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Published on: December 16, 2021
Deficient SARS-CoV-2 hybrid immunity during inflammatory bowel disease
Amin Alirezaylavasani1, Ingrid Marie Egner1, Børresdatter Dahl2
1Department of Immunology, Oslo University Hospital, Oslo, Norway; KG Jebsen Centre for B cell Malignancies, Institute of Clinical Medicine, University of Oslo, Norway; Precision Immunotherapy Alliance, University of Oslo, Oslo, Norway.
Patients with Inflammatory Bowel Disease (IBD) show altered immune responses to COVID-19 vaccines and infections. Breakthrough infections boost antibody levels but not cellular immunity, indicating a need for tailored vaccine strategies for IBD patients.
Area of Science:
- Immunology
- Virology
- Gastroenterology
Background:
- Inflammatory Bowel Disease (IBD) patients on immunosuppressants are at high risk for severe COVID-19.
- Understanding immune responses to SARS-CoV-2 vaccination and breakthrough infections (BTI) is crucial for this vulnerable group.
Purpose of the Study:
- To investigate systemic inflammation and cellular immune responses to SARS-CoV-2 in IBD patients post-vaccination and BTI.
- To identify optimal vaccine strategies and therapies for enhancing COVID-19 immunity in IBD patients.
Main Methods:
- Comparative analysis of serological and cellular immune responses between IBD patients and healthy donors (HD).
- Assessment of antibody levels (anti-RBD IgG), memory B cells, and CD8 T cell responses post-vaccination and BTI.
Main Results:
- IBD patients had lower serological responder rates and faster antibody waning after the third vaccine dose compared to HD.
- Breakthrough infections increased anti-RBD IgG and Spike-specific memory B cells in IBD patients.
- Cellular immune responses showed no significant enhancement post-BTI; instead, SARS-CoV-2 specific and bystander CD8 T cells were activated.
Conclusions:
- Chronic inflammation in IBD complicates immune responses to SARS-CoV-2.
- Tailored vaccine regimens and anti-inflammatory therapies are needed to improve cellular immunity against SARS-CoV-2 in IBD patients.
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