Antibody Response Six Months after SARS-CoV-2 mRNA Vaccination in Patients with Inflammatory Bowel Disease

Frey, Sarah; Chowdhury, Reezwana; Connolly, Cynthia; Werbel, William A; Segev, Dorry L.; Parian, Alyssa; Tsipotis, Evangelos; Dudley-Brown, Sharon; Lazarev, Mark; Melia, Joanna; Truta, Brindusa; Yu, Haibin; Selaru, Florin M.

doi:10.1016/j.cgh.2021.12.045

Cited by 20 publications

(26 citation statements)

References 10 publications

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“…In the present study, IBD patients receiving immunosuppressive therapy had significantly lower S-IgG levels ( p = 0.001) than healthy controls six months after the second vaccination, but independent of individual existing immunosuppressive therapies, our study found no significant differences of S-IgG seroconversion rates in IBD patients (75% vs. 100% in healthy controls) 6 months after vaccination. These data support the findings of Frey et al (2022) [ 32 ], who demonstrated a seroconversion rate (S-IgG) in 78.7% of immunosuppressed IBD patients 6 months after COVID-19 vaccination. Nevertheless, the sVNT assay in our study revealed significantly different seroconversion rates between both groups (45% in IBD patients vs. 100% in healthy controls) and significantly different percentage sVNT inhibition values (sVNT 14% in IBD patients vs. 79% in healthy controls, p = 0.003).…”

Section: Discussionsupporting

confidence: 92%

Impaired Humoral Immunity with Concomitant Preserved T Cell Reactivity in IBD Patients on Treatment with Infliximab 6 Month after Vaccination with the SARS-CoV-2 mRNA Vaccine BNT162b2: A Pilot Study

Vollenberg

Tepasse

Lorentzen

et al. 2022

JPM

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Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic has been caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The most important approach to prevent severe disease progression and to contain the pandemic is the use of COVID-19 vaccines. The aim of this study was to investigate the humoral and cellular response in immunosuppressed patients with inflammatory bowel disease (IBD) on treatment with anti-TNF (infliximab, adalimumab) and anti-α4ß7-Integrin (vedolizumab) 6 months after mRNA vaccination against SARS-CoV-2 compared to healthy subjects. Methods: In this prospective study, 20 IBD patients and 9 healthy controls were included 6 months after the second BNT162b2 vaccination. In addition to quantitative determination of IgG antibody levels against the SARS-CoV-2 receptor-binding domain (RBD) of the spike protein subunit S1, a SARS-CoV-2 surrogate neutralization test (sVNT) was used to assess potential neutralization capacity. SARS-CoV-2-specific T-cell responses were measured using an interferon-γ (IFN-γ) release assay (IGRA; Euroimmun Medical Laboratory Diagnostics, Lübeck, Germany). Results: S-IgG could still be detected in the majority of IBD patients 6 months after second vaccination. Compared to healthy controls, IBD patients treated with anti-TNF agents showed both lower neutralizing activity in sVNT (percent inhibition of ACE2 receptor binding by RBD protein) and lower IgG-S (AU/mL) antibody levels (AB) (sVNT: 79% vs. 2%, p < 0. 001; AB: 1018 AU/mL vs. 141 AU/mL, p = 0.025). In contrast, patients on therapy with vedolizumab showed no impairment in humoral immune response (sVNT, S-IgG) compared with healthy controls. Specific T-cellular reactivity was detected in 73% of IBD patients and in 67% of healthy controls independent of immunosuppressive therapy (anti-TNF., vedolizumab) (p = 0.189). Conclusion: Six months after BNT162b2 vaccination, this study found significantly decreased antibody levels in patients under anti-TNF therapy. IBD patients under anti-TNF and vedolizumab therapy had no impairment of T-cellular reactivity compared to healthy controls at this time point. Further studies with larger collectives for confirmation should follow.

