Is humoral and cellular response to SARS-CoV-2 vaccine modified by DMT in patients with multiple sclerosis and other autoimmune diseases?

Abstract

Background: The effect of disease-modifying therapies on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine response is unclear. Objectives: We aim to determine the immunological responses to SARS-CoV-2 in multiple sclerosis (MS) and anti-CD20-treated patients with other autoimmune diseases (AID). Methods: Humoral and cellular responses we determined before and 30-90 days after vaccination in patients with MS and anti-CD20-treated patients with other AID in two Catalan centers. Results: 457 patients were enrolled. Findings showed that humoral response decreased under anti-CD20s or sphingosine 1-phosphate receptor modulators (S1PRM) and with longer treatment duration and increased after 4.5 months from the last anti-CD20 infusion. Cellular response decreased in S1PRM-treated. Patients on anti-CD20 can present cellular responses even in the absence of antibodies. Conclusion: Anti-CD20s and S1PRM modify the immunological responses to SARS-CoV-2 vaccines.

Two years of COVID-19 in the MS community: What have we learnt so far?

“…As MS is an immune-mediated disease and DMTs alter or suppress the immune system in different ways, many recent studies have focused on the immunological responses after SARS-CoV-2 infection or vaccination. Overall, most pwMS present an immunological response after SARS-CoV-2 infection (humoral response: 76.8%-83.4%; cellular response: 59.5%) [11][12][13] or vaccination (humoral response: 74.4%-86.8%; cellular response: 62%-84.4%) [14][15][16][17] regardless of their treatment. However, it is clear by now that anti-CD20 therapies and sphingosine-1-phosphate receptor modulator (SP1RM) therapies decrease these responses.…”

“…However, it is clear by now that anti-CD20 therapies and sphingosine-1-phosphate receptor modulator (SP1RM) therapies decrease these responses. 11,[15][16][17][18] Anti-CD20 therapies impair memory B-cell production, leading to a blunted humoral response. In the study of Sormani et al, an SARS-CoV-2 serological response, after COVID-19, was observed in only 44.6% of patients on anti-CD20 therapies compared with 78.7% of the rest of patients.…”

“…11 Similar seroconversion rates are seen after vaccination (40.0%-50.0%). 15,17,18 In these patients, seroconversion is highly predicted by B-cell count and time elapsed since last infusion. 14,17,18 Despite the reduction of seroconversion, it remains a robust T-cell response after both infection (66.7%) 13 and vaccination (86.4%-92%).…”

“…15,17,18 In these patients, seroconversion is highly predicted by B-cell count and time elapsed since last infusion. 14,17,18 Despite the reduction of seroconversion, it remains a robust T-cell response after both infection (66.7%) 13 and vaccination (86.4%-92%). 16,17 Therefore, in anti-CD20-treated patients, optimizing the moment of vaccine administration could potentially lead to an increased vaccine response.…”

“…14,17,18 Despite the reduction of seroconversion, it remains a robust T-cell response after both infection (66.7%) 13 and vaccination (86.4%-92%). 16,17 Therefore, in anti-CD20-treated patients, optimizing the moment of vaccine administration could potentially lead to an increased vaccine response. SP1RM therapies prevent lymphocytes from leaving the lymph nodes.…”