Waning humoral and cellular immunity after COVID-19 vaccination in patients with psoriasis treated with methotrexate and biologics: a cohort study

被引：4

作者：

Kvist-Hansen, Amanda ^{[1
]}

Perez-Alos, Laura ^{[2
]}

Al-Sofi, Rownaq Fares ^{[1
]}

Heftdal, Line Dam ^{[3
,4
]}

Hamm, Sebastian Rask ^{[3
]}

Moller, Dina Leth ^{[3
]}

Pries-Heje, Mia Marie ^{[5
]}

Fogh, Kamille ^{[5
,6
]}

Hansen, Cecilie Bo

Hasselbalch, Rasmus Bo ^{[5
,6
]}

Madsen, Johannes Roth ^{[2
]}

Armenteros, Jose Juan Almagro ^{[7
]}

Frikke-Schmidt, Ruth ^{[8
,9
]}

Hilsted, Linda ^{[8
]}

Sorensen, Erik ^{[10
]}

Ostrowski, Sisse Rye ^{[9
,10
]}

Bundgaard, Henning ^{[5
,9
]}

Nielsen, Susanne Dam ^{[3
,9
]}

Iversen, Kasper ^{[5
,9
,11
]}

Zachariae, Claus ^{[1
,9
]}

Garred, Peter ^{[2
,9
]}

Skov, Lone ^{[1
,9
]}

机构：

[1] Copenhagen Univ Hosp, Herlev & Gentofte Hosp, Dept Dermatol & Allergy, Copenhagen, Denmark

[2] Copenhagen Univ Hosp, Dept Clin Immunol, Lab Mol Med, Rigshosp, Sect 7631, Copenhagen, Denmark

[3] Copenhagen Univ Hosp, Dept Infect Dis, Viro Immunol Res Unit, Rigshosp, Copenhagen, Denmark

[4] Copenhagen Univ Hosp, Dept Hematol, Rigshosp, Copenhagen, Denmark

[5] Copenhagen Univ Hosp, Dept Cardiol, Rigshosp, Copenhagen, Denmark

[6] Copenhagen Univ Hosp, Dept Cardiol, Herlev & Gentofte Hosp, Copenhagen, Denmark

[7] Stanford Univ, Dept Genet, Sch Med, Stanford, CA 94305 USA

[8] Copenhagen Univ Hosp, Dept Clin Biochem, Rigshosp, Copenhagen, Denmark

[9] Univ Copenhagen, Fac Hlth & Med Sci, Dept Clin Med, Copenhagen, Denmark

[10] Copenhagen Univ Hosp, Dept Clin Immunol, Rigshosp, Sect 2034, Copenhagen, Denmark

[11] Copenhagen Univ Hosp, Herlev & Gentofte Hosp, Dept Emergency Med, Copenhagen, Denmark

来源：

BRITISH JOURNAL OF DERMATOLOGY | 2023年 / 188卷 / 05期

关键词：

BNT162B2;

D O I：

10.1093/bjd/ljad023

中图分类号：

R75 [皮肤病学与性病学];

学科分类号：

100206 ;

摘要：

This study investigated long-term immunity after mRNA-based COVID-19 vaccination in patients with psoriasis receiving methotrexate or biologics. Markers of immunity included SARS-CoV-2 spike glycoprotein-specific IgG and IgA, neutralizing capacity, and interferon-gamma release from T cells stimulated with peptides of the SARS-CoV-2 spike glycoprotein. At 6 months after vaccination patients receiving anti-TNF agents had a faster waning of humoral and cellular markers compared with controls. Background mRNA-based COVID-19 vaccines have short- and long-term efficacy in healthy individuals, but their efficacy in patients with psoriasis receiving immunomodulatory therapy is less studied. Objectives To investigate long-term immunity after COVID-19 vaccination in patients with psoriasis receiving immunomodulatory therapy. Methods A prospective cohort study including patients (n = 123) with psoriasis receiving methotrexate (MTX) or biologics and controls (n = 226). Only mRNA-based COVID-19 vaccines administered with standard intervals between doses were investigated. Markers of immunity included SARS-CoV-2 spike glycoprotein-specific IgG and IgA, neutralizing capacity, and interferon-gamma release from T cells stimulated with peptides of the SARS-CoV-2 spike glycoprotein. Results The proportion of IgG responders was lower 6 months after vaccination in patients receiving anti-tumour necrosis factor (TNF) treatment compared with controls. Anti-TNF treatment was associated with lower IgG levels (beta = -0.82, 95% confidence interval -1.38 to -0.25; P = 0.001). The median neutralizing index was lower in the anti-TNF group [50% inhibition (interquartile range [IQR] 37-89)] compared with controls [98% inhibition (IQR 96-99)]; P < 0.001. Cellular responses were numerically lowest in the anti-TNF group. Conclusions Treatment with anti-TNF has an impact on the immunity elicited by mRNA-based COVID-19 vaccination in patients with psoriasis, resulting in a faster waning of humoral and cellular markers of immunity; however, the clinical implications are unknown.

引用

页码：661 / 669

页数：9

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