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Section: Discussionsupporting

confidence: 92%

Impaired Humoral Immunity with Concomitant Preserved T Cell Reactivity in IBD Patients on Treatment with Infliximab 6 Month after Vaccination with the SARS-CoV-2 mRNA Vaccine BNT162b2: A Pilot Study

Vollenberg

Tepasse

Lorentzen

et al. 2022

JPM

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“…Subjects receiving anti-TNF preparations had the lowest immune response. These and other similar findings clearly indicate that anti SARS-CoV-2 antibody concentrations despite declining even in healthy subjects, tend be very low after 6 months from the second dose in IBD patients, particularly when they are treated with anti-TNF preparations ( 59 , 60 , 73 ). This means that, even more than in healthy subjects, a booster dose is essential to assure protection against COVID-19 in these patients and long-term efficacy of this dose should be adequately monitored to evidence the need for periodical vaccine administrations.…”

Section: Immune Response Of Patients With Inflammatory Bowel Disease ...supporting

confidence: 75%

“…Regarding response of IBD patients to COVID-19 vaccines, a wider breadth of evidence is available, particularly regarding initial response of patients immunized with two doses of the presently available mRNA vaccines (54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70). Generally, data collected in IBD patients exposed to COVID-19 vaccines resemble those evidenced after SARS-CoV-2 infection.…”

Section: Immune Response Of Patients With Inflammatory Bowel Disease ...mentioning

confidence: 99%

Risks of SARS-CoV-2 Infection and Immune Response to COVID-19 Vaccines in Patients With Inflammatory Bowel Disease: Current Evidence

Esposito

Caminiti

Giordano³

et al. 2022

Front. Immunol.

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Inflammatory bowel diseases (IBD), including Crohn’s disease, ulcerative colitis, and unclassified inflammatory bowel disease, are a group of chronic, immune mediated conditions that are presumed to occur in genetically susceptible individuals because of a dysregulated intestinal immune response to environmental factors. IBD patients can be considered subjects with an aberrant immune response that makes them at increased risk of infections, particularly those due to opportunistic pathogens. In many cases this risk is significantly increased by the therapy they receive. Aim of this narrative review is to describe the impact of SARS-CoV-2 infection and the immunogenicity of COVID-19 vaccines in patients with IBD. Available data indicate that patients with IBD do not have an increased susceptibility to infection with SARS-CoV-2 and that, if infected, in the majority of the cases they must not modify the therapy in place because this does not negatively affect the COVID-19 course. Only corticosteroids should be reduced or suspended due to the risk of causing severe forms. Furthermore, COVID-19 seems to modify the course of IBD mainly due to the impact on intestinal disease of the psychological factors deriving from the measures implemented to deal with the pandemic. The data relating to the immune response induced by SARS-CoV-2 or by COVID-19 vaccines can be considered much less definitive. It seems certain that the immune response to disease and vaccines is not substantially different from that seen in healthy subjects, with the exception of patients treated with anti-tumor necrosis factor alone or in combination with other immunosuppressants who showed a reduced immune response. How much, however, this problem reduces induced protection is not known. Moreover, the impact of SARS-CoV-2 variants on IBD course and immune response to SARS-CoV-2 infection and COVID-19 vaccines has not been studied and deserves attention. Further studies capable of facing and solving unanswered questions are needed in order to adequately protect IBD patients from the risks associated with SARS-CoV-2 infection.

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“… 22 In contrast, it appears that patients with IBD sustain humoral immunity over time, with 1 study showing that all 75 participants, all of whom were on a form of immune-modifying therapy, maintained measurable serum antibody concentrations 6 months after a 2-dose primary series. 23 It is important to note that patients with IBD have higher rates of humoral immune response to COVID-19 vaccines than solid organ transplant recipients or those treated with B cell–depleting therapies, as described above. Previous studies have described a 95% to 99% humoral immune response rate following vaccination with a 2-dose mRNA vaccine series in patients with IBD.…”

Section: Discussionmentioning

confidence: 99%

Humoral Immunogenicity of 3 COVID-19 Messenger RNA Vaccine Doses in Patients With Inflammatory Bowel Disease

Schell

Knutson

Saha

et al. 2022

Inflammatory Bowel Diseases

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Antibody Response Six Months after SARS-CoV-2 mRNA Vaccination in Patients with Inflammatory Bowel Disease

Cited by 20 publications

References 10 publications

Impaired Humoral Immunity with Concomitant Preserved T Cell Reactivity in IBD Patients on Treatment with Infliximab 6 Month after Vaccination with the SARS-CoV-2 mRNA Vaccine BNT162b2: A Pilot Study

Impaired Humoral Immunity with Concomitant Preserved T Cell Reactivity in IBD Patients on Treatment with Infliximab 6 Month after Vaccination with the SARS-CoV-2 mRNA Vaccine BNT162b2: A Pilot Study

Risks of SARS-CoV-2 Infection and Immune Response to COVID-19 Vaccines in Patients With Inflammatory Bowel Disease: Current Evidence

Humoral Immunogenicity of 3 COVID-19 Messenger RNA Vaccine Doses in Patients With Inflammatory Bowel Disease

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