Longitudinal T-Cell Responses After a Third SARS-CoV-2 Vaccination in Patients With Multiple Sclerosis on Ocrelizumab or Fingolimod.

Neurol Neuroimmunol Neuroinflamm

From the Department of Immunopathology (V.P.C., L.Y.L.K., M.D., V.A.L.K., N.J.M.V., M.S., T.R., G.W., S.M.v.H., A.t.B.), Sanquin Research and Landsteiner Laboratory, Amsterdam UMC; Department of Neurology and Neurophysiology (L.K., L.W., K.P.J.v.D., E.W.S., F.E.), Amsterdam Neuroscience, Amsterdam UMC, location AMC, University of Amsterdam; Department of Hematopoiesis (R.R.H., C.E.v.d.S.), Sanquin Research and Landsteiner Laboratory, Amsterdam UMC; Department of Experimental Immunohematology (R.R.H.), Sanquin Research and Landsteiner Laboratory, Amsterdam, the Netherlands; Department of Microbiology and Immunology (C.E.v.d.S.), University of Melbourne, Peter Doherty Institute for Infection and Immunity, Victoria, Australia; Amsterdam Rheumatology and Immunology Center (L.B., G.W.), location Reade, Department of Rheumatology; Amsterdam Rheumatology and Immunology Center (S.W.T.), Amsterdam UMC, Department of Rheumatology and Clinical Immunology, University of Amsterdam; Department of Neurology (J.K., Z.L.E.v.K.), Amsterdam UMC, Vrije Universiteit; Department 32 of Pediatric Immunology (T.W.K.), Rheumatology and Infectious Disease, Amsterdam UMC, location AMC, University of Amsterdam; and Swammerdam Institute for Life Sciences (S.M.v.H.), University of Amsterdam, the Netherlands.

Published: July 2022

Objectives: To evaluate whether a third vaccination shows an added effect on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) T-cell responses in patients with multiple sclerosis treated with ocrelizumab or fingolimod.

Methods: This is a substudy of a prospective multicenter study on SARS-CoV-2 vaccination in patients with immune-mediated diseases. Patients with MS treated with ocrelizumab, fingolimod, and no disease-modifying therapies and healthy controls were included. The number of interferon (IFN)-γ secreting SARS-CoV-2-specific T cells at multiple time points before and after 3 SARS-CoV-2 vaccinations were evaluated.

Results: In ocrelizumab-treated patients (N = 24), IFN-γ-producing SARS-CoV-2-specific T-cell responses were induced after 2 vaccinations with median levels comparable to healthy controls (N = 12) and patients with MS without disease-modifying therapies (N = 10). A third vaccination in ocrelizumab-treated patients (N = 8) boosted T-cell responses that had declined after the second vaccination, but did not lead to higher overall T-cell responses as compared to immediately after a second vaccination. In fingolimod-treated patients, no SARS-CoV-2-specific T cells were detected after second (N = 12) and third (N = 9) vaccinations.

Discussion: In ocrelizumab-treated patients with MS, a third SARS-CoV-2 vaccination had no additive effect on the maximal T-cell response but did induce a boost response. In fingolimod-treated patients, no T-cell responses could be detected following both a second and third SARS-CoV-2 vaccination.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9082763PMC
http://dx.doi.org/10.1212/NXI.0000000000001178DOI Listing

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