Favourable humoral but reduced cellular immune response to COVID-19 mRNA BNT162b2 vaccine in patients with childhood-onset systemic lupus erythematosus

Objective To evaluate both humoral and cellular immune responses to the COVID-19 messenger RNA (mRNA; BNT162b2) vaccine in patients with childhood-onset SLE (cSLE) compared with healthy controls and patient controls (kidney transplant (KTx) recipients).Methods This single-centre, cross-sectional and...

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Main Authors: Ozgur Kasapcopur, Nur Canpolat, Sezgin Sahin, Bekir Kocazeybek, Ayşe Ağbaş, Esra Karabag Yilmaz, Aybuke Gunalp, Dogukan Ozbey, Ruveyda Gulmez, Seha Kamil Saygili, Salim Caliskan
Format: Article
Language:English
Published: BMJ Publishing Group 2024-09-01
Series:Lupus Science and Medicine
Online Access:https://lupus.bmj.com/content/11/2/e001268.full
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author Ozgur Kasapcopur
Nur Canpolat
Sezgin Sahin
Bekir Kocazeybek
Ayşe Ağbaş
Esra Karabag Yilmaz
Aybuke Gunalp
Dogukan Ozbey
Ruveyda Gulmez
Seha Kamil Saygili
Salim Caliskan
author_facet Ozgur Kasapcopur
Nur Canpolat
Sezgin Sahin
Bekir Kocazeybek
Ayşe Ağbaş
Esra Karabag Yilmaz
Aybuke Gunalp
Dogukan Ozbey
Ruveyda Gulmez
Seha Kamil Saygili
Salim Caliskan
author_sort Ozgur Kasapcopur
collection DOAJ
description Objective To evaluate both humoral and cellular immune responses to the COVID-19 messenger RNA (mRNA; BNT162b2) vaccine in patients with childhood-onset SLE (cSLE) compared with healthy controls and patient controls (kidney transplant (KTx) recipients).Methods This single-centre, cross-sectional and case–control study included 16 patients with cSLE, 19 healthy controls and 19 KTx recipients. We assessed SARS-CoV-2-specific humoral (anti-SARS-CoV-2 IgG, neutralising antibody (nAb)) and cellular (interferon gamma release assay (IGRA)) immune responses at least 1 month after administration of two doses of the mRNA vaccine.Results Humoral immune response rates (anti-SARS-CoV-2 IgG and nAb seropositivity) in patients with cSLE were comparable to healthy controls (100% vs 100% and 100% vs 95%, respectively) but significantly higher than in KTx recipients (74% and 42%, p<0.05 for both). Cellular immune response rate measured by IGRA was lower in patients with cSLE compared with healthy controls (56.3% vs 89.5%, p=0.050) and comparable to KTx recipients (63%). IGRA-negative patients with cSLE had significantly lower total leucocyte and lymphocyte counts at vaccination time as compared with their counterparts (p=0.008 and p=0.001, respectively). No differences were found in disease activity or immunosuppressive therapies between IGRA-negative and IGRA-positive patients with cSLE.Conclusion Patients with cSLE showed robust humoral but compromised cellular immune responses to the COVID-19 mRNA vaccine, associated with lower lymphocyte counts. These findings highlight the need for further research to enhance vaccine efficacy in this vulnerable group.
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spelling doaj-art-d25527ea6ea24c6ba3b4a569d85885192025-08-20T01:56:14ZengBMJ Publishing GroupLupus Science and Medicine2053-87902024-09-0111210.1136/lupus-2024-001268Favourable humoral but reduced cellular immune response to COVID-19 mRNA BNT162b2 vaccine in patients with childhood-onset systemic lupus erythematosusOzgur Kasapcopur0Nur Canpolat1Sezgin Sahin2Bekir Kocazeybek3Ayşe Ağbaş4Esra Karabag Yilmaz5Aybuke Gunalp6Dogukan Ozbey7Ruveyda Gulmez8Seha Kamil Saygili9Salim Caliskan10Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, TurkeyDepartment of Pediatric Nephrology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, TurkeyDepartment of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, TurkeyDepartment of Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, TurkeyDepartment of Pediatric Nephrology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, TurkeyDepartment of Pediatric Nephrology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, TurkeyDepartment of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, TurkeyDepartment of Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, TurkeyDepartment of Pediatric Nephrology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, TurkeyDepartment of Pediatric Nephrology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, TurkeyDepartment of Pediatric Nephrology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, TurkeyObjective To evaluate both humoral and cellular immune responses to the COVID-19 messenger RNA (mRNA; BNT162b2) vaccine in patients with childhood-onset SLE (cSLE) compared with healthy controls and patient controls (kidney transplant (KTx) recipients).Methods This single-centre, cross-sectional and case–control study included 16 patients with cSLE, 19 healthy controls and 19 KTx recipients. We assessed SARS-CoV-2-specific humoral (anti-SARS-CoV-2 IgG, neutralising antibody (nAb)) and cellular (interferon gamma release assay (IGRA)) immune responses at least 1 month after administration of two doses of the mRNA vaccine.Results Humoral immune response rates (anti-SARS-CoV-2 IgG and nAb seropositivity) in patients with cSLE were comparable to healthy controls (100% vs 100% and 100% vs 95%, respectively) but significantly higher than in KTx recipients (74% and 42%, p<0.05 for both). Cellular immune response rate measured by IGRA was lower in patients with cSLE compared with healthy controls (56.3% vs 89.5%, p=0.050) and comparable to KTx recipients (63%). IGRA-negative patients with cSLE had significantly lower total leucocyte and lymphocyte counts at vaccination time as compared with their counterparts (p=0.008 and p=0.001, respectively). No differences were found in disease activity or immunosuppressive therapies between IGRA-negative and IGRA-positive patients with cSLE.Conclusion Patients with cSLE showed robust humoral but compromised cellular immune responses to the COVID-19 mRNA vaccine, associated with lower lymphocyte counts. These findings highlight the need for further research to enhance vaccine efficacy in this vulnerable group.https://lupus.bmj.com/content/11/2/e001268.full
spellingShingle Ozgur Kasapcopur
Nur Canpolat
Sezgin Sahin
Bekir Kocazeybek
Ayşe Ağbaş
Esra Karabag Yilmaz
Aybuke Gunalp
Dogukan Ozbey
Ruveyda Gulmez
Seha Kamil Saygili
Salim Caliskan
Favourable humoral but reduced cellular immune response to COVID-19 mRNA BNT162b2 vaccine in patients with childhood-onset systemic lupus erythematosus
Lupus Science and Medicine
title Favourable humoral but reduced cellular immune response to COVID-19 mRNA BNT162b2 vaccine in patients with childhood-onset systemic lupus erythematosus
title_full Favourable humoral but reduced cellular immune response to COVID-19 mRNA BNT162b2 vaccine in patients with childhood-onset systemic lupus erythematosus
title_fullStr Favourable humoral but reduced cellular immune response to COVID-19 mRNA BNT162b2 vaccine in patients with childhood-onset systemic lupus erythematosus
title_full_unstemmed Favourable humoral but reduced cellular immune response to COVID-19 mRNA BNT162b2 vaccine in patients with childhood-onset systemic lupus erythematosus
title_short Favourable humoral but reduced cellular immune response to COVID-19 mRNA BNT162b2 vaccine in patients with childhood-onset systemic lupus erythematosus
title_sort favourable humoral but reduced cellular immune response to covid 19 mrna bnt162b2 vaccine in patients with childhood onset systemic lupus erythematosus
url https://lupus.bmj.com/content/11/2/e001268.full
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