Evaluation of humoral and cellular response to third dose of BNT162b2 mRNA COVID-19 vaccine in patients treated with B-cell depleting therapy

Davide Firinu; Giuseppe Fenu; Giuseppina Sanna; Giulia A Costanzo; Andrea Perra; Marcello Campagna; Roberto Littera; Carlotta Locci; Alessandra Marongiu; Riccardo Cappai; Maurizio Melis; Germano Orrù; Stefano Del Giacco; Ferdinando Coghe; Aldo Manzin; Luchino Chessa

doi:10.1016/j.jaut.2022.102848

Evaluation of humoral and cellular response to third dose of BNT162b2 mRNA COVID-19 vaccine in patients treated with B-cell depleting therapy

J Autoimmun. 2022 Jul:131:102848. doi: 10.1016/j.jaut.2022.102848. Epub 2022 Jun 13.

Authors

Davide Firinu¹, Giuseppe Fenu², Giuseppina Sanna³, Giulia A Costanzo⁴, Andrea Perra⁵, Marcello Campagna⁴, Roberto Littera⁶, Carlotta Locci⁴, Alessandra Marongiu³, Riccardo Cappai⁷, Maurizio Melis², Germano Orrù⁴, Stefano Del Giacco⁴, Ferdinando Coghe⁶, Aldo Manzin³, Luchino Chessa⁴

Affiliations

¹ Department of Medical Sciences and Public Health, University of Cagliari. and Unit of Internal Medicine, Policlinico Universitario - AOU di Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, CA, Italy. Electronic address: davide.firinu@unica.it.
² Department of Neuroscience, ARNAS Brotzu, 09100, Cagliari, Italy.
³ Microbiology and Virology Unit, Department of Biomedical Sciences, University of Cagliari, 09042, Monserrato, Italy.
⁴ Department of Medical Sciences and Public Health, University of Cagliari. and Unit of Internal Medicine, Policlinico Universitario - AOU di Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, CA, Italy.
⁵ Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, 09100, Cagliari, Italy.
⁶ Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, 09100, Cagliari, Italy.
⁷ Laboratory Clinical Chemical Analysis and Microbiology, University Hospital of Cagliari, 09042, Monserrato, Italy.

Abstract

Objective: to investigate the responses to mRNA COVID-19 vaccines in a cohort of immunosuppressed patients affected by immune-mediated inflammatory diseases (IMID).

Methods: we have measured humoral and cellular immunity using quantitative IgG anti-SARS-CoV-2 Spike antibody (anti-S-IgG), neutralization assays and specific interferon-gamma (IFN-g) release assay (IGRA) before and after the third dose of BNT162b2. The response of those on anti-CD20 (n = 18) was then compared with healthy controls (HC, n = 18) and IMID naïve to anti-CD20 drugs (n = 13).

Results: a third BNT162b2 dose is highly immunogenic in IMID patients naïve to anti-CD20, as 100% of the subjects seroconverted compared to the 55% in anti-CD20. The rate of IGRA response was of 79% in anti-CD20, 50% in IMID naïve to anti-CD20, 100% in HC. Among those who have seroconverted, IMID patients had significantly reduced anti-S-IgG and neutralization titers compared to HC, whereas no significant difference was observed when comparing anti-CD20 and HC. Furthermore, 13% of anti-CD20 and 7.7% of IMID were simultaneously negative for both neutralizing antibodies and IGRA after three doses.

Conclusion: these data draw attention to the immunogenicity of COVID-19 vaccination in treated IMID, taking specific groups into consideration for vaccination program.

Keywords: Autoimmune disease; BNT162b2; CD-20; COVID-19; IMID; Vaccination.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antibodies, Viral
Antigens, CD20
BNT162 Vaccine
COVID-19 Vaccines*
COVID-19* / prevention & control
Humans
Immunity, Humoral
Immunoglobulin G
RNA, Messenger / genetics

Substances

Antibodies, Viral
Antigens, CD20
COVID-19 Vaccines
Immunoglobulin G
RNA, Messenger
BNT162 Vaccine