Analysis of the humoral and cellular response after <i>the third</i><scp>COVID</scp>‐19 vaccination in patients with autoimmune hepatitis

Hartl, Johannes; Ruether, Darius Ferenc; Duengelhoef, Paul Maria; Brehm, Thomas Theo; Steinmann, Silja; Weltzsch, Jan Philipp; Glaser, Fabian; Sterneck, Martina; Sebode, Marcial; Weiler‐Normann, Christina; Lütgehetmann, Marc; Schaub, Golda M.; Haag, Friedrich; Schramm, Christoph; Wiesch, Julian Schulze zur; Lohse, Ansgar W.

doi:10.1111/liv.15368

Cited by 13 publications

(12 citation statements)

References 20 publications

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“…Compared to the antibody level of primary immunity, the median level of nCoV NTAb and nCoV S-RBD was increased by 5.26- and 8.03-fold, respectively. Consistent with the literature [25] , patients with CLD improve the humoral immune response after completing booster immunity, and the antibody level of patients with autoimmune hepatitis negative for nCoV S-RBD was increased by 148-fold [25] . Booster immunity prompted an immune response in liver transplant patients negative for nCoV S-RBD [23] .…”

Section: Discussionsupporting

confidence: 85%

Immune response of primary and booster immunity of SARS-CoV-2 vaccination among patients with chronic liver disease

Ruixin

Yang

Wang

et al. 2022

Preprint

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Aim: The present study discussed the humoral immune response and antibody dynamics after primary and booster immunity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines among patients with chronic liver disease (CLD) in the real world. Thus, it provided data to develop SARS-CoV-2 vaccination strategy. Methods: Patients with confirmed CLD and completed primary or booster immunity of SARS-CoV-2 vaccines were enrolled. Serological specimens were collected after primary or booster immunity of SARS-CoV-2 vaccines to detect novel coronavirus neutralizing antibody (nCoV NTAb) and novel coronavirus spike receptor-binding domain antibody (nCoV S-RBD). Thus, we could evaluate the humoral immune response and antibody dynamics after primary and booster immunity of SARS-CoV-2 vaccines among patients with CLD. Simultaneously, baseline demographics, liver disease-related situations, comorbidity-related situations, SARS-CoV-2 vaccination information, and laboratory examination-related indicators of patients were collected. Results: A total of 315 patients received SARS-CoV-2 vaccines, including 223 patients who completed the primary immunity of SARS-CoV-2 vaccines, 114 patients who completed booster immunity of SARS-CoV-2 vaccines, and 22 patients who underwent the antibody detection of SARS-CoV-2 vaccines after both primary and booster immunities. The positive rate of nCoV NTAb was 59.64% in Primary and 87.72% in Booster (P<0.001). The median level of nCoV NTAb was 11.53 AU/mL in Primary and 31.98 AU/mL in Booster (P<0.001). The positive rate of nCoV S-RBD was 69.06% in Primary and 91.23% in Booster (P<0.001). The median level of nCoV S-RBD was 21.60AU/mL in Primary and 112.65 AU/mL in Booster (P<0.001). After booster immunity of SARS-CoV-2 vaccines in 22 patients, the positive rate of nCoV NTAb increased from 59.09% to 86.36%, and that of nCoV S-RBD increased from 68.18% to 90.91%. The median level of nCoV NTAb increased from 11.24 AU /mL to 59.14 AU /mL after booster immunity. The median level of nCoV S-RBD increased from 27.28 AU/mL to 219.10 AU/mL. Compared to the antibody level of primary immunity, the median level of nCoV NTAb and nCoV S-RBD in 22 patients was increased by 5.26 and 8.03 times, respectively. Among 22 patients, 9 were negative for nCoV NTAb after primary immunity, while 6 were transformed positive after booster immunity, and the positive conversion rate of nCoV NTAb was 66.7%. On the other hand, 7 patients were negative for nCoV S-RBD after primary immunity, while 5 were transformed positive after booster immunity, and the positive conversion rate of nCoV S-RBD was 71.4%. Conclusion: Patients with CLD show improved humoral immune response after completing primary and booster immunity of SARS-CoV-2 vaccines, while booster immunity further improves the positive rate and antibody level of patients with CLD. Finally, the positive conversion rate among patients with primary immunity failure also can be improved after booster immunity. Keywords: immune response; primary and booster immunity; SARS-CoV-2 vaccination; chronic liver disease

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Section: Discussionsupporting

confidence: 85%

Immune response of primary and booster immunity of SARS-CoV-2 vaccination among patients with chronic liver disease

Ruixin

Yang

Wang

et al. 2022

Preprint

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“…Seroconversion was achieved in all AIH patients and antibody levels were significantly increased, especially in those with low antibody titres after the second vaccine dose, but titres were still lower compared with healthy controls132 (figure 4A). However, the magnitude of spike-specific T cells did not increase compared with the second vaccine dose132 (figure 4A). Thus, these data may support the concept of a fourth vaccination in this patient population, as the booster vaccination significantly improved at least the antibody response in those patients with a weak immune response prior to the booster vaccination.…”

