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Impact of synthetic and biological immunomodulatory therapy on the duration of 17DD yellow fever vaccine-induced immunity in rheumatoid arthritis

Article scientifique 2019 Anglais

Résumé

The 17DD-yellow fever (YF) vaccine induces a long-lasting protective immunity, resulting from humoral and cellular immunological memory. The treatment of rheumatoid arthritis (RA) patients with disease-modifying anti-rheumatic drugs (DMARD) may affect pre-existing 17DD-vaccine protective immunity and increase the risk of acquiring YF infection. Our goal was to determine whether DMARD would affect the duration of YF-specific protective immunity in RA patients. A total of 122 RA patients, previously immunized with the 17DD-YF vaccine (1–5, 5–9, and ≥ 10 years) and currently under DMARD therapy, were enrolled in the present investigation. Immunomodulatory therapy encompasses the use of conventional synthetic DMARD alone (csDMARD) or combines with biological DMARD (cs+bDMARD). A total of 226 healthy subjects were recruited as a control group (CONT). Neutralizing antibody responses were measured by a plaque-reduction neutralization test (PRNT), and cellular immunity was evaluated by an in vitro 17DD-YF-specific peripheral blood lymphoproliferative assay. The data demonstrated that csDMARD therapy did not affect the duration of protective immunity induced by the 17DD-YF vaccine compared to that of CONT, as both presented a significant time-dependent decline at 10 years after vaccination. Conversely, cs+bDMARD therapy induced a premature depletion in the main determinants of the vaccine protective response, with diminished PRNT seropositivity levels between 5 and 9 years and impaired effector memory in CD8+ T cells as early as 1–5 years after 17DD-YF vaccination. These findings could support changing the vaccination schedule of this population, with the possibility of a planned booster dose upon the suspension of bDMARD in cases where this is allowed, even before 10 years following 17DD-YF vaccination. The benefit of a planned booster dose should be evaluated in further studies. RBR-946bv5 . Date of registration: March 05, 2018. Retrospectively registered

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Ferreira, C., Campi‐Azevedo, A., Peruhype-Magalhães, V., Coelho-dos-Reis, J., Antonelli, L., Torres, K., Freire, L., Costa-Rocha, I., Oliveira, A., Maia, M., Lima, S., Domingues, C., Teixeira‐Carvalho, A., Martins‐Filho, O., Mota, L. (2019). Impact of synthetic and biological immunomodulatory therapy on the duration of 17DD yellow fever vaccine-induced immunity in rheumatoid arthritis. https://doi.org/10.1186/s13075-019-1854-6

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Auteur(s)

Clarissa de Castro Ferreira Ana Carolina Campi‐Azevedo Vanessa Peruhype-Magalhães Jordana Grazziela Alves Coelho-dos-Reis Lis Ribeiro do Valle Antonelli Karen Torres Larissa Chaves Freire Ismael Artur da Costa-Rocha Ana Oliveira Maria de Lourdes de Sousa Maia Sheila Maria Barbosa de Lima Carla Magda Allan Santos Domingues Andréa Teixeira‐Carvalho Olindo Assis Martins‐Filho Lícia Maria Henrique da Mota

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