RT Journal Article
SR Electronic
T1 BNT162b2 vaccine-induced humoral and cellular responses against SARS-CoV-2 variants in systemic lupus erythematosus
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 575
OP 583
DO 10.1136/annrheumdis-2021-221097
VO 81
IS 4
A1 Quentin Moyon
A1 Delphine Sterlin
A1 Makoto Miyara
A1 François Anna
A1 Alexis Mathian
A1 Raphael Lhote
A1 Pascale Ghillani-Dalbin
A1 Paul Breillat
A1 Sasi Mudumba
A1 Sophia de Alba
A1 Fleur Cohen-aubart
A1 Julien Haroche
A1 Micheline Pha
A1 Thi Huong Du Boutin
A1 Hedi Chaieb
A1 Pedro Macedo Flores
A1 Pierre Charneau
A1 Guy Gorochov
A1 Zahir Amoura
YR 2022
UL http://ard.bmj.com/content/81/4/575.abstract
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.