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Impaired neutralizing antibody activity against B.1.617.2 (delta) after anti-SARS-CoV-2 vaccination in patients receiving anti-CD20 therapy

Background: To characterize humoral response after standard anti-SARS-CoV-2 vaccination in Rituximab-treated patients and to determine the optimal time point after last Rituximab treatment for appropriate immunization. Methods: Sixty-four patients who received Rituximab within the last seven years p...

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Main Authors: Töllner, Maximilian (Author) , Speer, Claudius (Author) , Benning, Louise (Author) , Bartenschlager, Marie (Author) , Nußhag, Christian (Author) , Morath, Christian (Author) , Zeier, Martin (Author) , Süsal, Caner (Author) , Schnitzler, Paul (Author) , Schmitt, Wilhelm (Author) , Bergner, Raoul (Author) , Bartenschlager, Ralf (Author) , Lorenz, Hanns-Martin (Author) , Schaier, Matthias (Author)
Format: Article (Journal)
Language:English
Published: 21 March 2022
In: Journal of Clinical Medicine
Year: 2022, Volume: 11, Issue: 6, Pages: 1-16
ISSN:2077-0383
DOI:10.3390/jcm11061739
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/jcm11061739
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2077-0383/11/6/1739
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Author Notes:Maximilian Töllner, Claudius Speer, Louise Benning, Marie Bartenschlager, Christian Nusshag, Christian Morath, Martin Zeier, Caner Süsal, Paul Schnitzler, Wilhelm Schmitt, Raoul Bergner, Ralf Bartenschlager, Hanns-Martin Lorenz and Matthias Schaier
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Summary:Background: To characterize humoral response after standard anti-SARS-CoV-2 vaccination in Rituximab-treated patients and to determine the optimal time point after last Rituximab treatment for appropriate immunization. Methods: Sixty-four patients who received Rituximab within the last seven years prior to the first anti-SARS-CoV-2 vaccination were recruited in a prospective observational study. Anti-S1 IgG, SARS-CoV-2 specific neutralization, and various SARS-CoV-2 target antibodies were determined. A live virus assay was used to assess neutralizing antibody activity against B.1.617.2 (delta). In Rituximab-treated patients, CD19+ peripheral B-cells were quantified using flow cytometry. Results: After second vaccination, all antibodies were significantly reduced compared to healthy controls. Neutralizing antibody activity against B.1.617.2 (delta) was detectable with a median (IQR) ID50 of 0 (0-1:20) compared to 1:320 (1:160-1:320) in healthy controls (for all p < 0.001). Longer time period since last Rituximab administration correlated with higher anti-SARS-CoV-2 antibody levels and a stronger neutralization of B.1.617.2 (delta). With one exception, only patients with a CD19+ cell proportion ≥ 1% had detectable neutralizing antibodies. Conclusion: Our data indicate that a reconstitution of the B-cell population to >1% seems crucial in developing neutralizing antibodies against SARS-CoV-2. We suggest that anti-SARS-CoV-2 vaccination should be administered at least 8-12 months after the last Rituximab treatment for sufficient humoral responses.
Item Description:Gesehen am 02.07.2022
Physical Description:Online Resource
ISSN:2077-0383
DOI:10.3390/jcm11061739

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