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    Antibody decay, T cell immunity and breakthrough infections following two SARS-CoV-2 vaccine doses in inflammatory bowel disease patients treated with infliximab and vedolizumab

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    URI
    https://rde.dspace-express.com/handle/11287/622411
    Author
    Lin, S.
    Kennedy, N. A.
    Saifuddin, A.
    Sandoval, D. M.
    Reynolds, C. J.
    Seoane, R. C.
    Kottoor, S. H.
    Pieper, F. P.
    Lin, K. M.
    Butler, D. K.
    Chanchlani, N.
    Nice, R.
    Chee, D.
    Bewshea, C.
    Janjua, M.
    McDonald, T. J.
    Sebastian, S.
    Alexander, J. L.
    Constable, L.
    Lee, J. C.
    Murray, C. D.
    Hart, A. L.
    Irving, P. M.
    Jones, G. R.
    Kok, K. B.
    Lamb, C. A.
    Lees, C. W.
    Altmann, D. M.
    Boyton, R. J.
    Goodhand, J. R.
    Powell, N.
    Ahmad, T.
    Date
    2022-03-16
    Journal
    Nature communications
    Type
    Journal Article
    Publisher
    Nature
    DOI
    10.1038/s41467-022-28517-z
    Rights
    © 2022. The Author(s).
    Metadata
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    Abstract
    Anti tumour necrosis factor (anti-TNF) drugs increase the risk of serious respiratory infection and impair protective immunity following pneumococcal and influenza vaccination. Here we report SARS-CoV-2 vaccine-induced immune responses and breakthrough infections in patients with inflammatory bowel disease, who are treated either with the anti-TNF antibody, infliximab, or with vedolizumab targeting a gut-specific anti-integrin that does not impair systemic immunity. Geometric mean [SD] anti-S RBD antibody concentrations are lower and half-lives shorter in patients treated with infliximab than vedolizumab, following two doses of BNT162b2 (566.7 U/mL [6.2] vs 4555.3 U/mL [5.4], p <0.0001; 26.8 days [95% CI 26.2 - 27.5] vs 47.6 days [45.5 - 49.8], p <0.0001); similar results are also observed with ChAdOx1 nCoV-19 vaccination (184.7 U/mL [5.0] vs 784.0 U/mL [3.5], p <0.0001; 35.9 days [34.9 - 36.8] vs 58.0 days [55.0 - 61.3], p value < 0.0001). One fifth of patients fail to mount a T cell response in both treatment groups. Breakthrough SARS-CoV-2 infections are more frequent (5.8% (201/3441) vs 3.9% (66/1682), p = 0.0039) in patients treated with infliximab than vedolizumab, and the risk of breakthrough SARS-CoV-2 infection is predicted by peak anti-S RBD antibody concentration after two vaccine doses. Irrespective of the treatments, higher, more sustained antibody levels are observed in patients with a history of SARS-CoV-2 infection prior to vaccination. Our results thus suggest that adapted vaccination schedules may be required to induce immunity in at-risk, anti-TNF-treated patients.
    Citation
    Nat Commun. 2022 Mar 16;13(1):1379. doi: 10.1038/s41467-022-28517-z.
    Publisher URL
    https://doi.org/10.1038/s41467-022-28517-z
    Note
    This article is freely available online. Click on the 'Additional Link' above to access the full-text via the publisher's site.
    Collections
    • 2022 RD&E publications
    • COVID-19
    • Gastroenterology

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