Impairment of CD4+ T and Memory B Cell Responses but Normal Memory CD8+T-Cell Activation on Crohn's Disease after COVID-19 Vaccination: A Twin Case.

Fabiana Gil Melgaço,Juliana Gil Melgaço,Tamiris Azamor,Ana Paula Dinis Ano Bom,Livia Melo Villar

doi:10.3390/v13112143

Fabiana Gil Melgaço, Juliana Gil Melgaço + Show 3 more

Open Access

https://doi.org/10.3390/v13112143

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Abstract

Vaccines to prevent the impact of SARS-CoV-2 are now available, including for patients with autoimmune diseases. However, there is no information about how inflammatory bowel disease (IBD) treatment could impact the cellular and humoral immune responses. This study evaluated SARS-CoV-2-specific humoral and cellular responses after vaccination with a two-dose schedule in a Crohn’s disease patient treated with Infliximab (10 mg/kg); we included comparisons with a monozygotic twin. The results showed that the Crohn’s disease’s twin (twin 2) had no antibody detection and reduced activation of CD4+ T cell responses, unlike the twin without the autoimmune disease (twin 1). Twin 2 developed antigen-specific central memory CD8+ T-cells and IFNγ production after the second dose of COVID-19 vaccination, similar to twin 1. These findings elucidated the role of T-cell immunity after COVID-19 immunization on IBD patients despite the lack of antibody production. Finally, our observation supports the consensus recommendation for IBD patients to receive COVID-19 vaccines.

Highlights

SARS-CoV-2 has been devastating worldwide [1]
People affected with autoimmune diseases (AID) are being urgently immunized [3], but little is known about the SARS-CoV-2 cellular immune responses on inflammatory bowel disease (IBD)
Vaccines to prevent the impact of SARS-CoV-2 are available, including for patients with autoimmune diseases

Summary

Introduction

SARS-CoV-2 has been devastating worldwide [1]. Brazil still has many cases and deaths with lower vaccination rates (11.7%) versus other countries [2]. People affected with autoimmune diseases (AID) are being urgently immunized [3], but little is known about the SARS-CoV-2 cellular immune responses on inflammatory bowel disease (IBD). COVID-19 symptoms versus healthy subjects [5]. Data from COVID-19-vaccinated IBD patients show controversial results along antibody detection. Some authors describe an impairment of SARS-CoV-2-IgG [6], and others reported normal detection of the specific antibodies after complete vaccination [7]. It has been known that IBD patients have an increase of pro-inflammatory cytokines, rising CD4+ helper T cells responses, mainly Th1 activation, leading to gut inflammation [8,9]. Infliximab, an anti-TNF monoclonal antibody, has been an adequate therapy for Crohn’s disease worldwide, and its effect is based on neutralizing the bioactive TNF in the intestinal mucosa, as well as it can promote apoptotic

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