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S13.1 Developing systemic autoimmune diseases in healthy subjects persistently positive for antiphospholipid antibodies: long-term follow-up study S13.1抗磷脂抗体持续呈阳性的健康受试者发生全身性自身免疫性疾病:长期随访研究
Pub Date : 2022-09-27 DOI: 10.1136/lupus-2022-elm2022.28
F. Ceccarelli, F. Natalucci, G. Olivieri, C. Pirone, L. Picciariello, V. Orefice, F. Spinelli, C. Alessandri, A. Chistolini, F. Conti
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引用次数: 0
S05.2 Risk of COVID-19 induced systemic lupus erythematosus flare: analysis of the AP-HP clinical data warehouse S05.2新冠肺炎致系统性红斑狼疮爆发风险:AP-HP临床数据仓库分析
Pub Date : 2022-09-27 DOI: 10.1136/lupus-2022-elm2022.12
A. Mageau, T. Papo, J. Timsit, K. Sacré
S05.2 Table 1ConclusionsAutoimmune flares seem to be frequent after COVID-19 infection among SLE population. We did not identify any risk factor associated with a risk of post-COVID-19 SLE flare.
表1结论在SLE人群中,COVID-19感染后自身免疫性耀斑似乎很常见。我们没有发现任何与covid -19后SLE发作风险相关的风险因素。
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引用次数: 0
S05.1 Efficacy and safety of the anti-SARS-CoV-2 BNT162b2 vaccine among SLE patients: the covalus project S05.1抗sars - cov -2 BNT162b2疫苗在SLE患者中的有效性和安全性:covalus项目
Pub Date : 2022-09-27 DOI: 10.1136/lupus-2022-elm2022.11
A. Mageau, V. Ferré, P. Nicaise Roland, T. Papo, T. Goulenok, J. Tchen, N. Charles, K. Sacré
PurposeVaccination in patients with autoimmune disease like systemic lupus erythematosus (SLE) raises a special concern because its impact on autoimmunity remains partially unknown. While clinical data from large cohort are reassuring [1], very little has been described on the post vaccination immune system reaction. Besides, long-term efficacy of the vaccine, especially regarding T-cell response has not been evaluated in detail.MethodsWe conducted a prospective observational study that included all the adult SLE patients vaccinated by the BNT162b2 anti-SARS-CoV-2 vaccine in a single tertiary medical center in Paris. We evaluated the efficacy and the safety of the vaccine just before the first dose and then one month (M1), three months (M3) and six months (M6) later. Apart from the standard clinical and biological follow-up, we measured, at each time, the proportion of plasmacytoid dendritic cells (PDCs) producing interferon-α (IFN-α) using intracellular flow cytometry staining. We quantified the activation of autoimmune T cells at each visit by stimulating the peripheral blood mononuclear cells (PBMCs) with nuclear antigens and quantifying the proportion of activated (CD154+ CD69+) among non-naïve (CD45-RA -) CD4 T cells. We also evaluated the anti-SARS-CoV-2 T cell response by an Interferon Gamma Release Assay (IGRA) test.ResultsWe included 57 SLE patients and 11 healthy volunteers (HV) vaccinated by the BNT162b2 vaccine according to the French national recommendations. SLE patients were mostly female (49/57, 86.0%) with a median [IQR] age of 44.0 [38.1–50.8] years and a time since SLE diagnosis of 10.8 [4.2–19-8] years. Their treatment regimen was heterogeneous: 47/57 (82.5%) received hydroxychloroquine;35 (61.4%) steroids, and 10 (17.5%) were on another immunosuppressive drug (mycophenolate mofetil, azathioprine or rituximab). We observed only one clinical SLE flare during the post vaccination follow-up. Except for this patient, we observed no modification in the anti-dsDNA titer among SLE patients. At M3 compared to T0, we observed more PDCs producing INF-α in the SLE group: 1.17% [0.72–1.77] vs 0.68% [0.34–1.18], p=0.002 but not in the HV group. The proportion of non-naïve CD4 T cells activated (CD154+ CD69+) by the nuclear antigens did not change after vaccination. Regarding the T cell response, we observed that 71% of the SLE patients had a positive IGRA test at M3, whereas at M6, only 36% of them had a positive IGRA test. The antiviral T cell response correlated well with the humoral response: there was no patient with negative anti-Spike serology and positive IGRA and 78% of patients with a positive serology had a positive IGRA test.ConclusionWe observed that BNT162b2 vaccine had a mild impact on innate and adaptative immunity on SLE patients. The antiviral T cell response was well correlated to the humoral anti-Spike response and decreased significantly from M3 to M6.
目的:系统性红斑狼疮(SLE)等自身免疫性疾病患者接种疫苗引起特别关注,因为其对自身免疫的影响仍部分未知。虽然来自大队列的临床数据令人放心[1],但很少有关于疫苗接种后免疫系统反应的描述。此外,疫苗的长期疗效,特别是关于t细胞反应的长期疗效尚未得到详细评价。方法在巴黎某三级医疗中心开展了一项前瞻性观察研究,纳入了所有接种了BNT162b2抗sars - cov -2疫苗的成年SLE患者。我们在首次接种前、1个月(M1)、3个月(M3)和6个月(M6)后分别对疫苗的有效性和安全性进行评估。除了标准的临床和生物学随访外,我们每次都使用细胞内流式细胞术染色测量产生干扰素-α (IFN-α)的浆细胞样树突状细胞(PDCs)的比例。我们通过用核抗原刺激外周血单个核细胞(PBMCs)并量化non-naïve (CD45-RA -) CD4 T细胞中活化(CD154+ CD69+)的比例来量化每次访问时自身免疫T细胞的活化。我们还通过干扰素γ释放试验(IGRA)评估了抗sars - cov -2 T细胞的反应。结果纳入57例SLE患者和11例按照法国国家推荐接种BNT162b2疫苗的健康志愿者(HV)。SLE患者以女性居多(49/57,86.0%),中位[IQR]年龄为44.0[38.1-50.8]岁,SLE诊断时间为10.8[4.2-19-8]年。他们的治疗方案是异质性的:47/57(82.5%)接受羟氯喹;35(61.4%)类固醇;10(17.5%)使用另一种免疫抑制药物(霉酚酸酯、硫唑嘌呤或利妥昔单抗)。在接种疫苗后的随访中,我们只观察到一例临床SLE发作。除该患者外,我们在SLE患者中未观察到抗dsdna滴度的变化。与T0相比,在M3时,我们观察到SLE组中更多的PDCs产生INF-α: 1.17% [0.72-1.77] vs 0.68% [0.34-1.18], p=0.002,但在HV组中没有。接种疫苗后,non-naïve CD4 T细胞被核抗原激活的比例(CD154+ CD69+)没有变化。关于T细胞反应,我们观察到71%的SLE患者在M3时IGRA检测阳性,而在M6时,只有36%的SLE患者IGRA检测阳性。抗病毒T细胞反应与体液反应有很好的相关性:没有抗spike血清学阴性和IGRA阳性的患者,血清学阳性的患者中有78%的IGRA检测阳性。结论BNT162b2疫苗对SLE患者的先天免疫和适应性免疫均有轻微影响。抗病毒T细胞反应与体液抗spike反应密切相关,且从M3到M6显著降低。
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引用次数: 1
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