Imperial College London
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DrJamesAlexander

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Honorary Senior Lecturer
 
 
 
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Contact

 

j.alexander

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Lin:2022:10.1038/s41467-022-28517-z,
author = {Lin, S and Kennedy, NA and Saifuddin, A and Sandoval, DM and Reynolds, CJ and Seoane, RC and Kottoor, SH and Pieper, FP and Lin, K-M and Butler, DK and Chanchlani, N and Nice, R and Chee, D and Bewshea, C and Janjua, M and McDonald, TJ and Sebastian, S and Alexander, JL and Constable, L and Lee, JC and Murray, CD and Hart, AL and Irving, PM and Jones, G-R and Kok, KB and Lamb, CA and Lees, CW and Altmann, DM and Boyton, RJ and Goodhand, JR and Powell, N and Ahmad, T},
doi = {10.1038/s41467-022-28517-z},
journal = {Nature Communications},
title = {Antibody decay, T cell immunity and breakthrough infections following two SARS-CoV-2 vaccine doses in inflammatory bowel disease patients treated with infliximab and vedolizumab},
url = {http://dx.doi.org/10.1038/s41467-022-28517-z},
volume = {13},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Anti tumour necrosis factor (anti-TNF) drugs increase the risk of serious respiratory infection and impair protective immunity following pneumococcal and influenza vaccination. Here we report SARS-CoV-2 vaccine-induced immune responses and breakthrough infections in patients with inflammatory bowel disease, who are treated either with the anti-TNF antibody, infliximab, or with vedolizumab targeting a gut-specific anti-integrin that does not impair systemic immunity. Geometric mean [SD] anti-S RBD antibody concentrations are lower and half-lives shorter in patients treated with infliximab than vedolizumab, following two doses of BNT162b2 (566.7 U/mL [6.2] vs 4555.3 U/mL [5.4], p <0.0001; 26.8 days [95% CI 26.2 – 27.5] vs 47.6 days [45.5 – 49.8], p <0.0001); similar results are also observed with ChAdOx1 nCoV-19 vaccination (184.7 U/mL [5.0] vs 784.0 U/mL [3.5], p <0.0001; 35.9 days [34.9 – 36.8] vs 58.0 days [55.0 – 61.3], p value < 0.0001). One fifth of patients fail to mount a T cell response in both treatment groups. Breakthrough SARS-CoV-2 infections are more frequent (5.8% (201/3441) vs 3.9% (66/1682), p = 0.0039) in patients treated with infliximab than vedolizumab, and the risk of breakthrough SARS-CoV-2 infection is predicted by peak anti-S RBD antibody concentration after two vaccine doses. Irrespective of the treatments, higher, more sustained antibody levels are observed in patients with a history of SARS-CoV-2 infection prior to vaccination. Our results thus suggest that adapted vaccination schedules may be required to induce immunity in at-risk, anti-TNF-treated patients.
AU  - Lin,S
AU  - Kennedy,NA
AU  - Saifuddin,A
AU  - Sandoval,DM
AU  - Reynolds,CJ
AU  - Seoane,RC
AU  - Kottoor,SH
AU  - Pieper,FP
AU  - Lin,K-M
AU  - Butler,DK
AU  - Chanchlani,N
AU  - Nice,R
AU  - Chee,D
AU  - Bewshea,C
AU  - Janjua,M
AU  - McDonald,TJ
AU  - Sebastian,S
AU  - Alexander,JL
AU  - Constable,L
AU  - Lee,JC
AU  - Murray,CD
AU  - Hart,AL
AU  - Irving,PM
AU  - Jones,G-R
AU  - Kok,KB
AU  - Lamb,CA
AU  - Lees,CW
AU  - Altmann,DM
AU  - Boyton,RJ
AU  - Goodhand,JR
AU  - Powell,N
AU  - Ahmad,T
DO  - 10.1038/s41467-022-28517-z
PY  - 2022///
SN  - 2041-1723
TI  - Antibody decay, T cell immunity and breakthrough infections following two SARS-CoV-2 vaccine doses in inflammatory bowel disease patients treated with infliximab and vedolizumab
T2  - Nature Communications
UR  - http://dx.doi.org/10.1038/s41467-022-28517-z
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000770096400025&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://www.nature.com/articles/s41467-022-28517-z
UR  - http://hdl.handle.net/10044/1/98633
VL  - 13
ER  -
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