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Sallegger C, Hodl I, Dreo B, Ihm VL, Thiel J, Stradner M, Fessler J, Consortium C. POS1265 DISTURBED CELLULAR IMMUNITY FOLLOWING mRNA VACCINATION AGAINST COVID-19 IN PATIENTS WITH B-CELL DEPLETING THERAPY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundImmunocompromised patients are considered high-risk and prioritized for vaccination against COVID-19 (1). Furthermore, vaccination-induced CD4 and CD8 T-cell responses have been suggested to have a protective role in COVID-19 (2). If T-cell responses are diminished after vaccination in immunocompromised individuals is not known to date.ObjectivesTo investigate cellular immunity following mRNA vaccination against COVID-19 in healthy individuals and patients undergoing B-cell depletion therapy.MethodsIn this interim analysis of the CoVVac study (NCT04858607), we analyzed T-cell responses in autoimmune patients treated with B-cell depleting therapy (BD, n=41) and age-matched healthy controls (HCs, n=50) 3-4 weeks after the second dose of mRNA vaccination against COVID-19. Therefore, we isolated PBMCs and stimulated them with a peptide pool covering the spike protein in vitro. Reactive CD4 and CD8 T-cells were determined by staining for IFNg, TNFa, IL-2 and GzmB by flow cytometry. Anti-SARS-CoV-2 antibody assays targeting the receptor-binding domain (RBD) or trimeric S protein (TSP) were performed to elucidate concomitant B-cell responses.ResultsWe observed significant alterations in anti-SARS-CoV-2 antibody responses in our cohort, the frequency of IFNg+ and IL-2+ CD4 and CD8 T-cells was similar in BD patients and controls. On the other hand, TNFa+ CD4 T-cells were significantly enriched in healthy controls versus BD patients (p=0.017) and correlated significantly with antibody titres (p=0.003). Similarly, GzmB+ CD8 T-cells were significantly diminished in our patient cohort (p<0.001) and also showed a significant correlation with antibody titres (p<0.001). Overall, the frequency of GzmB+ CD8 T-cells correlated very well with reactivity of T-cell subsets for other cytokines. This effect, however, is lost in the BD cohort. No difference was observed in the frequency of TNFa+ CD8 T-cells between the groups.Only 21 (42%) healthy individuals and 14 (34%) patients showed reactive T-cells for all the cytokines tested. This observation is mainly explained by a lack of cytokine production of CD8 T-cells in 26 (52%) HCs and 27 (66%) BD patients. In turn, 22 (44%) HCs and 17 (42%) patients didn’t show any IL-2 producing CD8 cells. Of note, only 2 (4%) of HCs showed no GzmB+ CD8 T-cells whereas the number increased to 15 (37%) of BD individuals (p<0.001). In contrast, 42 (84%) HCs as well as 32 (78%) of patients showed production of all IFNg, TNFa and IL-2 in CD4 T-cells.ConclusionOur data suggest that most patients with B-cell depleting therapy are able to mount T-cell responses similar to those of healthy individuals while a minority of these patients did not show complete immunity against SARS CoV-2. Further analyses are needed to better understand a possible link of B-cell depletion therapy and CD8 T-cell responses.References[1]Shields AM, Burns SO, Savic S, Richter AG; UK PIN COVID-19 Consortium. COVID-19 in patients with primary and secondary immunodeficiency: The United Kingdom experience. J Allergy Clin Immunol. 2021 Mar;147(3):870-875.e1.[2]Angyal, A., Longet, S., Chalk, J., 2022. T-cell and antibody responses to first BNT162b2 vaccine dose in previously infected and SARS-CoV-2-naive UK health-care workers: a multicentre prospective cohort study. The Lancet Microbe 3Disclosure of InterestsNone declared
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Appa A, Takahashi S, Rodriguez-Barraquer I, Chamie G, Sawyer A, Consortium CLIAHUB, Duarte E, Hakim J, Turcios K, Vinden J, Janson O, Manglik A, Peluso MJ, Deeks SG, Henrich TJ, Torres L, Rodgers M, Hackett J, Chiu C, Havlir D, Greenhouse B. Universal PCR and antibody testing demonstrate little to no transmission of SARS-CoV-2 in a rural community. medRxiv 2020:2020.08.15.20175786. [PMID: 32839781 PMCID: PMC7444294 DOI: 10.1101/2020.08.15.20175786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND The absence of systematic surveillance for SARS-CoV-2 has curtailed accurate appraisal of transmission intensity. Our objective was to perform case detection of an entire rural community to quantify SARS-CoV-2 transmission using PCR and antibody testing. METHODS We conducted a cross-sectional survey of the prevalence and cumulative incidence of SARS-CoV-2 infection in the rural town of Bolinas, California (population 1,620), four weeks following shelter-in-place orders. Residents and county essential workers were tested between April 20th-24th, 2020. Prevalence by PCR and seroprevalence combining data from two forms of antibody testing were performed in parallel (Abbott ARCHITECT IgG to nucleocapsid protein and in-house IgG ELISA to the receptor binding domain). RESULTS Of 1,891 participants, 1,312 were confirmed Bolinas residents (>80% community ascertainment). Zero participants were PCR positive. Assuming 80% sensitivity, it would have been unlikely to observe these results (p<0.05) if there were >3 active infections in the community. Based on antibody results, estimated prevalence of prior infection was 0.16% (95% CrI: 0.02%, 0.46%). Seroprevalence estimates using only one of the two tests would have been higher, with greater uncertainty. The positive predictive value (PPV) of a positive result on both tests was 99.11% (95% CrI: 95.75%, 99.94%), compared to PPV 44.19%-63.32% (95% CrI range 3.25%-98.64%) if only one test was utilized. CONCLUSIONS Four weeks following shelter-in-place, active and prior SARS-CoV-2 infection in a rural Northern California community was extremely rare. In this low prevalence setting, use of two antibody tests increased the PPV and precision of seroprevalence estimates.
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Affiliation(s)
- Ayesha Appa
- University Of California San Francisco, San Francisco, CA, USA
| | - Saki Takahashi
- University Of California San Francisco, San Francisco, CA, USA
| | | | - Gabriel Chamie
- University Of California San Francisco, San Francisco, CA, USA
| | - Aenor Sawyer
- University Of California San Francisco, San Francisco, CA, USA
| | - CLIAHUB Consortium
- University Of California San Francisco, San Francisco, CA, USA
- Chan Zuckerberg Biohub, San Francisco, CA, USA
| | - Elias Duarte
- University Of California San Francisco, San Francisco, CA, USA
| | - Jill Hakim
- University Of California San Francisco, San Francisco, CA, USA
| | | | - Joanna Vinden
- University of California Berkeley, Berkeley, CA, USA
| | - Owen Janson
- University Of California San Francisco, San Francisco, CA, USA
| | - Aashish Manglik
- University Of California San Francisco, San Francisco, CA, USA
| | | | - Steven G. Deeks
- University Of California San Francisco, San Francisco, CA, USA
| | | | - Leonel Torres
- University Of California San Francisco, San Francisco, CA, USA
| | | | | | - Charles Chiu
- University Of California San Francisco, San Francisco, CA, USA
| | - Diane Havlir
- University Of California San Francisco, San Francisco, CA, USA
| | - Bryan Greenhouse
- University Of California San Francisco, San Francisco, CA, USA
- Chan Zuckerberg Biohub, San Francisco, CA, USA
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