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  • Asplund Högelin, K.Karolinska Institutet (författare)

B-cell repopulation dynamics and drug pharmacokinetics impact SARS-CoV-2 vaccine efficacy in anti-CD20-treated multiple sclerosis patients

  • Artikel/kapitelEngelska2022

Förlag, utgivningsår, omfång ...

  • 2022-07-20
  • Wiley,2022
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:kth-325694
  • https://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-325694URI
  • https://doi.org/10.1111/ene.15492DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:150242579URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • QC 20230412
  • Background and purpose: Recent findings document a blunted humoral response to SARS-CoV-2 vaccination in patients on anti-CD20 treatment. Although most patients develop a cellular response, it is still important to identify predictors of seroconversion to optimize vaccine responses. Methods: We determined antibody responses after SARS-CoV-2 vaccination in a real-world cohort of multiple sclerosis patients (n = 94) treated with anti-CD20, mainly rituximab, with variable treatment duration (median = 2.9, range = 0.4–9.6 years) and time from last anti-CD20 infusion to vaccination (median = 190, range = 60–1032 days). Results: We find that presence of B cells and/or rituximab in blood predict seroconversion better than time since last infusion. Using multiple logistic regression, presence of >0.5% B cells increased probability of seroconversion with an odds ratio (OR) of 5.0 (95% confidence interval [CI] = 1.0–28.1, p = 0.055), whereas the corresponding OR for ≥6 months since last infusion was 1.45 (95% CI = 0.20–10.15, p = 0.705). In contrast, detectable rituximab levels were negatively associated with seroconversion (OR = 0.05, 95% CI = 0.002–0.392, p = 0.012). Furthermore, naïve and memory IgG+ B cells correlated with antibody levels. Although retreatment with rituximab at 4 weeks or more after booster depleted spike-specific B cells, it did not noticeably affect the rate of decline in antibody titers. Interferon-γ and/or interleukin-13 T-cell responses to the spike S1 domain were observed in most patients, but with no correlation to spike antibody levels. Conclusions: These findings are relevant for providing individualized guidance to patients and planning of vaccination schemes, in turn optimizing benefit–risk with anti-CD20. 

Ämnesord och genrebeteckningar

  • MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Neurologi hsv//swe
  • MEDICAL AND HEALTH SCIENCES Clinical Medicine Neurology hsv//eng
  • B-cell depletion
  • multiple sclerosis
  • rituximab
  • SARS-CoV-2
  • vaccination
  • elasomeran
  • gamma interferon
  • interleukin 13
  • nucleocapsid protein
  • ocrelizumab
  • ofatumumab
  • SARS-CoV-2 vaccine
  • tozinameran
  • adult
  • antibody response
  • antibody titer
  • Article
  • B lymphocyte
  • cohort analysis
  • controlled study
  • demographics
  • female
  • human
  • human cell
  • immunophenotyping
  • limit of detection
  • major clinical study
  • male
  • pre B lymphocyte
  • retreatment
  • seroconversion
  • T lymphocyte subpopulation
  • treatment duration

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Ruffin, N.Karolinska Institutet (författare)
  • Pin, ElisaKTH,Affinitets-proteomik,Science for Life Laboratory, SciLifeLab(Swepub:kth)u1pmjyje (författare)
  • Hober, Sophia,Professor,1965-KTH,Science for Life Laboratory, SciLifeLab,Proteinteknologi(Swepub:kth)u11qqzc1 (författare)
  • Nilsson, PeterKTH,Science for Life Laboratory, SciLifeLab,Affinitets-proteomik(Swepub:kth)u1ws88sk (författare)
  • Starvaggi Cucuzza, C.Karolinska Institutet (författare)
  • Khademi, M.Karolinska Institutet (författare)
  • Olsson, T.Karolinska Institutet (författare)
  • Piehl, F. (författare)
  • Al Nimer, F.Karolinska Institutet (författare)
  • Karolinska InstitutetAffinitets-proteomik (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:European Journal of Neurology: Wiley29:11, s. 3317-33281351-51011468-1331

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