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在接受免疫抑制药物的多发性硬化症患者中,三到四种mRNACOVID-19疫苗:血清转化和变种中和

Céline Louapre¹, Lisa Belin², Stéphane Marot³

¹CIC Neurosciences, Hôpital de la Pitié Salpêtrière, INSERM, CNRS, Assistance Publique Hôpitaux de Paris, Sorbonne Université, Paris Brain Institute-ICM, Paris, France.

European journal of neurology

|June 13, 2023

概括

一种增强的严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2) 疫苗方案在接受抗CD20治疗的多发性硬化症 (MS) 患者中适度改善了抗体反应. 然而,中和活性仍然很低,特别是在对抗Omicron变种时,即使在增强剂后.

科学领域:

免疫学免疫学免疫学
神经学神经学
疫苗学疫苗学疫苗学

背景情况:

接受抗CD20疗法的多发性硬化症 (MS) 患者表现出改变的免疫反应.
评估免疫受损人群中的疫苗疗效对于公共卫生至关重要.
严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2) 疫苗需要在特定的患者群体中进行评估.

研究的目的:

在多发性硬化症 (MS) 患者中,评估BNT162b2接种疫苗后的幽默免疫反应和中和活性.
为了比较使用抗CD20,fingolimod或其他疾病修饰疗法治疗的MS患者的疫苗反应.
评估增强型初级疫苗接种方案 (三次注射) 对SARS-CoV-2疫苗反应的影响.

主要方法:

90名多发性硬化患者的前性纵向队列研究.
对抗SARS-CoV-2受体结合域 (RBD) 免疫球蛋白G抗体的量化.
对B.1,Delta和Omicron变种的病毒中和能力的评估,使用酶相关的免疫吸收试验和病毒中和试验.

主要成果:

与其他治疗方法相比,在接受抗CD20和fingolimod初级疫苗接种后的患者中,抗RBD抗体阳性显著下降.
在抗CD20和fingolimod组中,中和活性降低,在所有患者中,对Omicron变异的反应显著较低.
延迟的辅助疫苗接种导致抗CD20组的抗RBD血清阳性轻微增加,但对Omicron的中和活性仍然很低.

结论:

一个增强的初级疫苗接种方案在接受抗CD20治疗的MS患者中适度增加了抗体标位.
针对SARS-CoV-2变种,特别是Omicron的中和活性,即使在增强剂后,在接受抗CD20治疗的MS患者中仍然适度.
可能需要进一步的策略来优化在接受抗CD20治疗的MS患者中疫苗的有效性.

关键词:

BNT162b2b2 在线阅读在 COVID-19 疫情中,在SARS-CoV-2变种中.免疫抑制剂免疫抑制剂多发性硬化症多发性硬化症

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