Section: Sars-cov-2 and The Adaptive Immune Responsementioning

confidence: 95%

“…Indeed, Hartl et al investigated the influence of a third mRNA-based or vector-based COVID-19 vaccination on the adaptive immune response in 81 AIH patients 132. Seroconversion was achieved in all AIH patients and antibody levels were significantly increased, especially in those with low antibody titres after the second vaccine dose, but titres were still lower compared with healthy controls132 (figure 4A). However, the magnitude of spike-specific T cells did not increase compared with the second vaccine dose132 (figure 4A).…”

Section: Sars-cov-2 and The Adaptive Immune Responsementioning

confidence: 99%

SARS-CoV-2 and the liver: clinical and immunological features in chronic liver disease

Luxenburger

Thimme

2023

Gut

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SARS-CoV-2 infection may affect the liver in healthy individuals but also influences the course of COVID-19 in patients with chronic liver disease (CLD). As described in healthy individuals, a strong SARS-CoV-2-specific adaptive immune response is important for the outcome of COVID-19, however, knowledge on the adaptive immune response in CLD is limited.Here, we review the clinical and immunological features of SARS-CoV-2 infection in individuals with CLD. Acute liver injury occurs in many cases of SARS-CoV-2 infection and may be induced by multiple factors, such as cytokines, direct viral infection or toxic effects of COVID-19 drugs. In individuals with CLD, SARS-CoV-2 infection may have a more severe course and promote decompensation and particularly in patients with cirrhosis. Compared with healthy individuals, the SARS-CoV-2-specific adaptive immune responses is impaired in patients with CLD after both, natural infection and vaccination but improves at least partially after booster vaccination.Following SARS-CoV-2 vaccination, rare cases of acute vaccine-induced liver injury and the development of autoimmune-like hepatitis have been reported. However, the concomitant elevation of liver enzymes is reversible under steroid treatment.

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“…Davidov et al assessed immune responses in liver transplant recipients before and after the third dose of the BNT162b2mRNA vaccine and found that enhanced vaccination significantly increased the humoral immune response rate (56% vs. 98%) and the level of anti-S-RBD IgG and neutralizing antibodies [18] . Another study by Hartl et al confirmed a significant increase in the median S-RBD antibody levels in patients with autoimmune hepatitis (AIH) after the third COVID-19 vaccination [19] . However, these studies only included patients with liver transplantation and AIH, excluding patients with CLD, especially cirrhosis.…”

Section: Discussionmentioning

confidence: 89%

“…98%) and the level of anti-S-RBD IgG and neutralizing antibodies [18] . Another study by Hartl et al confirmed a significant increase in the median S-RBD antibody levels in patients with autoimmune hepatitis (AIH) after the third COVID-19 vaccination [19] . However, these studies only included patients with liver transplantation and AIH, excluding patients with CLD, especially cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

Safety and Immunogenicity of a Booster SARS-Cov-2 Vaccination in Patients with Chronic Liver Disease

Chen

Sun

et al. 2022

Preprint

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This article is aim to investigate the safety and immunogenicity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine booster in patients with chronic liver disease（CLD）. A total of 114 patients with CLD who received a SARS-CoV-2 vaccine booster were enrolled in this study. Serum samples were collected from enrolled patients at least 14 days after the booster dose and tested for SARS-CoV-2 neutralizing antibody (novel coronavirus neutralizing antibody, nCoV NTAb) and IgG antibody against SARS-CoV-2 spike binding domain（novel coronavirus spike receptor-binding domain antibody，nCoV S-RBD antibody）levels. The positive rates of nCoV NTAb and nCoV S-RBD in patients with CLD were 87.72% and 91.23%, respectively, after the booster injection of coronavirus disease 2019 (COVID-19) vaccine. The booster injection resulted in the production of nCov NTAb in 66.7% of patients and nCov-SRBD antibody in 71.43% of patients with CLD who failed basic immunization. After basic SARS-CoV-2 immunization, the booster SARS-CoV2 vaccine increased the serum conversion rate and the level of nCov NTAb and nCov-SRBD antibodies in patients with CLD (including patients with cirrhosis). The severity of the liver disease is related to the immune response to COVID-19 vaccine.

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Analysis of the humoral and cellular response after the thirdCOVID‐19 vaccination in patients with autoimmune hepatitis

Cited by 13 publications

References 20 publications

Immune response of primary and booster immunity of SARS-CoV-2 vaccination among patients with chronic liver disease

Immune response of primary and booster immunity of SARS-CoV-2 vaccination among patients with chronic liver disease

SARS-CoV-2 and the liver: clinical and immunological features in chronic liver disease

Safety and Immunogenicity of a Booster SARS-Cov-2 Vaccination in Patients with Chronic Liver Disease

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