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Bitoun S, Henry J, Desjardins D, Vauloup-Fellous C, Dib N, Belkhir R, Mouna L, Joly C, Bitu M, Ly B, Pascaud J, Seror R, Roque Afonso AM, Le Grand R, Mariette X. Rituximab impairs B-cell response but not T-cell response to COVID-19 vaccine in auto-immune diseases. Arthritis Rheumatol 2021; 74:927-933. [PMID: 34962357 PMCID: PMC9011892 DOI: 10.1002/art.42058] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/10/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022]
Abstract
Objective Antibody response to the messenger RNA (mRNA) COVID‐19 vaccine has been shown to be diminished in rituximab (RTX)–treated patients. We undertook this study to compare humoral and T cell responses between healthy controls, patients with autoimmune diseases treated with RTX, and those treated with other immunosuppressants, all of whom had been vaccinated with 2 doses of the mRNA COVID‐19 vaccine. Methods We performed anti‐spike IgG and neutralization assays just before and 28 days after the second BNT162b2 (Pfizer‐BioNTech) vaccine dose. The specific T cell response was assessed in activated CD4 and CD8 T cells using intracellular flow cytometry staining of cytokines (interferon‐γ, tumor necrosis factor, and interleukin‐2) after stimulation with SARS–CoV‐2 spike peptide pools. Results A lower proportion of responders with neutralizing antibodies to the vaccine was observed in the RTX group (29%; n = 24) compared to the other immunosuppressants group (80%; n = 35) (P = 0.0001) and the healthy control group (92%; n = 26) (P < 0.0001). No patients treated with RTX in the last 6 months showed a response. Time since last infusion was the main factor influencing humoral response in RTX‐treated patients. The functional CD4 and CD8 cellular responses to SARS–CoV‐2 peptides for each single cytokine or polyfunctionality were not different in the RTX group compared to the other immunosuppressants group or the control group. In RTX‐treated patients, the T cell response was not different between patients with and those without a humoral response. Conclusion RTX induced a diminished antibody response to the mRNA COVID‐19 vaccine, but the functional T cell response was not altered compared to healthy controls and autoimmune disease patients treated with other immunosuppressants. Further work is needed to assess the clinical protection granted by a functionally active T cell response in the absence of an anti‐spike antibody response.
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Affiliation(s)
- Samuel Bitoun
- Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, FHU CARE, Rheumatology department.,Université Paris-Saclay, Inserm UMR 1184, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | - Julien Henry
- Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, FHU CARE, Rheumatology department
| | - Delphine Desjardins
- Université Paris-Saclay, Inserm UMR 1184, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | | | - Nicolas Dib
- Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, FHU CARE, Rheumatology department
| | - Rakiba Belkhir
- Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, FHU CARE, Rheumatology department
| | - Lina Mouna
- Université Paris Saclay, INSERM U1193, AP-HP, Hôpital Paul Brousse, Virology department
| | - Candie Joly
- Université Paris-Saclay, Inserm UMR 1184, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | - Marie Bitu
- Université Paris-Saclay, Inserm UMR 1184, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | - Bineta Ly
- Université Paris-Saclay, Inserm UMR 1184, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | - Juliette Pascaud
- Université Paris-Saclay, Inserm UMR 1184, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | - Raphaèle Seror
- Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, FHU CARE, Rheumatology department.,Université Paris-Saclay, Inserm UMR 1184, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | | | - Roger Le Grand
- Université Paris-Saclay, Inserm UMR 1184, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | - Xavier Mariette
- Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, FHU CARE, Rheumatology department.,Université Paris-Saclay, Inserm UMR 1184, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
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2
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Bitoun S, Henry J, Vauloup-Fellous C, Dib N, Belkhir R, Mouna L, Joly C, Desjardins D, Bitu M, Le Grand R, Seror R, Roque Afonso AM, Mariette X. Response to COVID-19 mRNA vaccination in multiple myeloma is conserved but impaired compared to controls. J Hematol Oncol 2021; 14:166. [PMID: 34645504 PMCID: PMC8512646 DOI: 10.1186/s13045-021-01183-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/01/2021] [Indexed: 11/10/2022] Open
Abstract
Patients with multiple myeloma are at high risk of severe forms of COVID-19. Despite data showing diminished response to vaccine, the era of highly efficient mRNA vaccine might be a gamechanger. We sought to examine response to mRNA vaccine between healthy controls (n = 28) and multiple myeloma (MM) patients (n = 27). Response was analyzed 1 month after the second dose of anti-SARS-CoV-2 BNT162b2 vaccine. Multiple myeloma patients showed diminished levels of Anti-Spike IgG levels compared to controls, but with a high proportion of patients achieving a humoral response (89% vs. 97% in controls). Neutralizing antibodies were present in 74% of patients versus 96% of controls. Patients under current daratumumab treatment had neutralizing activity of anti-SARS-CoV-2 antibodies. Multiple myeloma patients show diminished response to SARS-COV-2 vaccine but with still high response rate. The main potential risk factor of non-response to COVID-19 vaccine was uncontrolled disease under treatment.
