TNF inhibitors affect the induction and maintenance of spike-specific B-cell responses after mRNA vaccination

Objectives Tumour necrosis factor inhibitors (TNFi) are widely used and effective as treatment for immune-mediated inflammatory diseases (IMIDs). However, TNFi therapy causes a faster waning of antibody responses following vaccination. The underlying cause by which TNFi affect humoral immunity remai...

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Main Authors: Sander W Tas, Taco W Kuijpers, Gertjan Wolbink, Theo Rispens, Anja Ten Brinke, Juan J Garcia-Vallejo, S Marieke van Ham, Mark Löwenberg, Luuk Wieske, Laura Boekel, Filip Eftimov, Eileen W Stalman, Maurice Steenhuis, Adriaan G Volkers, Christine Kreher, Lisan H Kuijper, Mariël C Duurland, Laura Fernández Blanco, Amélie Bos, Charlotte Menage, Tineke Jorritsma, Marit J van Gils, Mathieu Claireaux, Geert RAM D’Haens, Laura YL Kummer, Niels JM Verstegen, Veronique AL Konijn, Maryse Tempert, Koos PJ van Dam
Format: Article
Language:English
Published: BMJ Publishing Group 2025-08-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/11/3/e005724.full
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author Sander W Tas
Taco W Kuijpers
Gertjan Wolbink
Theo Rispens
Anja Ten Brinke
Juan J Garcia-Vallejo
S Marieke van Ham
Mark Löwenberg
Luuk Wieske
Laura Boekel
Filip Eftimov
Eileen W Stalman
Maurice Steenhuis
Adriaan G Volkers
Christine Kreher
Lisan H Kuijper
Mariël C Duurland
Laura Fernández Blanco
Amélie Bos
Charlotte Menage
Tineke Jorritsma
Marit J van Gils
Mathieu Claireaux
Geert RAM D’Haens
Laura YL Kummer
Niels JM Verstegen
Veronique AL Konijn
Maryse Tempert
Koos PJ van Dam
author_facet Sander W Tas
Taco W Kuijpers
Gertjan Wolbink
Theo Rispens
Anja Ten Brinke
Juan J Garcia-Vallejo
S Marieke van Ham
Mark Löwenberg
Luuk Wieske
Laura Boekel
Filip Eftimov
Eileen W Stalman
Maurice Steenhuis
Adriaan G Volkers
Christine Kreher
Lisan H Kuijper
Mariël C Duurland
Laura Fernández Blanco
Amélie Bos
Charlotte Menage
Tineke Jorritsma
Marit J van Gils
Mathieu Claireaux
Geert RAM D’Haens
Laura YL Kummer
Niels JM Verstegen
Veronique AL Konijn
Maryse Tempert
Koos PJ van Dam
author_sort Sander W Tas
collection DOAJ
description Objectives Tumour necrosis factor inhibitors (TNFi) are widely used and effective as treatment for immune-mediated inflammatory diseases (IMIDs). However, TNFi therapy causes a faster waning of antibody responses following vaccination. The underlying cause by which TNFi affect humoral immunity remains to be elucidated. The formation of long-lasting, high-affinity antibodies after vaccination results from germinal centre (GC)-derived, T cell-dependent B-cell responses. Therefore, this study investigated how TNFi affect the formation and maintenance of antigen-specific B- and CD4+ T-cell responses following SARS-CoV-2 mRNA vaccination.Methods SARS-CoV-2 spike-specific B-cell responses were characterised using spectral flow cytometry. Spike-specific CD4+ T cells were measured using an activation-induced marker assay. 15 patients with inflammatory bowel disease (IBD) treated with TNFi were compared with 9 IBD patients without systemic immunosuppression and 10 healthy controls.Results Spike-specific CD4+T-cell frequency and phenotype, including T follicular helper cells, were not affected by TNFi. Total spike-specific B-cell frequencies were reduced in TNFi-treated patients. Deep phenotyping revealed lower IgG+memory B-cell frequencies in TNFi-treated patients 3–6 months after vaccination. These data were confirmed in TNFi-treated rheumatoid arthritis patients. Interestingly, already at day 7 after the second vaccination, TNFi therapy reduced the induction of class-switched CD11c- CD71+activated B cells, which are believed to be GC-derived. Conversely, CD11c+B cells, associated with extrafollicular B-cell responses, were not affected by TNFi therapy.Conclusions These data suggest that TNFi therapy affects the differentiation of GC-derived B cells, which may explain its effect on humoral immune responses.
