Preserved T cell responses to SARS-CoV-2 in anti-CD20 treated multiple sclerosis.
Schmidt, Felix A
MetadataShow full item record
Schwarz, T., Otto, C., Jones, T. C., Pache, F., Schindler, P., Niederschweiberer, M., Schmidt, F. A., et al. (2022). Preserved T cell responses to SARS-CoV-2 in anti-CD20 treated multiple sclerosis.. Mult Scler, 28 (7. ARTN 13524585221094478), 1041-1050. https://doi.org/10.1177/13524585221094478
BACKGROUND: Optimal management of anti-CD20-treated patients with multiple sclerosis (pwMS) is an important clinical task during the current severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic. OBJECTIVES: To characterize humoral and cellular immune responses to SARS-CoV-2 vaccinations/infections in a longitudinal cohort of anti-CD20 treated (n = 175) and anti-CD20 therapy-naïve (n = 41) pwMS. METHODS: Anti-SARS-CoV-2 spike protein immunoglobulin G (IgG) and IgA, virus neutralizing capacity, IgG avidity and SARS-CoV-2-specific T cells were determined. RESULTS: Following two SARS-CoV-2 vaccinations, not only SARS-CoV-2 spike protein IgG and IgA, but also neutralizing capacity and avidity of SARS-CoV-2 IgG were lower in anti-CD20-treated (n = 51) than in anti-CD20 therapy-naïve pwMS (n = 14) and in healthy controls (HC, n = 19). However, in all anti-CD20-treated pwMS vaccinated twice (n = 26) or infected with SARS-CoV-2 (n = 2), in whom SARS-CoV-2-specific T cells were measured, SARS-CoV-2-specific T cells were detectable, at levels similar to those of twice-vaccinated anti-CD20 therapy-naïve pwMS (n = 7) and HC (n = 19). SARS-CoV-2-S1 IgG levels (r = 0.42, p = 0.002), antibody avidity (r = 0.7, p < 0.001), and neutralizing capacity (r = 0.44, p = 0.03) increased with time between anti-CD20 infusion and second vaccination. Based on detection of SARS-CoV-2 antibodies, SARS-CoV-2 infections occurred in 4 out of 175 (2.3%) anti-CD20-treated pwMS, all of whom recovered fully. CONCLUSIONS: These findings should inform treatment decisions and SARS-CoV-2 vaccination management in pwMS.
Multiple sclerosis, SARS-CoV-2, T cells, anti-CD20 therapy, antibodies, vaccination, Antibodies, Viral, COVID-19, COVID-19 Vaccines, Humans, Immunoglobulin A, Immunoglobulin G, Multiple Sclerosis, SARS-CoV-2, Spike Glycoprotein, Coronavirus, T-Lymphocytes, Vaccination
External DOI: https://doi.org/10.1177/13524585221094478
This record's URL: https://www.repository.cam.ac.uk/handle/1810/338365
Attribution-NonCommercial 4.0 International
Licence URL: https://creativecommons.org/licenses/by-nc/4.0/