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Affiliation(s)
- Samuel Bitoun
- Rheumatology Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, FHU CARE, 78 Avenue du general Leclerc, 94270, Le Kremlin-Bicêtre, France. .,Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, Le Kremlin-Bicêtre, France.
| | - Julien Henry
- Rheumatology Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, FHU CARE, 78 Avenue du general Leclerc, 94270, Le Kremlin-Bicêtre, France
| | - Christelle Vauloup-Fellous
- Virology Department, Université Paris-Saclay, INSERM U1193, AP-HP, Hôpital Paul Brousse, Villejuif, France
| | - Nicolas Dib
- Rheumatology Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, FHU CARE, 78 Avenue du general Leclerc, 94270, Le Kremlin-Bicêtre, France
| | - Rakiba Belkhir
- Rheumatology Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, FHU CARE, 78 Avenue du general Leclerc, 94270, Le Kremlin-Bicêtre, France
| | - Lina Mouna
- Virology Department, Université Paris-Saclay, INSERM U1193, AP-HP, Hôpital Paul Brousse, Villejuif, France
| | - Candie Joly
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, Le Kremlin-Bicêtre, France
| | - Delphine Desjardins
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, Le Kremlin-Bicêtre, France
| | - Marie Bitu
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, Le Kremlin-Bicêtre, France
| | - Roger Le Grand
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, Le Kremlin-Bicêtre, France
| | - Raphaèle Seror
- Rheumatology Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, FHU CARE, 78 Avenue du general Leclerc, 94270, Le Kremlin-Bicêtre, France.,Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, Le Kremlin-Bicêtre, France
| | - Anne-Marie Roque Afonso
- Virology Department, Université Paris-Saclay, INSERM U1193, AP-HP, Hôpital Paul Brousse, Villejuif, France
| | - Xavier Mariette
- Rheumatology Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, FHU CARE, 78 Avenue du general Leclerc, 94270, Le Kremlin-Bicêtre, France.,Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Inserm, CEA, Fontenay-aux-Roses, Le Kremlin-Bicêtre, France
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Olivo A, Lécuroux C, Bitu M, Avettand-Fenoel V, Boufassa F, Essat A, Meyer L, Doisne JM, Favier B, Vaslin B, Schlecht-Louf G, Noël N, Goujard C, Lambotte O, Bourgeois C. CXCR3 and CXCR5 are highly expressed in HIV-1-specific CD8 central memory T cells from infected patients. Eur J Immunol 2021; 51:2040-2050. [PMID: 33963550 DOI: 10.1002/eji.202048943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 03/17/2021] [Accepted: 05/03/2021] [Indexed: 11/10/2022]
Abstract
New ways of characterizing CD8+ memory T cell responses in chronic infections are based on the measurement of chemokine receptor expression (CXCR3, CXCR5, and CX3CR1). We applied these novel phenotyping strategies to chronic HIV infection by comparing healthy donors (HDs), HIV-infected patients receiving antiretroviral therapy (ART), and spontaneous HIV controllers (HICs). In all groups, the memory cells exhibited high proportion of CXCR3+ cells. Proportions of CXCR5+ and CX3CR1+ cells were preferentially observed among central memory cells (Tcm) and effector memory cells (Tem) respectively. Chronic controlled HIV infection impacted the chemokine receptor profile of both HIV-specific and nonspecific CD8+ T cells. In total CD8+ T cells, the proportions of CXCR3- CXCR5- CX3CR1- Tcm and Tem were lower in HIV-infected patients than in HDs with subtle differences between ART and HICs. Such phenotyping strategy also revealed differences in exhaustion and senescence phenotypes, the CXCR3+ CXCR5+ CX3CR1- being more exhausted and senescent than the CXCR3+ CXCR5- CX3CR1- Tcm fraction. Among HIV-specific CD8+ T cells, the vast majority of Tcm cells were CXCR3+ and CXCR5+ cells in contrast with their nonspecific counterparts. In conclusion, the addition of migration markers contributes to better characterize Tcm/Tem compartment.
