Benaroya Research Institute Team Examines COVID Vaccine Response in People Under Treatment for MS and Other Autoimmune Diseases
Studies in the lab of Estelle Bettelli, PhD, at BRI demonstrate that disease modifying therapies used to treat individuals with multiple sclerosis significantly change immune responses generated by COVID-19 vaccines.
Data from these studies could inform best approaches against COVID-19, not only for people with autoimmune diseases or those who are immunocompromised, but for everyone.
The study, entitled Cutting Edge: Effect of Disease-Modifying Therapies on SARS-Cov-2 Vaccine-Induced Immune Responses in Multiple Sclerosis Patients, was published in the March 14 edition of The Journal of Immunology.
“Several recent studies looked at the effects of DMTs used to manage multiple sclerosis on the generation of antibodies against SARS-CoV-2,” Dr. Bettelli said. “However, few studies looked at the effects of these DMTs on both humoral and cellular responses to SARS-CoV-2 vaccines. Our study is one of them, and they suggest that some DMTs could limit the protective immune responses generated by SARS-CoV-2 vaccines.”
According to lead author and postdoctoral research associate Yevgeniy Yuzefpolskiy, PhD, the team expected to see differences between the controls and people with MS who were treated with DMTs. But the changes in T cell phenotype - and the extent of those changes - proved surprising.
“For example, it was surprising to observe a blunted response in MS patients treated with the medication fingolimod,” Dr. Yuzefpolskiy noted. “Also unexpected was the change in the anti-SARS-CoV-2 specific T cell phenotype we observed in individuals treated with dimethyl fumarate.”
“Further, we had anticipated that antibodies against SARS-CoV-2 would be altered in anti-CD20 treated individuals. However, it was interesting to see that a large part of their cellular response to SARS-CoV-2 was conserved,” he said.
MS is an inflammatory disease of the central nervous system that is often treated through therapies that suppress the immune system. While SARS-CoV-2 mRNA vaccines have been very effective in the general population, whether MS patients treated with such therapies are afforded the same level of protection has not been clear. These data provide useful information regarding vaccine immune response in patients with autoimmunity.
Dr. Bettelli says that future studies are necessary to determine whether the alterations observed in SARS-CoV-2 vaccine responses in individuals with MS treated with DMTs significantly alter their protection against COVID-19. However, the data suggest that certain DMTs could limit the efficacy of SARS-CoV-2 vaccines, so administration of DMTs may need to be adapted in consultation with physicians. Also, other types of SARS-CoV-2 vaccines may need to be developed to help improve vaccine effectiveness in individuals treated with specific immune system altering DMTs. The data have direct implications for DMT-treated individuals with autoimmunity, but they are relevant for everyone else because they inform on the different components and mechanisms by which our immune system help protect us against SARS-CoV-2.