PT  - JOURNAL ARTICLE
AU  - Quentin Moyon
AU  - Delphine Sterlin
AU  - Makoto Miyara
AU  - François Anna
AU  - Alexis Mathian
AU  - Raphael Lhote
AU  - Pascale Ghillani-Dalbin
AU  - Paul Breillat
AU  - Sasi Mudumba
AU  - Sophia de Alba
AU  - Fleur Cohen-aubart
AU  - Julien Haroche
AU  - Micheline Pha
AU  - Thi Huong Du Boutin
AU  - Hedi Chaieb
AU  - Pedro Macedo Flores
AU  - Pierre Charneau
AU  - Guy Gorochov
AU  - Zahir Amoura
TI  - BNT162b2 vaccine-induced humoral and cellular responses against SARS-CoV-2 variants in systemic lupus erythematosus
AID  - 10.1136/annrheumdis-2021-221097
DP  - 2022 Apr 01
TA  - Annals of the Rheumatic Diseases
PG  - 575--583
VI  - 81
IP  - 4
4099  - http://ard.bmj.com/content/81/4/575.short
4100  - http://ard.bmj.com/content/81/4/575.full
SO  - Ann Rheum Dis2022 Apr 01; 81
AB  - Objectives Our aim was to evaluate systemic lupus erythematosus (SLE) disease activity and SARS-CoV-2-specific immune responses after BNT162b2 vaccination.Methods In this prospective study, disease activity and clinical assessments were recorded from the first dose of vaccine until day 15 after the second dose in 126 patients with SLE. SARS-CoV-2 antibody responses were measured against wild-type spike antigen, while serum-neutralising activity was assessed against the SARS-CoV-2 historical strain and variants of concerns (VOCs). Vaccine-specific T cell responses were quantified by interferon-γ release assay after the second dose.Results BNT162b2 was well tolerated and no statistically significant variations of BILAG (British Isles Lupus Assessment Group) and SLEDAI (SLE Disease Activity Index) scores were observed throughout the study in patients with SLE with active and inactive disease at baseline. Mycophenolate mofetil (MMF) and methotrexate (MTX) treatments were associated with drastically reduced BNT162b2 antibody response (β=−78, p=0.007; β=−122, p<0.001, respectively). Anti-spike antibody response was positively associated with baseline total immunoglobulin G serum levels, naïve B cell frequencies (β=2, p=0.018; β=2.5, p=0.003) and SARS-CoV-2-specific T cell response (r=0.462, p=0.003). In responders, serum neutralisation activity decreased against VOCs bearing the E484K mutation but remained detectable in a majority of patients.Conclusion MMF, MTX and poor baseline humoral immune status, particularly low naïve B cell frequencies, are independently associated with impaired BNT162b2 mRNA antibody response, delineating patients with SLE who might need adapted vaccine regimens and follow-up.All data relevant to the study are included in the article.