Development of humoral and cellular immunological memory against SARS-CoV-2 despite B cell depleting treatment in multiple sclerosis.

Asplund Högelin K, Ruffin N, Pin E, Månberg A, Hober S, Gafvelin G, Grönlund H, Nilsson P, Khademi M, Olsson T, Piehl F, Al Nimer F

iScience 24 (9) 103078 [2021-09-24; online 2021-09-02]

B cell depleting therapies (BCDTs) are widely used as immunomodulating agents for autoimmune diseases such as multiple sclerosis. Their possible impact on development of immunity to severe acute respiratory syndrome virus-2 (SARS-CoV-2) has raised concerns with the coronavirus disease 2019 (COVID-19) pandemic. We here evaluated the frequency of COVID-19-like symptoms and determined immunological responses in participants of an observational trial comprising several multiple sclerosis disease modulatory drugs (COMBAT-MS; NCT03193866) and in eleven patients after vaccination, with a focus on BCDT. Almost all seropositive and 17.9% of seronegative patients on BCDT, enriched for a history of COVID-19-like symptoms, developed anti-SARS-CoV-2 T cell memory, and T cells displayed functional similarity to controls producing IFN-γ and TNF. Following vaccination, vaccine-specific humoral memory was impaired, while all patients developed a specific T cell response. These results indicate that BCDTs do not abrogate SARS-CoV-2 cellular memory and provide a possible explanation as to why the majority of patients on BCDTs recover from COVID-19.

Autoimmunity and Serology Profiling [Collaborative]

PubMed 34490414

DOI 10.1016/j.isci.2021.103078

Crossref 10.1016/j.isci.2021.103078

pii: S2589-0042(21)01046-4
pmc: PMC8410640