HealthDay News — Patients with multiple sclerosis (MS) receiving anti-CD20 monoclonal antibody (aCD20) treatment can mount T-cell responses to mRNA COVID-19 vaccines, according to a study published online September 14 in Nature Medicine.
Sokratis A. Apostolidis, MD, from the University of Pennsylvania Perelman School of Medicine in Philadelphia, and colleagues examined induction of antigen-specific antibody, B-cell, and T-cell responses in 20 patients with MS on antibody monotherapy and in 10 healthy controls after BNT162b2 or mRNA-1273 mRNA vaccination.
The researchers found that for most patients, aCD20 treatment significantly reduced spike-specific and receptor-binding domain (RBD)-specific antibody and memory B-cell responses; this effect ameliorated with longer duration from the last aCD20 treatment and extent of B-cell reconstitution. After vaccination, all patients with MS treated with aCD20 generated antigen-specific CD4 and CD8 T-cell responses. aCD20 treatment skewed responses, compromising circulating follicular helper T (TFH)-cell responses and enhancing induction of CD8 T cells, while preserving type 1 helper T-cell priming. The most severe defect in circulating TFH responses and more robust CD8 T-cell responses were seen for patients with MS treated with aCD20 lacking anti-RBD immunoglobulin G.
“Measuring both antibodies and T-cell response gives us a more complete picture of a patient’s immune response, and reveals that patients who can’t generate antibodies as well as a healthy person are actually still protected by the COVID-19 vaccine,” Apostolidis said in a statement.
Several authors disclosed financial ties to the pharmaceutical industry.