Immunosuppressants in dermatology on vaccine immunogenicity: a prospective cohort study of pemphigus patients in the pandemic
IntroductionBoth cellular and humoral responses are important for vaccine protection, but recommendations on immunosuppressants in dermatology are largely based on pre-pandemic experiences. This study aimed to investigate the impacts of immunosuppressants on humoral and cellular immunogenicity to CO...
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Frontiers Media S.A.
2024-11-01
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| author | Kun-Lin Lu Kun-Lin Lu Kun-Lin Lu Kun-Lin Lu Kun-Lin Lu Hua-En Lee Hua-En Lee Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Rosaline Chung-Yee Hui Rosaline Chung-Yee Hui Ya-Ching Chang Ya-Ching Chang Chun-Wei Lu Chun-Wei Lu Chun-Wei Lu Chun-Wei Lu Chun-Wei Lu Chuang-Wei Wang Chuang-Wei Wang Chuang-Wei Wang Chuang-Wei Wang Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung |
| author_facet | Kun-Lin Lu Kun-Lin Lu Kun-Lin Lu Kun-Lin Lu Kun-Lin Lu Hua-En Lee Hua-En Lee Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Rosaline Chung-Yee Hui Rosaline Chung-Yee Hui Ya-Ching Chang Ya-Ching Chang Chun-Wei Lu Chun-Wei Lu Chun-Wei Lu Chun-Wei Lu Chun-Wei Lu Chuang-Wei Wang Chuang-Wei Wang Chuang-Wei Wang Chuang-Wei Wang Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung |
| author_sort | Kun-Lin Lu |
| collection | DOAJ |
| description | IntroductionBoth cellular and humoral responses are important for vaccine protection, but recommendations on immunosuppressants in dermatology are largely based on pre-pandemic experiences. This study aimed to investigate the impacts of immunosuppressants on humoral and cellular immunogenicity to COVID-19 vaccinations in pemphigus patients.MethodsSARS-CoV-2-naïve pemphigus patients and age-, and sex-matched healthy controls were recruited from multiple tertiary medical centers during 2021-2023. Anti-spike protein-related T-cell responses, antibody titers, and high-parameter cell analysis of the peripheral blood were utilized to investigate the inhibitory effects of immunosuppressants, including rituximab and azathioprine.ResultsA total of 32 patients and 120 healthy controls were enrolled. COVID-19 vaccinations spaced at least six months after the last rituximab infusion did not cause a significant difference in anti-viral T-cell or antibody responses between rituximab-naïve and rituximab-treated patients. All pemphigus patients demonstrated improved antibody responses after the third vaccination and none of them suffered from severe COVID-19 illness. Intriguingly, we found that daily dosages of 100 mg or more of azathioprine were linked to significantly decreased anti-viral T-cell responses induced by the vaccination (mean of fold change [SD]; higher azathioprine dosage = 0.70 [0.61] folds vs. lower azathioprine dosage = 2.11 [1.03] folds; p = 0.044).ConclusionExcept for a subset of patients with unrecovered B-cell deficiency, rituximab infusion with proper scheduling of vaccination preserved better anti-viral T-cell responses and did not lead to hindered antibody responses in pemphigus patients. All pemphigus patients benefited from receiving the third booster regardless of B-cell status. |
| format | Article |
| id | doaj-art-a57b7a458a654d5ea91c0af1ba4a0039 |
| institution | OA Journals |
| issn | 1664-3224 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-a57b7a458a654d5ea91c0af1ba4a00392025-08-20T02:32:48ZengFrontiers Media S.A.Frontiers in Immunology1664-32242024-11-011510.3389/fimmu.2024.15069621506962Immunosuppressants in dermatology on vaccine immunogenicity: a prospective cohort study of pemphigus patients in the pandemicKun-Lin Lu0Kun-Lin Lu1Kun-Lin Lu2Kun-Lin Lu3Kun-Lin Lu4Hua-En Lee5Hua-En Lee6Chun-Bing Chen7Chun-Bing Chen8Chun-Bing Chen9Chun-Bing Chen10Chun-Bing Chen11Chun-Bing Chen12Chun-Bing Chen13Chun-Bing Chen14Chun-Bing Chen15Rosaline Chung-Yee Hui16Rosaline Chung-Yee Hui17Ya-Ching Chang18Ya-Ching Chang19Chun-Wei Lu20Chun-Wei Lu21Chun-Wei Lu22Chun-Wei Lu23Chun-Wei Lu24Chuang-Wei Wang25Chuang-Wei Wang26Chuang-Wei Wang27Chuang-Wei Wang28Wen-Hung Chung29Wen-Hung Chung30Wen-Hung Chung31Wen-Hung Chung32Wen-Hung Chung33Wen-Hung Chung34Wen-Hung Chung35Wen-Hung Chung36Wen-Hung Chung37Wen-Hung Chung38Wen-Hung Chung39Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Keelung, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanChang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, TaiwanDepartment of Dermatology, Xiamen Chang Gung Hospital, Xiamen, ChinaKeelung Chang Gung Memorial Hospital, Keelung, TaiwanDepartment of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Keelung, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Keelung, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanChang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, TaiwanDepartment of Dermatology, Xiamen Chang Gung Hospital, Xiamen, ChinaCancer Vaccine and Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital, Linkou, TaiwanImmune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, TaiwanGraduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, TaiwanWhole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan0School of Medicine, National Tsing Hua University, Hsinchu, TaiwanDepartment