SARS-CoV-2 Humoral Immunity Persists Following Rituximab Therapy
Lu, Liangjian Chan, Chang Yien Lim, Yi Yang Than, Mya Teo, Sharon Lau, YW Ng, Kar Hui Yap, Hui Kim
Lu, Liangjian
Lim, Yi Yang
Teo, Sharon
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Alternative Title
Abstract
Long-term humoral immunity is mediated by short-lived plasma cells (replenished by memory B cells) and long-lived plasma cells. Their relative contributions are uncertain for immunity to SARS-CoV-2, especially given the widespread use of novel mRNA vaccines. Yet, this has far-reaching implications in terms of the need for regular booster doses in the general population and perhaps even revaccination in patients receiving B cell-depleting therapy. We aimed to characterise anti-SARS-CoV-2 antibody titres in patients receiving Rituximab following previous SARS-CoV-2 vaccination. We recruited 10 fully vaccinated patients (age: 16.9 ± 2.52 years) with childhoodonset nephrotic syndrome, not in relapse, receiving Rituximab for their steroid/calcineurin-inhibitor
sparing effect. Antibodies to SARS-CoV-2 spike (S) and nucleocapsid (N) proteins were measured
immediately prior to Rituximab and again ~6 months later, using the Roche Elecys® Anti-SARSCoV-2 (S) assay. All ten patients were positive for anti-S antibodies prior to Rituximab, with six patients (60%) having titres above the upper limit of detection (>12,500 U/mL). Following Rituximab therapy, there was a reduction in anti-S titres (p = 0.043), but all patients remained positive for anti-S antibodies, with five patients (50%) continuing to have titres >12,500 U/mL. Six patients (60%) were positive for anti-N antibodies prior to Rituximab. Following Rituximab therapy, only three of these six patients remained positive for anti-N antibodies (p = 0.036 compared to anti-S seroreversion). Humoral immunity to SARS-CoV-2 is likely to be mediated in part by long-lived plasma cells.
Keywords
SARS-CoV-2, mRNA vaccines, long-lived plasma cells, Rituximab
Source Title
Vaccines
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
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Date
2023-12-18
DOI
10.3390/vaccines11121864
Type
Article