG] and in vitro neutralization of binding to angiotensin-converting enzyme 2 [ACE2]. Peripheral blood B-cell phenotype populations were assessed by flow cytometry. SARS-CoV-2 antigen-specific B-cell responses were assessed in ex vivo culture.</p><p><strong>Results: </strong>Median anti-SP IgG post-third vaccination in our IBD cohort was significantly lower than HCs [7862 vs 19 622 AU/mL, p < 0.001] as was ACE2 binding inhibition [p < 0.001]. IBD patients previously infected with COVID-19 [30%] had similar quantitative antibody response as HCs previously infected with COVID-19 [p = 0.12]. Lowest anti-SP IgG titres and neutralization were seen in IBD patients on anti-tumour necrosis factor [anti-TNF] agents, without prior COVID-19 infection, but all IBD patients show an attenuated vaccine response compared to HCs. Patients with IBD have reduced memory B-cell populations and attenuated B-cell responses to SARS-CoV-2 antigens if not previously infected with COVID-19 [p = 0.01]. Higher anti-TNF drug levels and zinc levels <65 ng/ml were associated with significantly lower serological responses.</p><p><strong>Conclusions: </strong>Patients with IBD have an attenuated response to three doses of SARS-CoV-2 vaccine. Physicians should consider patients with higher anti-TNF drug levels and/or zinc deficiency as potentially at higher risk of attenuated response to vaccination.</p>","PeriodicalId":15547,"journal":{"name":"Journal of Crohns & Colitis","volume":" ","pages":"1445-1456"},"PeriodicalIF":8.3000,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Reduced Serological Response to COVID-19 Booster Vaccine is Associated with Reduced B Cell Memory in Patients With Inflammatory Bowel Disease; VARIATION [VAriability in Response in IBD AgainsT SARS-COV-2 ImmunisatiON].\",\"authors\":\"Jayne Doherty, Neil O'Morain, Roisin Stack, Miriam Tosetto, Rosanna Inzitiari, Sophie O'Reilly, Lili Gu, Juliette Sheridan, Garret Cullen, Edel Mc Dermott, Maire Buckley, Gareth Horgan, Hugh Mulcahy, Margaret Walshe, Elizabeth J Ryan, Virginie Gautier, John Prostko, Edwin Frias, David Daghfal, Peter Doran, Colm O'Morain, Glen A Doherty\",\"doi\":\"10.1093/ecco-jcc/jjad065\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and aims: </strong>Patients with inflammatory bowel disease [IBD] have an attenuated response to initial COVID-19 vaccination. We sought to characterize the impact of IBD and its treatment on responses after the third vaccine against SARS-CoV-2.</p><p><strong>Methods: </strong>This was a prospective multicentre observational study of patients with IBD [n = 202] and healthy controls [HC, n = 92]. Serological response to vaccination was assessed by quantification of anti-spike protein [SP] immunoglobulin [Ig]G levels [anti-SPIgG] and in vitro neutralization of binding to angiotensin-converting enzyme 2 [ACE2]. Peripheral blood B-cell phenotype populations were assessed by flow cytometry. SARS-CoV-2 antigen-specific B-cell responses were assessed in ex vivo culture.</p><p><strong>Results: </strong>Median anti-SP IgG post-third vaccination in our IBD cohort was significantly lower than HCs [7862 vs 19 622 AU/mL, p < 0.001] as was ACE2 binding inhibition [p < 0.001]. IBD patients previously infected with COVID-19 [30%] had similar quantitative antibody response as HCs previously infected with COVID-19 [p = 0.12]. Lowest anti-SP IgG titres and neutralization were seen in IBD patients on anti-tumour necrosis factor [anti-TNF] agents, without prior COVID-19 infection, but all IBD patients show an attenuated vaccine response compared to HCs. Patients with IBD have reduced memory B-cell populations and attenuated B-cell responses to SARS-CoV-2 antigens if not previously infected with COVID-19 [p = 0.01]. Higher anti-TNF drug levels and zinc levels <65 ng/ml were associated with significantly lower serological responses.