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Affiliation(s)
- Anaëlle Olivo
- CEA-Université Paris-Saclay-INSERM U1184, Immunology of Viral Infections, Autoimmune, Hematological and Bacterial diseases, (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, Paris, France
| | - Camille Lécuroux
- CEA-Université Paris-Saclay-INSERM U1184, Immunology of Viral Infections, Autoimmune, Hematological and Bacterial diseases, (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, Paris, France
| | - Marie Bitu
- CEA-Université Paris-Saclay-INSERM U1184, Immunology of Viral Infections, Autoimmune, Hematological and Bacterial diseases, (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, Paris, France
| | - Véronique Avettand-Fenoel
- AP-HP, Laboratoire de Microbiologie Clinique, Hôpital Necker-Enfants Malades, Paris, France.,Université de Paris, Faculté de Médecine, Paris, France.,INSERM U1016, CNRS, UMR8104, Institut Cochin, Paris, France
| | - Faroudy Boufassa
- INSERM CESP U1018, Université Paris-Saclay, Paris, France.,Université Paris-Saclay, Paris, France
| | - Asma Essat
- INSERM CESP U1018, Université Paris-Saclay, Paris, France.,Université Paris-Saclay, Paris, France
| | - Laurence Meyer
- INSERM CESP U1018, Université Paris-Saclay, Paris, France.,Université Paris-Saclay, Paris, France
| | - Jean-Marc Doisne
- INSERM U1223, Innate Immunity Unit, Institut Pasteur, Paris, France
| | - Benoit Favier
- CEA-Université Paris-Saclay-INSERM U1184, Immunology of Viral Infections, Autoimmune, Hematological and Bacterial diseases, (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, Paris, France
| | - Bruno Vaslin
- CEA-Université Paris-Saclay-INSERM U1184, Immunology of Viral Infections, Autoimmune, Hematological and Bacterial diseases, (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, Paris, France
| | - Géraldine Schlecht-Louf
- Université Paris-Saclay, Paris, France.,Université Paris-Saclay, Inserm, Inflammation, Microbiome and Immunosurveillance, 92140, Clamart, France
| | - Nicolas Noël
- CEA-Université Paris-Saclay-INSERM U1184, Immunology of Viral Infections, Autoimmune, Hematological and Bacterial diseases, (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, Paris, France.,Université Paris-Saclay, Paris, France.,Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, Service de Médecine Interne et Immunologie Clinique, Bicêtre, Le Kremlin-Bicêtre, Paris, France
| | - Cécile Goujard
- INSERM CESP U1018, Université Paris-Saclay, Paris, France.,Université Paris-Saclay, Paris, France.,Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, Service de Médecine Interne et Immunologie Clinique, Bicêtre, Le Kremlin-Bicêtre, Paris, France
| | - Olivier Lambotte
- CEA-Université Paris-Saclay-INSERM U1184, Immunology of Viral Infections, Autoimmune, Hematological and Bacterial diseases, (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, Paris, France.,Université Paris-Saclay, Paris, France.,Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, Service de Médecine Interne et Immunologie Clinique, Bicêtre, Le Kremlin-Bicêtre, Paris, France
| | - Christine Bourgeois
- CEA-Université Paris-Saclay-INSERM U1184, Immunology of Viral Infections, Autoimmune, Hematological and Bacterial diseases, (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, Paris, France.,Université Paris-Saclay, Paris, France
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