Detection of neutralizing anti–severe acute respiratory syndrome coronavirus 2 antibodies in patients with common variable immunodeficiency after immunization with messenger RNA vaccines

Romano, Ciro; Esposito, Sergio; Donnarumma, Giovanna; Marrone, Aldo

doi:10.1016/j.anai.2021.07.026

Cited by 20 publications

(17 citation statements)

References 9 publications

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“…Here, we confirmed our previous data showing low adaptive responses to immunization with the BNT162b2 vaccine in CVID subjects [ 26 ]. Our data contrasted with the high frequency of response reported in small heterogeneous cohorts of immunized PAD patients [ 35 , 36 , 37 , 38 ].…”

Section: Discussioncontrasting

confidence: 99%

B Cell Response Induced by SARS-CoV-2 Infection Is Boosted by the BNT162b2 Vaccine in Primary Antibody Deficiencies

Pulvirenti

Salinas

Milito

et al. 2021

Cells

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Background: Patients with primary antibody deficiencies are at risk in the current COVID-19 pandemic due to their impaired response to infection and vaccination. Specifically, patients with common variable immunodeficiency (CVID) generated poor spike-specific antibody and T cell responses after immunization. Methods: Thirty-four CVID convalescent patients after SARS-CoV-2 infection, 38 CVID patients immunized with two doses of the BNT162b2 vaccine, and 20 SARS-CoV-2 CVID convalescents later and immunized with BNT162b2 were analyzed for the anti-spike IgG production and the generation of spike-specific memory B cells and T cells. Results: Spike-specific IgG was induced more frequently after infection than after vaccination (82% vs. 34%). The antibody response was boosted in convalescents by vaccination. Although immunized patients generated atypical memory B cells possibly by extra-follicular or incomplete germinal center reactions, convalescents responded to infection by generating spike-specific memory B cells that were improved by the subsequent immunization. Poor spike-specific T cell responses were measured independently from the immunological challenge. Conclusions: SARS-CoV-2 infection primed a more efficient classical memory B cell response, whereas the BNT162b2 vaccine induced non-canonical B cell responses in CVID. Natural infection responses were boosted by subsequent immunization, suggesting the possibility to further stimulate the immune response by additional vaccine doses in CVID.

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Section: Discussioncontrasting

confidence: 99%

B Cell Response Induced by SARS-CoV-2 Infection Is Boosted by the BNT162b2 Vaccine in Primary Antibody Deficiencies

Pulvirenti

Salinas

Milito

et al. 2021

Cells

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“…Similarly, in the paper from Romano et al, 4 CVID patients developed neutralizing antibodies against SARS-CoV-2. The only patient who failed to have a substantial rise in post vaccination titers had a marked decrease in the frequency of circulating B cells ( 25 ). In a recent paper, a high percentage of fully immunized CVID patients developed anti-Spike IgG, at significantly lower levels than in the healthy control group ( 26 ).…”

Section: Insight On Sars-cov-2mentioning

confidence: 99%

The Immune Response to SARS-CoV-2 Vaccination: Insights Learned From Adult Patients With Common Variable Immune Deficiency

2022

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CVID patients have an increased susceptibility to vaccine-preventable infections. The question on the potential benefits of immunization of CVID patients against SARS-CoV-2 offered the possibility to analyze the defective mechanisms of immune responses to a novel antigen. In CVID, as in immunocompetent subjects, the role of B and T cells is different between infected and vaccinated individuals. Upon vaccination, variable anti-Spike IgG responses have been found in different CVID cohorts. Immunization with two doses of mRNA vaccine did not generate Spike-specific classical memory B cells (MBCs) but atypical memory B cells (ATM) with low binding capacity to Spike protein. Spike-specific T-cells responses were also induced in CVID patients with a variable frequency, differently from specific T cells produced after multiple exposures to viral antigens following influenza virus immunization and infection. The immune response elicited by SARS-CoV-2 infection was enhanced by subsequent immunization underlying the need to immunize convalescent COVID-19 CVID patients after recovery. In particular, immunization after SARS-Cov-2 infection generated Spike-specific classical memory B cells (MBCs) with low binding capacity to Spike protein and Spike-specific antibodies in a high percentage of CVID patients. The search for a strategy to elicit an adequate immune response post-vaccination in CVID patients is necessary. Since reinfection with SARS-CoV-2 has been documented, at present SARS-CoV-2 positive CVID patients might benefit from new preventing strategy based on administration of anti-SARS-CoV-2 monoclonal antibodies.

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“…We understand the concerns expressed by Drs Mungmunpuntipantip and Wiwanitkit regarding the efficacy and safety of messenger (m)RNA vaccines in patients with common variable immunodeficiency (CVID); however, we still strongly stick to the conclusions expressed in our report. 1 With regard to efficacy, the aim of our study was to evaluate whether patients with CVID could generate neutralizing antibodies against severe acute respiratory syndrome coronavirus 2, and all but 1 actually did. 1 Clearly, as already mentioned in the article, evaluation of the clinical significance of these antibodies (ie, protection against severe manifestations of coronavirus disease 2019 [COVID-19] and death) requires further studies.…”

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confidence: 99%

“… 1 With regard to efficacy, the aim of our study was to evaluate whether patients with CVID could generate neutralizing antibodies against severe acute respiratory syndrome coronavirus 2, and all but 1 actually did. 1 Clearly, as already mentioned in the article, evaluation of the clinical significance of these antibodies (ie, protection against severe manifestations of coronavirus disease 2019 [COVID-19] and death) requires further studies. 1 Nevertheless, it should not be overlooked that vaccine-induced cell-mediated immunity may as well contribute to vaccination efficacy.…”

mentioning

confidence: 99%

“… 1 Clearly, as already mentioned in the article, evaluation of the clinical significance of these antibodies (ie, protection against severe manifestations of coronavirus disease 2019 [COVID-19] and death) requires further studies. 1 Nevertheless, it should not be overlooked that vaccine-induced cell-mediated immunity may as well contribute to vaccination efficacy. 2 Therefore, prediction of vaccination efficacy should not be solely anticipated on the basis of antispike antibody titers.…”

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confidence: 99%

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Romano

Esposito²,

Donnarumma

et al. 2021

Annals of Allergy, Asthma & Immunology

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Detection of neutralizing anti–severe acute respiratory syndrome coronavirus 2 antibodies in patients with common variable immunodeficiency after immunization with messenger RNA vaccines

Cited by 20 publications

References 9 publications

B Cell Response Induced by SARS-CoV-2 Infection Is Boosted by the BNT162b2 Vaccine in Primary Antibody Deficiencies

B Cell Response Induced by SARS-CoV-2 Infection Is Boosted by the BNT162b2 Vaccine in Primary Antibody Deficiencies

The Immune Response to SARS-CoV-2 Vaccination: Insights Learned From Adult Patients With Common Variable Immune Deficiency

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