Avani Dave, Jai Hind College
A recent study conducted by Satveer Mahil et al., showcased in the current year’s European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) and published in The Lancet Rheumatology, demonstrates that it is not the response of T-cell but that of the antibody to the first jab of the Pfizer COVID-19 vaccine that was seen to be debilitated in patients who took methotrexate, an immunosuppressive agent. On the contrary, the T-cell and antibody response was not seen to be altered in the case of patients taking tumour necrosis factor (TNF) inhibitors or other biological immunosuppressants.
Immunity-related inflammatory diseases are observed in approximately 3% – 7% of the population residing in Europe and North America. Some of the most commonly occurring diseases are psoriasis, rheumatoid arthritis, and inflammatory bowel disease. The weakening of the hyperactive immune response can be brought about by utilizing immunosuppressants like methotrexate, TNF inhibitors, and several targeted therapies. Although these drugs are efficient in controlling the response they simultaneously lead to the development of chronic infections.
The patients using immunosuppressants to treat inflammatory diseases were not a part of the COVID-19 vaccine trials, which is why there is insufficient data to study the effect of the vaccine on these targeted groups of patients.
An extension of the time interval between the consecutive doses has been incorporated in several countries to ensure that a greater population gets vaccinated. This makes it very essential to assess the immune response in the people that have taken the first dose, which will lead to a more discrete understanding of the subsequent protocols.
Dr Satveer Mahil and his colleagues from St John’s Institute of Dermatology, Guy’s and St Thomas’ NHS Foundation Trust, and King’s College London conducted this study, where they brought about the enrolment of 101 participants in a time frame of 3 months, January 2021 to April 2021. Out of the total 101 enrolments, 84 patients were suffering from psoriasis while 17 of them were healthy volunteers. The average age of these 101 participants’ was around 43, 45% were female, 84%belonged to white ethnicity, the volunteers had never suffered from covid-19.
The patients suffering from psoriasis were divided into 4 different groups based on the various immunosuppressants.
- 17 patients were on methotrexate; 15mg/week.
- 27 patients were on TNF inhibitors.
- 15 patients were on interleukin (IL)-17 inhibitors.
- 25 patients were on IL-23 inhibitors.
The first round of measurement of the participants’ immune response was conducted just before the single dose of Pfizer vaccine was given, followed by the second round of collection of immune response measurements after 28 days of the first dose. The rate of antibody production was observed to be lower in the participants who were kept on immunosuppressive treatment and was the least in patients who were on methotrexate. On the contrary, all the 17 healthy participants showed normal seroconversion rates. The T-cell response in the entire sample size showed a homogeneous distribution. The data from the second round of immune response measurement is yet to be collected and will allow us to reach a more conclusive end.
In the authors’ opinion, the efficacy of the vaccine in the case of immunocompromised individuals and their response to a potential attack by the SARS-CoV-2 stands to be a concerning area due to the high immunity escaping ability of the multiple variants of the novel virus. As global vaccine drives aim to cover a larger population, it becomes increasingly important to focus on identifying the effects of the COVID-19 vaccine on this group of individuals.
Analysis of the data collected from this study records the unaltered T-cell responses in patients who were taking immunosuppressive agents like methotrexate or even a biologic therapy after the single dose of Pfizer COVID-19 vaccine. These patients need to be monitored continuously to be able to successfully dictate the clinical efficacy of the vaccines.
Also read: The first official case of Zika virus in Kerala!
Sources: “Antibody but Not T-Cell Response after First Dose of Pfizer COVID-19 Vaccine Is Weakened in Patients Receiving Methotrexate.” Science Codex. (July 8, 2021). https://www.sciencecodex.com/antibody-not-t-cell-response-after-first-dose-pfizer-covid-19-vaccine-weakened-patients-receiving
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About the author: Avani Dave is currently in the final year of her bachelor’s degree, majoring in Life Sciences. Holding a good academic and extra-curricular record, she is on a constant journey of acquiring exposure in her field of interest while simultaneously not limiting herself to just that. Avani likes studying Diseases and Syndromes and everything under this umbrella! That being said, she is adept at working across departments and promises to deliver.
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