Frontiers in Immunology (Jun 2022)
Immunosuppressant Treatment in Rheumatic Musculoskeletal Diseases Does Not Inhibit Elicitation of Humoral Response to SARS-CoV-2 Infection and Preserves Effector Immune Cell Populations
- Andrea Favalli,
- Andrea Favalli,
- Ennio Giulio Favalli,
- Andrea Gobbini,
- Andrea Gobbini,
- Elena Zagato,
- Elena Zagato,
- Mauro Bombaci,
- Gabriella Maioli,
- Elisa Pesce,
- Lorena Donnici,
- Paola Gruarin,
- Martina Biggioggero,
- Serena Curti,
- Lara Manganaro,
- Lara Manganaro,
- Edoardo Marchisio,
- Valeria Bevilacqua,
- Martina Martinovic,
- Tanya Fabbris,
- Maria Lucia Sarnicola,
- Mariacristina Crosti,
- Laura Marongiu,
- Laura Marongiu,
- Francesca Granucci,
- Francesca Granucci,
- Samuele Notarbartolo,
- Alessandra Bandera,
- Alessandra Bandera,
- Alessandra Bandera,
- Andrea Gori,
- Andrea Gori,
- Andrea Gori,
- Raffaele De Francesco,
- Raffaele De Francesco,
- Sergio Abrignani,
- Sergio Abrignani,
- Roberto Caporali,
- Roberto Caporali,
- Renata Grifantini
Affiliations
- Andrea Favalli
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Andrea Favalli
- Ph.D. Program in Translational and Molecular Medicine, Dottorato in Medicina Molecolare e Traslazionale (DIMET), University of Milan-Bicocca, Monza, Italy
- Ennio Giulio Favalli
- Division of Clinical Rheumatology, Aziende Socio Sanitarie Territoriali (ASST) Gaetano Pini-Centro Traumatologico Ortopedico (CTO) Institute, Milan, Italy
- Andrea Gobbini
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Andrea Gobbini
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy
- Elena Zagato
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Elena Zagato
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Mauro Bombaci
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Gabriella Maioli
- Division of Clinical Rheumatology, Aziende Socio Sanitarie Territoriali (ASST) Gaetano Pini-Centro Traumatologico Ortopedico (CTO) Institute, Milan, Italy
- Elisa Pesce
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Lorena Donnici
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Paola Gruarin
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Martina Biggioggero
- Division of Clinical Rheumatology, Aziende Socio Sanitarie Territoriali (ASST) Gaetano Pini-Centro Traumatologico Ortopedico (CTO) Institute, Milan, Italy
- Serena Curti
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Lara Manganaro
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Lara Manganaro
- Department of Pharmacological and Biomolecular Sciences (DiSFeB), University of Milan, Milan, Italy
- Edoardo Marchisio
- Dia.Pro, Diagnostic Bioprobes srl, Milan, Italy
- Valeria Bevilacqua
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Martina Martinovic
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Tanya Fabbris
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Maria Lucia Sarnicola
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Mariacristina Crosti
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Laura Marongiu
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Laura Marongiu
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy
- Francesca Granucci
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Francesca Granucci
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy
- Samuele Notarbartolo
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Alessandra Bandera
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Alessandra Bandera
- Infectious Diseases Unit, Foundation Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca’ Granda Ospedale MaggiorePoliclinico, Milan, Italy
- Alessandra Bandera
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
- Andrea Gori
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Andrea Gori
- Infectious Diseases Unit, Foundation Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca’ Granda Ospedale MaggiorePoliclinico, Milan, Italy
- Andrea Gori
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
- Raffaele De Francesco
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Raffaele De Francesco
- 0Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
- Sergio Abrignani
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- Sergio Abrignani
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Roberto Caporali
- Division of Clinical Rheumatology, Aziende Socio Sanitarie Territoriali (ASST) Gaetano Pini-Centro Traumatologico Ortopedico (CTO) Institute, Milan, Italy
- Roberto Caporali
- 1Department of Clinical Sciences and Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, University of Milan, Milan, Italy
- Renata Grifantini
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
- DOI
- https://doi.org/10.3389/fimmu.2022.873195
- Journal volume & issue
-
Vol. 13
Abstract
COVID-19 has proven to be particularly serious and life-threatening for patients presenting with pre-existing pathologies. Patients affected by rheumatic musculoskeletal disease (RMD) are likely to have impaired immune responses against SARS-CoV-2 infection due to their compromised immune system and the prolonged use of disease-modifying anti-rheumatic drugs (DMARDs), which include conventional synthetic (cs) DMARDs or biologic and targeted synthetic (b/ts) DMARDs. To provide an integrated analysis of the immune response following SARS-CoV-2 infection in RMD patients treated with different classes of DMARDs we carried out an immunological analysis of the antibody responses toward SARS-CoV-2 nucleocapsid and RBD proteins and an extensive immunophenotypic analysis of the major immune cell populations. We showed that RMD individuals under most DMARD treatments mount a sustained antibody response to the virus, with neutralizing activity. In addition, they displayed a sizable percentage of effector T and B lymphocytes. Among b-DMARDs, we found that anti-TNFα treatments are more favorable drugs to elicit humoral and cellular immune responses as compared to CTLA4-Ig and anti-IL6R inhibitors. This study provides a whole picture of the humoral and cellular immune responses in RMD patients by reassuring the use of DMARD treatments during COVID-19. The study points to TNF-α inhibitors as those DMARDs permitting elicitation of functional antibodies to SARS-CoV-2 and adaptive effector populations available to counteract possible re-infections.
Keywords