医学
四分位间距
银屑病
免疫学
甲氨蝶呤
免疫
细胞免疫
接种疫苗
肿瘤坏死因子α
体液免疫
内科学
银屑病面积及严重程度指数
免疫系统
作者
Amanda Kvist-Hansen,Laura Pérez‐Alós,Rownaq Fares Al-Sofi,Line Dam Heftdal,Sebastian Rask Hamm,Dina Leth Møller,Mia Marie Pries-Heje,Kamille Fogh,Cecilie Bo Hansen,Rasmus Bo Hasselbalch,Johannes Roth Madsen,José Juan Almagro Armenteros,Ruth Frikke‐Schmidt,Linda Hilsted,Erik Sørensen,Sisse Rye Ostrowski,Henning Bundgaard,Susanne Dam Nielsen,Kasper Iversen,Claus Zachariae,Peter Garred,Lone Skov
摘要
mRNA-based COVID-19 vaccines have short- and long-term efficacy in healthy individuals, but their efficacy in patients with psoriasis receiving immunomodulatory therapy is less studied.To investigate long-term immunity after COVID-19 vaccination in patients with psoriasis receiving immunomodulatory therapy.A prospective cohort study including patients (n = 123) with psoriasis receiving methotrexate (MTX) or biologics and controls (n = 226). Only mRNA-based COVID-19 vaccines administered with standard intervals between doses were investigated. Markers of immunity included SARS-CoV-2 spike glycoprotein-specific IgG and IgA, neutralizing capacity, and interferon-γ release from T cells stimulated with peptides of the SARS-CoV-2 spike glycoprotein.The proportion of IgG responders was lower 6 months after vaccination in patients receiving anti-tumour necrosis factor (TNF) treatment compared with controls. Anti-TNF treatment was associated with lower IgG levels (β = -0.82, 95% confidence interval -1.38 to -0.25; P = 0.001). The median neutralizing index was lower in the anti-TNF group [50% inhibition (interquartile range [IQR] 37-89)] compared with controls [98% inhibition (IQR 96-99)]; P < 0.001. Cellular responses were numerically lowest in the anti-TNF group.Treatment with anti-TNF has an impact on the immunity elicited by mRNA-based COVID-19 vaccination in patients with psoriasis, resulting in a faster waning of humoral and cellular markers of immunity; however, the clinical implications are unknown.
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