In patients with autoimmune disorders, the development of immune responses to SARS-CoV-2 infection or vaccination may be impaired by the disease itself as well as by the immunosuppressive treatments most patients receive.
Contrary to the authors’ expectations, a recent study showed that patients with rheumatic diseases showed T cell responses after COVID-19 recovery that were comparable to a control group without rheumatic disease or immunosuppressants (Lledo et al. Semin. Arthritis Rheum., 2021). Regardless of immunosuppressive regimen, the authors came to the same conclusion: T cell responses to SARS-CoV-2 antigens are present after COVID-19 recovery in most patients with rheumatic diseases and are not impaired by immunosuppressive therapies.
In a similar study, but on patients with Multiple Sclerosis (MS) and after mRNA vaccination instead of natural infection, authors Achiron et al. (J. Neuroimmunol. 2021) showed that memory B cell IgG responses differed depending on immunosuppressive regimen.
Using Mabtech IRIS, and our Path kits ELISpot Path: SARS-CoV-2 (RBD) Human IgG (ALP) and FluoroSpot Path: SARS-CoV-2 (S1scan+SNMO) Human IFN-γ/IL-2 the researchers could show that the patient group treated with ocrelizumab (humanized anti-CD20 mAb) had very low numbers of memory B cells but a memory T cell response equivalent to healthy donors. The patient group treated with fingolimod (immunomodulator), however, showed poor numbers of B and T memory cells.
Thus, the authors conclude that MS patient groups treated with these two regimens should be considered for a booster vaccine dose.
- Lledo et al., SARS-CoV-2-specific T-cell responses after COVID-19 recovery in patients with rheumatic diseases on immunosuppressive therapy. Semin. Arthritis Rheum. 2021
- Achiron et al., Humoral immune response in multiple sclerosis patients following PfizerBNT162b2 COVID19 vaccination: Up to 6 months cross-sectional study. J Neroimmunol. 2021