Multiple sclerosis patients under treatment with interferon β1-a or ocrelizumab exhibit different T and B cell responses to SARS-CoV-2 vaccine.

Multiple sclerosis (MS) is a long-term autoimmune disease characterized by inflammation and progressive degeneration of the central nervous system. Disease-modifying therapies (DMTs) have proved to be effective at ameliorating the course of MS. DMTs are immunomodulatory drugs affecting immune response to SARS-CoV-2 and its vaccine efficacy in MS patients (pwMS).

In this longitudinal study, we analyzed T and B cell subsets in peripheral blood and the antigen (spike)-specific T cell response in pwMS patients undergoing interferon β1-a (IFN) or ocrelizumab (OCRE), before and after BNT162b2 mRNA SARS-CoV-2 vaccination. Blood was collected from pwMS treated with IFN and OCRE before and after the two vaccine doses. Peripheral blood mononuclear cells were analyzed by flow cytometry to measure T and B cell frequency, the expression of activation/regulatory/memory T cell markers and their spike-specific T cell response.

CD20+ B-cells were decreased in OCRE- compared to IFN- treated pwMS before and after vaccination. CD8+ and CD4+ T cell responses and the immunological memory was comparable between the two groups. Th17 cells were increased after vaccination only in the OCRE-treated group. We detected a robust spike-specific T cell response, paralleled by a significant decrease of Treg frequency, in both pwMS groups.

Although IFN and OCRE induced distinct immunological profile, both DMTs allowed to mount a vaccine-induced cellular and humoral immune response. This study also represents a model that could be applied to dissect the vaccine-elicited immune response in individuals undergoing treatment with different biological drugs.
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Authors

Liotti Liotti, Maniscalco Maniscalco, Ferrara Ferrara, Mazzone Mazzone, Dehbozorgi Dehbozorgi, Szabó Szabó, Belardo Belardo, Marcogiuseppe Marcogiuseppe, De Martino De Martino, Di Battista Di Battista, Servillo Servillo, Moreggia Moreggia, Di Giulio Cesare Di Giulio Cesare, Andreone Andreone, Varricchi Varricchi, De Rosa De Rosa
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