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P588 T cell response to SARS-CoV-2 mRNA vaccines by an interferon-gamma release immunoassay in patients with Inflammatory Bowel disease receiving anti-TNF and thiopurine treatment

Mayorga Ayala, L.F.(1);Herrera-deGuise, C.(1);Esperalba, J.(2);Martinez-Gomez, X.(6);Céspedes Martinez, E.(1);Robles Alonso, V.(1);Jimenez, A.(1);Perez Martinez, Z.(1);Oller, E.(1);Ibarz, A.(1);Fernandez-Naval, C.(3);Martinez-Gallo, M.(4);Lopez Messeguer, M.(5);Casellas, F.(1);Borruel, N.(1);

(1)Unitat d’Atenció Crohn-Colitis, Servei d'Aparell Digestiu- Hospital Universitari Vall d'Hebron- Barcelona- Catalonia- Spain, Barcelona, Spain;(2)Universitat Autónoma de BarcelonaUAB- Barcelona- Catalonia- Spain, Servei de Microbiologia- Hospital Universitari Vall d'Hebron- Barcelona- Catalonia- Spain, Barcelona, Spain;(3)Universitat Autónoma de BarcelonaUAB- Barcelona- Catalonia- Spain, Servei de Microbiologia- Hospital Universitari Vall d'Hebron, Barcelona, Spain;(4)Universitat Autónoma de Barcelona UAB- Barcelona- Catalonia- Spain., Servei d'Immunologia- Hospital Universitari Vall d'Hebron- Barcelona- Catalonia- Spain, Barcelona, Spain;(5)Servei de Pneumologia, Hospital Universitari Vall d´Hebron- Barcelona, Barcelona, Spain;(6)Universitat Autónoma de BarcelonaUAB- Barcelona- Catalonia- Spain, Servei de Epidemiologia- Hospital Universitari Vall d'Hebron, Barcelona, Spain;

Background

Treatment with anti-TNF agents and thiopurines has been associated with an impaired immune response to some vaccines. SARS-CoV-2 vaccination is very effective in healthy individuals, but studies in inflammatory bowel disease (IBD) populations are scarce, especially regarding T cell response. We aimed to evaluate the T cell and antibody response in a cohort of IBD patients on anti-TNF and thiopurine treatment who received two doses of the SARS-CoV2 mRNA vaccine.

Methods

An observational, prospective study was carried out at our IBD clinic. We included Crohn’s disease (CD) and Ulcerative colitis (UC) patients receiving anti-TNF as monotherapy or anti-TNF + thiopurine (combo) or thiopurines only for at least six months at inclusion. Blood samples were drawn for interferon-gamma release assay (IGRA) and antibody determination six (+/- 2) weeks after the second vaccine dose. The specific T cell response to SARS-CoV-2 was determined by IGRA using Qiagen® QuantiFERON® SARS-CoV-2 RUO tubes with a patented Spike protein combination. Interferon-gamma was measured by CLIA using the LIAISON® QuantiFERON-®TB Gold Plus assay. As there is no validated cut-off point, we used those obtained in a cohort of 20 healthy health professionals published by our group (doi.org/10.1016/j.medcli.2021.09.013). Antibodies to the Spike (S) SARS-CoV-2 protein were analyzed by CLIA. Adverse events (AEs) and clinical activity were recorded.

Results

We recruited 148 IBD patients, 57 treated with anti-TNF monotherapy, 53 with combo, and 38 with thiopurine only. Seventy percent had CD, and 60% were male. Using the cut-off value of the cohort mentioned above, the T-cell response was positive in 92% of anti-TNF monotherapy, 83% in combo, and 87% of the thiopurine group (p=ns). The anti-S antibodies were positive in 100% of our cohort. There were no changes in disease activity rates after the second vaccination, nor were severe AEs detected.

Conclusion

SARS-CoV-2 mRNA vaccination was very effective in IBD patients receiving anti-TNF (combo or monotherapy) or thiopurine treatment as measured by both T cell and antibody response. IGRA-specific tests may constitute a valuable tool in assessing cellular immunity in immunocompromised patients.

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