</p><p><strong>Conclusions: </strong>Patients with IBD have an attenuated response to three doses of SARS-CoV-2 vaccine. Physicians should consider patients with higher anti-TNF drug levels and/or zinc deficiency as potentially at higher risk of attenuated response to vaccination.</p>\",\"PeriodicalId\":15547,\"journal\":{\"name\":\"Journal of Crohns & Colitis\",\"volume\":\" \",\"pages\":\"1445-1456\"},\"PeriodicalIF\":8.3000,\"publicationDate\":\"2023-10-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Crohns & Colitis\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ecco-jcc/jjad065\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Crohns & Colitis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ecco-jcc/jjad065","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 1
摘要
背景和目的：炎症性肠病（IBD）患者对首次接种新冠肺炎疫苗的反应减弱。我们试图描述IBD及其治疗对第三次接种严重急性呼吸系统综合征冠状病毒2型疫苗后反应的影响。方法：这是一项针对IBD患者的前瞻性多中心观察性研究 = 202]和健康对照[HC = 92]。通过定量抗刺突蛋白[SP]免疫球蛋白[Ig]G水平[anti-SPIgG]和体外中和与血管紧张素转换酶2[ACE2]的结合来评估对疫苗接种的血清学反应。通过流式细胞术评估外周血B细胞表型群体。在离体培养中评估了严重急性呼吸系统综合征冠状病毒2型抗原特异性B细胞反应。结果：在我们的IBD队列中，第三次接种后的抗SP IgG中位数显著低于HCs[7862 vs 19222 AU/mL，p 结论：IBD患者对三剂严重急性呼吸系统综合征冠状病毒2型疫苗的反应减弱。医生应将抗TNF药物水平较高和/或锌缺乏的患者视为对疫苗接种反应减弱的潜在风险较高。
Reduced Serological Response to COVID-19 Booster Vaccine is Associated with Reduced B Cell Memory in Patients With Inflammatory Bowel Disease; VARIATION [VAriability in Response in IBD AgainsT SARS-COV-2 ImmunisatiON].
Background and aims: Patients with inflammatory bowel disease [IBD] have an attenuated response to initial COVID-19 vaccination. We sought to characterize the impact of IBD and its treatment on responses after the third vaccine against SARS-CoV-2.
Methods: This was a prospective multicentre observational study of patients with IBD [n = 202] and healthy controls [HC, n = 92]. Serological response to vaccination was assessed by quantification of anti-spike protein [SP] immunoglobulin [Ig]G levels [anti-SPIgG] and in vitro neutralization of binding to angiotensin-converting enzyme 2 [ACE2]. Peripheral blood B-cell phenotype populations were assessed by flow cytometry. SARS-CoV-2 antigen-specific B-cell responses were assessed in ex vivo culture.
Results: Median anti-SP IgG post-third vaccination in our IBD cohort was significantly lower than HCs [7862 vs 19 622 AU/mL, p < 0.001] as was ACE2 binding inhibition [p < 0.001]. IBD patients previously infected with COVID-19 [30%] had similar quantitative antibody response as HCs previously infected with COVID-19 [p = 0.12]. Lowest anti-SP IgG titres and neutralization were seen in IBD patients on anti-tumour necrosis factor [anti-TNF] agents, without prior COVID-19 infection, but all IBD patients show an attenuated vaccine response compared to HCs. Patients with IBD have reduced memory B-cell populations and attenuated B-cell responses to SARS-CoV-2 antigens if not previously infected with COVID-19 [p = 0.01]. Higher anti-TNF drug levels and zinc levels <65 ng/ml were associated with significantly lower serological responses.
Conclusions: Patients with IBD have an attenuated response to three doses of SARS-CoV-2 vaccine. Physicians should consider patients with higher anti-TNF drug levels and/or zinc deficiency as potentially at higher risk of attenuated response to vaccination.
期刊介绍：
Journal of Crohns and Colitis is concerned with the dissemination of knowledge on clinical, basic science and innovative methods related to inflammatory bowel diseases. The journal publishes original articles, review papers, editorials, leading articles, viewpoints, case reports, innovative methods and letters to the editor.
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