Development of humoral and cellular immunological memory against SARS-CoV-2 despite B cell depleting treatment in multiple sclerosis

• Main Authors: Klara Asplund Högelin, Nicolas Ruffin, Elisa Pin, Anna Månberg, Sophia Hober, Guro Gafvelin, Hans Grönlund, Peter Nilsson, Mohsen Khademi, Tomas Olsson, Fredrik Piehl, Faiez Al Nimer
• Format: Article
• Language: English
• Published: Elsevier 2021-09-01
• Series: iScience
• Subjects: Immunology; Virology
• Online Access: http://www.sciencedirect.com/science/article/pii/S2589004221010464

Summary: B cell depleting therapies (BCDTs) are widely used as immunomodulating agents for autoimmune diseases such as multiple sclerosis. Their possible impact on development of immunity to severe acute respiratory syndrome virus-2 (SARS-CoV-2) has raised concerns with the coronavirus disease 2019 (COVID-19) pandemic. We here evaluated the frequency of COVID-19-like symptoms and determined immunological responses in participants of an observational trial comprising several multiple sclerosis disease modulatory drugs (COMBAT-MS; NCT03193866) and in eleven patients after vaccination, with a focus on BCDT. Almost all seropositive and 17.9% of seronegative patients on BCDT, enriched for a history of COVID-19-like symptoms, developed anti-SARS-CoV-2 T cell memory, and T cells displayed functional similarity to controls producing IFN-γ and TNF. Following vaccination, vaccine-specific humoral memory was impaired, while all patients developed a specific T cell response. These results indicate that BCDTs do not abrogate SARS-CoV-2 cellular memory and provide a possible explanation as to why the majority of patients on BCDTs recover from COVID-19.