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

Karabag Yilmaz, E; Agbas, A; Canpolat, N; Gunalp, A; Sahin, S; Ozbey, D; Gulmez, R; Saygili, SK; Kocazeybek, B; Kasapcopur, O; Caliskan, S

doi:10.1136/lupus-2024-001268

Pediatric rheumatology

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

Lupus Sci MedPublished 20 Sep 2024Cross-sectional case-control study

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Authors' conclusion

Patients with cSLE showed robust humoral but compromised cellular immune responses to the COVID-19 mRNA vaccine, associated with lower lymphocyte counts.

Study context

Population: Patients with childhood-onset SLE, healthy controls and KTx recipients, at least 1 month after two doses of BNT162b2 mRNA vaccine
Participants: 16 / 19 / 19

Comparison: Childhood-onset SLE vs healthy controls and kidney transplant recipients
cSLEn = 16
Healthy controlsn = 19reference
KTx recipientsn = 19
Outcome: SARS-CoV-2-specific humoral (anti-SARS-CoV-2 IgG, nAb) and cellular (IGRA) immune responses
Follow-up: At least 1 month after two doses

Methodological detailssingle-centre

Single-centre

Main finding

As reported in the abstract

Anti-SARS-CoV-2 IgG seropositivity

cSLE100%

Healthy controls100%

KTx recipients74%

P < 0.05 for both

Observational data: associations, not effects.

Further findings

Cellular immune response (IGRA) — cSLE vs Healthy controls · lower in cSLE

P = 0.050

cSLE56.3%

Healthy controls89.5%

KTx recipients63%

Outcome	cSLE	Healthy controls	KTx recipients	P value
nAb seropositivitycSLE vs KTx recipients · significantly higher in cSLE	— not stated in the abstract	95%	42%	P < 0.05 for both

— not stated in the abstract

Neutralising antibody (nAb) seropositivity

cSLE comparable to healthy controls

Cellular immune response (interferon gamma release assay (IGRA))

cSLE comparable to KTx recipients

Leucocyte and lymphocyte counts at vaccination, IGRA-negative vs IGRA-positive cSLE

Significantly lower total leucocyte count in IGRA-negative cSLE: P = 0.008
Significantly lower lymphocyte count in IGRA-negative cSLE: P = 0.001
No differences in disease activity or immunosuppressive therapies between IGRA-negative and IGRA-positive cSLE

Original publication

Favourable humoral but reduced cellular immune response to COVID-19 mRNA BNT162b2 vaccine in patients with childhood-onset systemic lupus erythematosus. Lupus Sci Med. Published 20 September 2024. doi:10.1136/lupus-2024-001268

Read the original article ↗

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