of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Keelung, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Keelung, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Keelung, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Dermatology, Xiamen Chang Gung Hospital, Xiamen, ChinaImmune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, TaiwanGraduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Keelung, TaiwanChang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, TaiwanDepartment of Dermatology, Xiamen Chang Gung Hospital, Xiamen, ChinaCancer Vaccine and Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital, Linkou, TaiwanDepartment of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Keelung, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanChang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, TaiwanDepartment of Dermatology, Xiamen Chang Gung Hospital, Xiamen, ChinaCancer Vaccine and Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital, Linkou, TaiwanImmune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, TaiwanWhole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan1Allergology Consortium, Xiamen Chang Gung Hospital, Xiamen, China2Department of Dermatology, Beijing Tsinghua Chang Gung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China3Department of Dermatology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China4Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, TaiwanIntroductionBoth cellular and humoral responses are important for vaccine protection, but recommendations on immunosuppressants in dermatology are largely based on pre-pandemic experiences. This study aimed to investigate the impacts of immunosuppressants on humoral and cellular immunogenicity to COVID-19 vaccinations in pemphigus patients.MethodsSARS-CoV-2-naïve pemphigus patients and age-, and sex-matched healthy controls were recruited from multiple tertiary medical centers during 2021-2023. Anti-spike protein-related T-cell responses, antibody titers, and high-parameter cell analysis of the peripheral blood were utilized to investigate the inhibitory effects of immunosuppressants, including rituximab and azathioprine.ResultsA total of 32 patients and 120 healthy controls were enrolled. COVID-19 vaccinations spaced at least six months after the last rituximab infusion did not cause a significant difference in anti-viral T-cell or antibody responses between rituximab-naïve and rituximab-treated patients. All pemphigus patients demonstrated improved antibody responses after the third vaccination and none of them suffered from severe COVID-19 illness. Intriguingly, we found that daily dosages of 100 mg or more of azathioprine were linked to significantly decreased anti-viral T-cell responses induced by the vaccination (mean of fold change [SD]; higher azathioprine dosage = 0.70 [0.61] folds vs. lower azathioprine dosage = 2.11 [1.03] folds; p = 0.044).ConclusionExcept for a subset of patients with unrecovered B-cell deficiency, rituximab infusion with proper scheduling of vaccination preserved better anti-viral T-cell responses and did not lead to hindered antibody responses in pemphigus patients. All pemphigus patients benefited from receiving the third booster regardless of B-cell status.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1506962/fullvaccine immunogenicityanti-viral humoral immunityanti-viral t-cell responserituximabazathioprinepemphigus vulgaris |
| spellingShingle | Kun-Lin Lu Kun-Lin Lu Kun-Lin Lu Kun-Lin Lu Kun-Lin Lu Hua-En Lee Hua-En Lee Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Chun-Bing Chen Rosaline Chung-Yee Hui Rosaline Chung-Yee Hui Ya-Ching Chang Ya-Ching Chang Chun-Wei Lu Chun-Wei Lu Chun-Wei Lu Chun-Wei Lu Chun-Wei Lu Chuang-Wei Wang Chuang-Wei Wang Chuang-Wei Wang Chuang-Wei Wang Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Wen-Hung Chung Immunosuppressants in dermatology on vaccine immunogenicity: a prospective cohort study of pemphigus patients in the pandemic Frontiers in Immunology vaccine immunogenicity anti-viral humoral immunity anti-viral t-cell response rituximab azathioprine pemphigus vulgaris |
| title | Immunosuppressants in dermatology on vaccine immunogenicity: a prospective cohort study of pemphigus patients in the pandemic |
| title_full | Immunosuppressants in dermatology on vaccine immunogenicity: a prospective cohort study of pemphigus patients in the pandemic |
| title_fullStr | Immunosuppressants in dermatology on vaccine immunogenicity: a prospective cohort study of pemphigus patients in the pandemic |
| title_full_unstemmed | Immunosuppressants in dermatology on vaccine immunogenicity: a prospective cohort study of pemphigus patients in the pandemic |
| title_short | Immunosuppressants in dermatology on vaccine immunogenicity: a prospective cohort study of pemphigus patients in the pandemic |
| title_sort | immunosuppressants in dermatology on vaccine immunogenicity a prospective cohort study of pemphigus patients in the pandemic |
| topic | vaccine immunogenicity anti-viral humoral immunity anti-viral t-cell response rituximab azathioprine pemphigus vulgaris |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1506962/full |
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