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We read Kennedy et al1’s findings with interest, and report in-depth analyses of antibody and T cell responses in patients with inflammatory bowel disease (IBD) to COVID-19 vaccination.
We prospectively recruited 100 SARS-CoV-2-uninfected patients with IBD on varying treatments at the Royal Melbourne Hospital (HREC/74403/MH-2021). Healthcare workers who did not have IBD and were not on immunosuppressive medication were enrolled as controls with approvals from Melbourne Health (HREC/68355/MH-2020) and University of Melbourne (HREC 22268, 21626). Participant characteristics are outlined in table 1. IBD medication regimens needed to be stable for at least 8 weeks prior to enrolment. Only one participant was on concomitant low-dose systemic corticosteroids with anti-TNF combination therapy. Eighty-nine patients received BNT162b2 (Pfizer–BioNTech), and 11 received ChAdOx1 nCoV-19 (Oxford–AstraZeneca). No participants had a clinical history of SARS-CoV-2 infection at enrolment.
Anti-S1/2 and anti-RBD SARS-CoV-2-specific antibodies were measured at baseline and at five time points after COVID-19 vaccination (figure 1A). Whole blood analyses of antibody-secreting cells (ASCs), circulating T follicular helper (Tfh) cells, CD4+ T cells and CD8+ T cells, was performed across V0-V6 to determine activation profiles. Spike protein S1/2 receptor binding domain specific IgG antibodies were measured using the LIAISON DiaSorin electrochemiluminenscence immunoassay. IgG ELISA was used to assess the presence of antibodies against ancestral SARS-CoV-2 RBD in plasma, as previously described.2 Activation-induced marker assay was performed on PBMCs at V0, V3 and V6 time points according to Grifoni et al with minor modifications.3 Four IBD participants were infected with COVID-19 during the study period, which was noted via …
KK and BC are joint senior authors.
Twitter @rupertleong, @IBDmedicaldoc
EZ and THON contributed equally.
Correction notice This article has been corrected since it published Online First. The author's name, Katherine Kedzierska, has been amended.
Contributors BC, KK and RWL supervised the study. EZ, THON, LFA, LK, KB, DAW, BC and KK designed the experiments. THON, LFA, LK and LCR performed humoral and T cell experiments. THON, LFA, LCR, SYC, WZ, JRH and IJF processed bloods and performed whole blood staining. EZ, THON, LFA, LK, TM and KB analysed data. EZ, JM and BC recruited the IBD vaccinated patients and collated patients’ clinical data. LCR, JM, KB and DAW recruited the healthy vaccinated cohorts. EZ, THON, LFA, BC and KK wrote the manuscript. All authors reviewed and approved the manuscript.
Funding This work was supported by the GESA Rose Amarant Grant to EZ, Eric Charles Smith Grant to BC, NHMRC Leadership Investigator Grant to KK (#1173871), NHMRC Emerging Leadership Level 1 Investigator Grant to THON (#1194036), NHMRC Emerging Leadership Level 2 Investigator Grant to DAW (#1174555), Research Grants Council of the Hong Kong Special Administrative Region, China (#T11-712/19-N n) to KK, MRFF Award (#2016062) to KK, THON and LCR, MRFF Award (#1202445) to KK, MRFF Award (#2005544) to KK.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.