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spelling doaj-art-c97f8b30e3ea4f2da72c87381881bdc22025-08-20T03:23:33ZengBMJ Publishing GroupRMD Open2056-59332025-08-0111310.1136/rmdopen-2025-005724TNF inhibitors affect the induction and maintenance of spike-specific B-cell responses after mRNA vaccinationSander W Tas0Taco W Kuijpers1Gertjan Wolbink2Theo Rispens3Anja Ten Brinke4Juan J Garcia-Vallejo5S Marieke van Ham6Mark Löwenberg7Luuk Wieske8Laura Boekel9Filip Eftimov10Eileen W Stalman11Maurice Steenhuis12Adriaan G Volkers13Christine Kreher14Lisan H Kuijper15Mariël C Duurland16Laura Fernández Blanco17Amélie Bos18Charlotte Menage19Tineke Jorritsma20Marit J van Gils21Mathieu Claireaux22Geert RAM D’Haens23Laura YL Kummer24Niels JM Verstegen25Veronique AL Konijn26Maryse Tempert27Koos PJ van Dam28Department of Rheumatology and Clinical Immunology, Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, Amsterdam, NetherlandsDepartment of Pediatric Immunology, Amsterdam UMC Location AMC, Amsterdam, the NetherlandsSanquin Research, Amsterdam, the NetherlandsSanquin Research, Amsterdam, the NetherlandsSanquin Research, Amsterdam, the NetherlandsDepartment of Molecular Cell Biology and Immunology, Amsterdam UMC Location VUmc, Amsterdam, the NetherlandsSanquin Research, Amsterdam, the NetherlandsDepartment of Gasteroenterology, Amsterdam UMC Location AMC, Amsterdam, the NetherlandsDepartment of Neurology and Neurophysiology, Amsterdam UMC Location AMC, Amsterdam, the NetherlandsAmsterdam Rheumatology and Immunology Center, Reade, Amsterdam, the NetherlandsDepartment of Neurology and Neurophysiology, Amsterdam UMC Location AMC, Amsterdam, the NetherlandsDepartment of Neurology and Neurophysiology, Amsterdam UMC Location AMC, Amsterdam, the NetherlandsSanquin Research, Amsterdam, the NetherlandsDepartment of Gasteroenterology, Amsterdam UMC Location AMC, Amsterdam, the NetherlandsSanquin Research, Amsterdam, the NetherlandsSanquin Research, Amsterdam, the NetherlandsSanquin Research, Amsterdam, the NetherlandsSanquin Research, Amsterdam, the NetherlandsSanquin Research, Amsterdam, the NetherlandsSanquin Research, Amsterdam, the NetherlandsSanquin Research, Amsterdam, the NetherlandsDepartment of Medical Microbiology and Infection Prevention, Amsterdam UMC Location VUmc, Amsterdam, the NetherlandsDepartment of Medical Microbiology and Infection Prevention, Amsterdam UMC Location VUmc, Amsterdam, the NetherlandsDepartment of Gasteroenterology, Amsterdam UMC Location AMC, Amsterdam, the NetherlandsSanquin Research, Amsterdam, the NetherlandsSanquin Research, Amsterdam, the NetherlandsSanquin Research, Amsterdam, the NetherlandsSanquin Research, Amsterdam, the NetherlandsDepartment of Neurology and Neurophysiology, Amsterdam UMC Location AMC, Amsterdam, the NetherlandsObjectives Tumour necrosis factor inhibitors (TNFi) are widely used and effective as treatment for immune-mediated inflammatory diseases (IMIDs). However, TNFi therapy causes a faster waning of antibody responses following vaccination. The underlying cause by which TNFi affect humoral immunity remains to be elucidated. The formation of long-lasting, high-affinity antibodies after vaccination results from germinal centre (GC)-derived, T cell-dependent B-cell responses. Therefore, this study investigated how TNFi affect the formation and maintenance of antigen-specific B- and CD4+ T-cell responses following SARS-CoV-2 mRNA vaccination.Methods SARS-CoV-2 spike-specific B-cell responses were characterised using spectral flow cytometry. Spike-specific CD4+ T cells were measured using an activation-induced marker assay. 15 patients with inflammatory bowel disease (IBD) treated with TNFi were compared with 9 IBD patients without systemic immunosuppression and 10 healthy controls.Results Spike-specific CD4+T-cell frequency and phenotype, including T follicular helper cells, were not affected by TNFi. Total spike-specific B-cell frequencies were reduced in TNFi-treated patients. Deep phenotyping revealed lower IgG+memory B-cell frequencies in TNFi-treated patients 3–6 months after vaccination. These data were confirmed in TNFi-treated rheumatoid arthritis patients. Interestingly, already at day 7 after the second vaccination, TNFi therapy reduced the induction of class-switched CD11c- CD71+activated B cells, which are believed to be GC-derived. Conversely, CD11c+B cells, associated with extrafollicular B-cell responses, were not affected by TNFi therapy.Conclusions These data suggest that TNFi therapy affects the differentiation of GC-derived B cells, which may explain its effect on humoral immune responses.https://rmdopen.bmj.com/content/11/3/e005724.full
spellingShingle Sander W Tas
Taco W Kuijpers
Gertjan Wolbink
Theo Rispens
Anja Ten Brinke
Juan J Garcia-Vallejo
S Marieke van Ham
Mark Löwenberg
Luuk Wieske
Laura Boekel
Filip Eftimov
Eileen W Stalman
Maurice Steenhuis
Adriaan G Volkers
Christine Kreher
Lisan H Kuijper
Mariël C Duurland
Laura Fernández Blanco
Amélie Bos
Charlotte Menage
Tineke Jorritsma
Marit J van Gils
Mathieu Claireaux
Geert RAM D’Haens
Laura YL Kummer
Niels JM Verstegen
Veronique AL Konijn
Maryse Tempert
Koos PJ van Dam
TNF inhibitors affect the induction and maintenance of spike-specific B-cell responses after mRNA vaccination
RMD Open
title TNF inhibitors affect the induction and maintenance of spike-specific B-cell responses after mRNA vaccination
title_full TNF inhibitors affect the induction and maintenance of spike-specific B-cell responses after mRNA vaccination
title_fullStr TNF inhibitors affect the induction and maintenance of spike-specific B-cell responses after mRNA vaccination
title_full_unstemmed TNF inhibitors affect the induction and maintenance of spike-specific B-cell responses after mRNA vaccination
title_short TNF inhibitors affect the induction and maintenance of spike-specific B-cell responses after mRNA vaccination
title_sort tnf inhibitors affect the induction and maintenance of spike specific b cell responses after mrna vaccination
url https://rmdopen.bmj.com/content/11/3/e005724.full
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