Evidence map›Paper›PMID 33851176›Full record

ArticlemedRxiv : the preprint server for health sciences2021

Glucocorticoids and B Cell Depleting Agents Substantially Impair Immunogenicity of mRNA Vaccines to SARS-CoV-2.

Parakkal Deepak, Wooseob Kim, Michael A Paley, Monica Yang, Alexander B Carvidi, Alia A El-Qunni, Alem Haile, Katherine Huang, Baylee Kinnett, Mariel J Liebeskind and 27 more

Open access · greenAbstract readPreprint
PubMed Full text at PMC Publisher
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 140 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Journal fur klinische Endokrinologie und Stoffwechsel · 2022
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

37 authors at 2 institutions in 1 country.

Parakkal DeepakInflammatory Bowel Diseases Center, Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Wooseob KimDivision of Immunobiology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA.
Michael A PaleyDivision of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Monica YangDivision of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Alexander B CarvidiDivision of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Alia A El-QunniDivision of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Alem HaileClinical Trials Unit, Washington University School of Medicine, St. Louis, MO, USA.
Katherine HuangDivision of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Baylee KinnettDivision of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Mariel J LiebeskindDepartment of Genetics, Washington University School of Medicine, St. Louis, MO, USA.
Zhuoming LiuDepartment of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, USA.
Lily E McMorrowDivision of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Diana PaezDivision of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Dana C PerantieDepartment of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
Rebecca E SchrieferDivision of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Shannon E SidesDepartment of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
Mahima ThapaDivision of Immunobiology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA.
Maté GergelyDivision of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Suha AbushammaDivision of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Michael KlebertDivision of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Lynne MitchellDivision of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Darren NixDivision of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Jonathan GrafDivision of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Kimberly E TaylorDivision of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Salim ChahinDepartment of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
Matthew A CiorbaInflammatory Bowels Diseases Center, Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Patricia KatzDivision of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Mehrdad MatloubianDivision of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Jane A O'HalloranDivision of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Rachel M PrestiDivision of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Gregory F WuDepartment of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Division of Immunobiology, Department of Pathology and Immunology, Washington, University School of Medicine, St. Louis, MO, USA; The Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, MO, USA.
Sean P J WhelanDepartment of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, USA.
William J BuchserDepartment of Genetics, Washington University School of Medicine, St. Louis, MO, USA.
Lianne S GenslerDivision of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Arthritis/Immunology Section, San Francisco Veterans Administration Health Care System, San Francisco, CA, USA.
Mary C NakamuraDivision of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Arthritis/Immunology Section, San Francisco Veterans Administration Health Care System, San Francisco, CA, USA.
Ali H EllebedyDivision of Immunobiology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA; The Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, MO, USA.
Alfred H J KimDivision of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA; Division of Immunobiology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA; The Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, MO, USA.
Washington University in St. Louis · USUniversity of California, San Francisco · US

Funding

Washington University Center for Cellular ImagingP30CA091842 · NCI · WASHINGTON UNIVERSITY · PI AIMEE S JAMES · 2001 to 2026
$128.0M
COLLABORATIVE INFLUENZA VACCINE INNOVATION CENTER: UNIVERSAL INFLUENZA VACCINE RESEARCH75N93019C00051 · NIAID · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI KRAMMER, FLORIAN · 2019 to 2025
$105.4M
WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
Washington University DDRCC Supplemental Equipment RequestP30DK052574 · NIDDK · WASHINGTON UNIVERSITY · PI Nicholas O. Davidson · 2000 to 2026
$30.8M
RESOURCE-BASED CENTER FOR THE ADVANCEMENT OF PRECISION MEDICINE IN RHEUMATOLOGYP30AR070155 · NIAMS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Mary C Nakamura · 2016 to 2026
$8.2M
Washington University Rheumatic DiseasesResearch Resource-based CenterP30AR073752 · NIAMS · WASHINGTON UNIVERSITY · PI Christine T. Pham · 2018 to 2026
$7.6M
Programming Durable Immune Responses To VaccinationU01AI141990 · NIAID · WASHINGTON UNIVERSITY · PI Ali Hassan Ellebedy · 2019 to 2026
$5.3M
TARGETING TRYPTOPHAN METABOLISM IN COLITIS ASSOCIATED CANCERR01DK109384 · NIDDK · WASHINGTON UNIVERSITY · PI CIORBA, MATTHEW AARON · 2016 to 2020
$1.7M
The Role of TRPV4 in central nervous system immunity and diseaseR01NS106289 · NINDS · WASHINGTON UNIVERSITY · PI WU, GREGORY · 2018 to 2021
$1.6M
NCATS NIH HHS UL1 TR002345NCI NIH HHS P30 CA091842NIAID NIH HHS 75N93019C00051NIAID NIH HHS HHSN272201400006CNIAID NIH HHS HHSN272201400008CNIAID NIH HHS U01 AI141990NIAMS NIH HHS P30 AR070155NIAMS NIH HHS P30 AR073752NIDDK NIH HHS P30 DK052574NIDDK NIH HHS R01 DK109384NINDS NIH HHS R01 NS106289
6 · The paper itself

Abstract

backgroundIndividuals with chronic inflammatory diseases (CID) are frequently treated with immunosuppressive medications that can increase their risk of severe COVID-19. While novel mRNA-based SARS-CoV-2 vaccination platforms provide robust protection in immunocompetent individuals, the immunogenicity in CID patients on immunosuppression is not well established. Therefore, determining the effectiveness of SARS-CoV-2 vaccines in the setting of immunosuppression is essential to risk-stratify CID patients with impaired protection and provide clinical guidance regarding medication management.

methodsWe conducted a prospective assessment of mRNA-based vaccine immunogenicity in 133 adults with CIDs and 53 immunocompetent controls. Blood from participants over 18 years of age was collected before initial immunization and 1-2 weeks after the second immunization. Serum anti-SARS-CoV-2 spike (S) IgG

resultsCompared to immunocompetent controls, a three-fold reduction in anti-S IgG titers (P=0.009) and SARS-CoV-2 neutralization (p<0.0001) were observed in CID patients. B cell depletion and glucocorticoids exerted the strongest effect with a 36- and 10-fold reduction in humoral responses, respectively (p<0.0001). Janus kinase inhibitors and antimetabolites, including methotrexate, also blunted antibody titers in multivariate regression analysis (P<0.0001, P=0.0023, respectively). Other targeted therapies, such as TNF inhibitors, IL-12/23 inhibitors, and integrin inhibitors, had only modest impacts on antibody formation and neutralization.

conclusionsCID patients treated with immunosuppressive therapies exhibit impaired SARS-CoV-2 vaccine-induced immunity, with glucocorticoids and B cell depletion therapy more severely impeding optimal responses.

Identifiers

PMID33851176
PMCPMC8043473
OpenAlexW3154998622

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.