Booster dose of SARS-CoV-2 messenger RNA vaccines strengthens the specific immune response of patients with rheumatoid arthritis: A prospective multicenter longitudinal study

Int J Infect Dis. 2022 Dec:125:195-208. doi: 10.1016/j.ijid.2022.10.035. Epub 2022 Nov 1.

Abstract

Objectives: To characterize the kinetics of humoral and T-cell responses in rheumatoid arthritis (RA)-patients followed up to 4-6 weeks (T3) after the SARS-CoV-2 vaccine booster dose.

Methods: Health care workers (HCWs, n = 38) and patients with RA (n = 52) completing the messenger RNA vaccination schedule were enrolled at T3. In each cohort, 25 subjects were sampled after 5 weeks (T1) and 6 months (T2) from the first vaccine dose. The humoral response was assessed by measuring anti-receptor-binding domain (RBD) and neutralizing antibodies, the T-cell response by interferon-γ-release assay (IGRA), T cell cytokine production, and B cell phenotype at T3 by flow cytometry.

Results: Patients with RA showed a significant reduction of antibody titers from T1 to T2 and a significant increase at T3. T-cell response by IGRA persisted over time in patients with RA, whereas it increased in HCWs. Most patients with RA scored positive for anti-RBD, neutralizing antibody and T-cell responses, although the magnitude was lower than HCWs. The spike-specific-cytokine response was mainly clusters of differentiation (CD)4+ T cells restricted in both cohorts and significantly lower with reduced interleukin-2 response and CD4-antigen-responding naïve T cells in patients with RA. Unswitched memory B cells were reduced in patients with RA compared with HCWs independently of vaccination.

Conclusion: COVID-19 vaccine booster strengthens the humoral immunity in patients with RA even with a reduced cytokine response.

Keywords: Antibody response; COVID-19 vaccine; Immunosuppressive therapy; Rheumatoid arthritis; SARS-CoV-2; T-cell response.

Publication types

  • Multicenter Study

MeSH terms

  • Antibodies, Neutralizing
  • Antibodies, Viral
  • Arthritis, Rheumatoid*
  • COVID-19 Vaccines
  • COVID-19* / prevention & control
  • Cytokines
  • Humans
  • Immunity, Cellular
  • Immunization, Secondary
  • Longitudinal Studies
  • Prospective Studies
  • RNA, Messenger
  • SARS-CoV-2
  • Vaccination
  • mRNA Vaccines

Substances

  • COVID-19 Vaccines
  • RNA, Messenger
  • Antibodies, Neutralizing
  • Cytokines
  • mRNA Vaccines
  • Antibodies, Viral

Supplementary concepts

  • COVID-19 vaccine booster shot