TY - JOUR
T1 - Methotrexate treatment hampers induction of vaccine-specific CD4 T cell responses in patients with IMID
AU - T2B! immunity against SARS-CoV-2 study group
AU - Kummer, Laura Y.L.
AU - Fernández Blanco, Laura
AU - Kreher, Christine
AU - Bos, Amélie
AU - Kuijper, Lisan H.
AU - Verstegen, Niels J.M.
AU - Van De Sandt, Carolien E.
AU - Konijn, Veronique A.L.
AU - Duurland, Mariël C.
AU - Menage, Charlotte
AU - Jorritsma, Tineke
AU - Steenhuis, Maurice
AU - Hagen, Ruth R.
AU - Van Den Dijssel, Jet
AU - De Jongh, Rivka
AU - Ashhurst, Tom
AU - van Gils, Marit J.
AU - Garcia-Vallejo, Juan J.
AU - Claireaux, Mathieu
AU - Stalman, Eileen W.
AU - Van Dam, Koos P.J.
AU - Wieske, Luuk
AU - Boekel, Laura
AU - Wolbink, Gertjan
AU - Tas, Sander W.
AU - Rispens, Theo
AU - Kuijpers, Taco W.
AU - Eftimov, Filip
AU - Van Ham, Sija Marieke
AU - Ten Brinke, Anja
AU - van Allaart, Renée C.F.
AU - Baars, Adája E.
AU - Bekkenk, Marcel W.
AU - Bemelman, Frederike J.
AU - Bosma, Angela L.
AU - Broens, Bo
AU - Brusse, Esther
AU - Busch, Matthias H.
AU - Cristianawati, Olvi
AU - van Doorn, Pieter A.
AU - Elias, George
AU - van Els, Cécile A.C.M.
AU - van Gils, Marit J.
AU - Goedee, H. Stephan
AU - D'Haens, Geert R.A.M.
AU - Hijnen, Dirk Jan
AU - Horváth, Barbara
AU - de Leeuw, Karina
AU - Rutgers, Abraham
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2024/10/7
Y1 - 2024/10/7
N2 - Objectives: Methotrexate (MTX) is one of the most commonly used medications to treat rheumatoid arthritis (RA). However, the effect of MTX treatment on cellular immune responses remains incompletely understood. This raises concerns about the vulnerability of these patients to emerging infections and following vaccination.Methods: In the current study, we investigated the impact of MTX treatment in patients with immune-mediated inflammatory disease on B and CD4 T cell SARS-CoV-2 vaccination responses. Eighteen patients with RA and two patients with psoriatic arthritis on MTX monotherapy were included, as well as 10 patients with RA without immunosuppressive treatment, and 29 healthy controls. CD4 T and B cell responses were analysed 7 days and 3-6 months after two SARS-CoV-2 messenger RNA vaccinations. High-dimensional flow cytometry analysis was used to analyse fresh whole blood, an activation-induced marker assay to measure antigen-specific CD4 T cells, and spike probes to study antigen-specific B cells.Results: Seven days following two SARS-CoV-2 vaccinations, total B and T cell counts were similar between MTX-treated patients and controls. In addition, spike-specific B cell frequencies were unaffected. Remarkably, the frequency of antigen-specific CD4 T cells was reduced in patients using MTX and correlated strongly with anti-RBD IgG antibodies. These results suggest that decreased CD4 T cell activity may result in slower vaccination antibody responses in MTX-treated patients.Conclusion: Taken together, MTX treatment reduces vaccine-induced CD4 T cell activation, which correlates with lower antibody responses.
AB - Objectives: Methotrexate (MTX) is one of the most commonly used medications to treat rheumatoid arthritis (RA). However, the effect of MTX treatment on cellular immune responses remains incompletely understood. This raises concerns about the vulnerability of these patients to emerging infections and following vaccination.Methods: In the current study, we investigated the impact of MTX treatment in patients with immune-mediated inflammatory disease on B and CD4 T cell SARS-CoV-2 vaccination responses. Eighteen patients with RA and two patients with psoriatic arthritis on MTX monotherapy were included, as well as 10 patients with RA without immunosuppressive treatment, and 29 healthy controls. CD4 T and B cell responses were analysed 7 days and 3-6 months after two SARS-CoV-2 messenger RNA vaccinations. High-dimensional flow cytometry analysis was used to analyse fresh whole blood, an activation-induced marker assay to measure antigen-specific CD4 T cells, and spike probes to study antigen-specific B cells.Results: Seven days following two SARS-CoV-2 vaccinations, total B and T cell counts were similar between MTX-treated patients and controls. In addition, spike-specific B cell frequencies were unaffected. Remarkably, the frequency of antigen-specific CD4 T cells was reduced in patients using MTX and correlated strongly with anti-RBD IgG antibodies. These results suggest that decreased CD4 T cell activity may result in slower vaccination antibody responses in MTX-treated patients.Conclusion: Taken together, MTX treatment reduces vaccine-induced CD4 T cell activation, which correlates with lower antibody responses.
KW - autoimmune diseases
KW - B-lymphocytes
KW - methotrexate
KW - T-lymphocytes
UR - https://www.scopus.com/pages/publications/85205792525
U2 - 10.1136/rmdopen-2024-004664
DO - 10.1136/rmdopen-2024-004664
M3 - Article
C2 - 39375177
AN - SCOPUS:85205792525
SN - 2044-6055
VL - 10
JO - RMD Open
JF - RMD Open
IS - 4
M1 - e004664
ER -