Booster dose of SARS-CoV-2 messenger RNA vaccines strengthens the specific immune response of patients with rheumatoid arthritis: A prospective multicenter longitudinal study

•After receiving a COVID-19 booster, the antibody response increases in controls and rheumatoid arthritis (RA)-patients.•After the booster, interferon-γ release assay-specific response remains stable in RA.•After the booster, the spike-specific response is clusters of differentiation (CD)4-driven in...

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Published in:International journal of infectious diseases Vol. 125; pp. 195 - 208
Main Authors: Farroni, Chiara, Aiello, Alessandra, Picchianti-Diamanti, Andrea, Laganà, Bruno, Petruccioli, Elisa, Agrati, Chiara, Garbuglia, Anna Rosa, Meschi, Silvia, Lapa, Daniele, Cuzzi, Gilda, Petrone, Linda, Vanini, Valentina, Salmi, Andrea, Altera, Anna Maria Gerarda, Repele, Federica, Grassi, Germana, Bettini, Aurora, Vita, Serena, Mariano, Andrea, Damiani, Arianna, Infantino, Maria, Grossi, Valentina, Manfredi, Mariangela, Niccoli, Laura, Puro, Vincenzo, Rosa, Roberta Di, Salemi, Simonetta, Sesti, Giorgio, Scolieri, Palma, Bruzzese, Vincenzo, Benucci, Maurizio, Cantini, Fabrizio, Nicastri, Emanuele, Goletti, Delia
Format: Journal Article
Language:English
Published: Canada Elsevier Ltd 01.12.2022
Elsevier
Subjects:
Antibody response
COVID-19 vaccine
Immunosuppressive therapy
Rheumatoid arthritis
SARS-CoV-2
T-cell response
COVID-19 vaccine
SARS-CoV-2
Immunosuppressive therapy
Rheumatoid arthritis
T-cell response
Antibody response
ISSN:1201-9712, 1878-3511, 1878-3511
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Summary:•After receiving a COVID-19 booster, the antibody response increases in controls and rheumatoid arthritis (RA)-patients.•After the booster, interferon-γ release assay-specific response remains stable in RA.•After the booster, the spike-specific response is clusters of differentiation (CD)4-driven in health care workers and patients with RA.•In RA, the booster is associated with low spike-CD4 response and interleukin-2 impairment. To characterize the kinetics of humoral and T-cell responses in rheumatoid arthritis (RA)-patients followed up to 4-6 weeks (T3) after the SARS-CoV-2 vaccine booster dose. Health care workers (HCWs, n = 38) and patients with RA (n = 52) completing the messenger RNA vaccination schedule were enrolled at T3. In each cohort, 25 subjects were sampled after 5 weeks (T1) and 6 months (T2) from the first vaccine dose. The humoral response was assessed by measuring anti-receptor-binding domain (RBD) and neutralizing antibodies, the T-cell response by interferon-γ-release assay (IGRA), T cell cytokine production, and B cell phenotype at T3 by flow cytometry. Patients with RA showed a significant reduction of antibody titers from T1 to T2 and a significant increase at T3. T-cell response by IGRA persisted over time in patients with RA, whereas it increased in HCWs. Most patients with RA scored positive for anti-RBD, neutralizing antibody and T-cell responses, although the magnitude was lower than HCWs. The spike-specific-cytokine response was mainly clusters of differentiation (CD)4+ T cells restricted in both cohorts and significantly lower with reduced interleukin-2 response and CD4-antigen-responding naïve T cells in patients with RA. Unswitched memory B cells were reduced in patients with RA compared with HCWs independently of vaccination. COVID-19 vaccine booster strengthens the humoral immunity in patients with RA even with a reduced cytokine response.
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ISSN:1201-9712
1878-3511
1878-3511
DOI:10.1016/j.ijid.2022.10.035