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Clinical MedicineIn-Press PreviewCOVID-19Immunology Open Access | 10.1172/JCI159500

Favorable vaccine-induced SARS-CoV-2 specific T cell response profile in patients undergoing immune-modifying therapies

Martin Qui,1 Nina Le Bert,1 Webber Pak Wo Chan,2 Malcolm Tan,2 Shou Kit Hang,1 Smrithi Hariharaputran,1 Jean Xiang Ying Sim,3 Jenny Guek Hong Low,3 Weiling Ng,4 Wei Yee Wan,4 Tiing Leong Ang,5 Antonio Bertoletti,1 and Ennaliza Salazar2

1Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore

2Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore

3Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore

4Department of Microbiology, Singapore General Hospital, Singapore, Singapore

5Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore

Find articles by Qui, M. in: JCI | PubMed | Google Scholar |

1Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore

2Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore

3Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore

4Department of Microbiology, Singapore General Hospital, Singapore, Singapore

5Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore

Find articles by Le Bert, N. in: JCI | PubMed | Google Scholar |

1Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore

2Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore

3Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore

4Department of Microbiology, Singapore General Hospital, Singapore, Singapore

5Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore

Find articles by Chan, W. in: JCI | PubMed | Google Scholar

1Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore

2Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore

3Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore

4Department of Microbiology, Singapore General Hospital, Singapore, Singapore

5Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore

Find articles by Tan, M. in: JCI | PubMed | Google Scholar |

1Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore

2Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore

3Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore

4Department of Microbiology, Singapore General Hospital, Singapore, Singapore

5Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore

Find articles by Hang, S. in: JCI | PubMed | Google Scholar |

1Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore

2Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore

3Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore

4Department of Microbiology, Singapore General Hospital, Singapore, Singapore

5Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore

Find articles by Hariharaputran, S. in: JCI | PubMed | Google Scholar

1Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore

2Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore

3Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore

4Department of Microbiology, Singapore General Hospital, Singapore, Singapore

5Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore

Find articles by Sim, J. in: JCI | PubMed | Google Scholar

1Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore

2Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore

3Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore

4Department of Microbiology, Singapore General Hospital, Singapore, Singapore

5Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore

Find articles by Low, J. in: JCI | PubMed | Google Scholar |

1Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore

2Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore

3Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore

4Department of Microbiology, Singapore General Hospital, Singapore, Singapore

5Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore

Find articles by Ng, W. in: JCI | PubMed | Google Scholar

1Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore

2Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore

3Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore

4Department of Microbiology, Singapore General Hospital, Singapore, Singapore

5Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore

Find articles by Wan, W. in: JCI | PubMed | Google Scholar

1Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore

2Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore

3Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore

4Department of Microbiology, Singapore General Hospital, Singapore, Singapore

5Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore

Find articles by Ang, T. in: JCI | PubMed | Google Scholar |

1Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore

2Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore

3Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore

4Department of Microbiology, Singapore General Hospital, Singapore, Singapore

5Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore

Find articles by Bertoletti, A. in: JCI | PubMed | Google Scholar |

1Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore

2Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore

3Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore

4Department of Microbiology, Singapore General Hospital, Singapore, Singapore

5Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore

Find articles by Salazar, E. in: JCI | PubMed | Google Scholar

Published May 10, 2022 - More info

J Clin Invest. https://doi.org/10.1172/JCI159500.
Copyright © 2022, Qui et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published May 10, 2022 - Version history
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Abstract

BACKGROUND. Patients undergoing immune-modifying therapies demonstrate a reduced humoral response after COVID-19 vaccination, but we lack a proper evaluation of the impact of such therapies on vaccine-induced T cell responses.

METHODS. We longitudinally characterized humoral and Spike-specific T cell responses in inflammatory bowel disease (IBD) patients who are on antimetabolite therapy (azathioprine or methotrexate), TNF inhibitors and/or other biologic treatment (anti-integrin or anti-p40) for up to 6 months after completing two-dose COVID-19 mRNA vaccination.

RESULTS. We demonstrated that a Spike-specific T cell response is not only induced in treated IBD patients at levels similar to healthy individuals, but also sustained at higher magnitude for up to 6 months after vaccination, particularly in those treated with TNF inhibitor therapy. Furthermore, the Spike-specific T cell response in these patients is mainly preserved against mutations present in SARS-CoV-2 B.1.1.529 (Omicron) and characterized by a Th1/IL-10 cytokine profile.

CONCLUSION. Despite the humoral response defects, patients under immune-modifying therapies demonstrated a favorable profile of vaccine-induced T cell responses that might still provide a layer of COVID-19 protection.

FUNDING. This study was funded by the National Centre for Infectious Diseases NCID Catalyst Grant (FY2021ES) and the National Research Fund Competitive Research Programme (NRF-CRP25-2020-0003). The funders played no role in the design, conduct, or reporting of this study.

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