CIDP: Analysis of Immunomarkers During COVID-19 MRNA-Vaccination and IVIg-Immunomodulation: An Exploratory Study

Overview

Journal J Neuroimmune Pharmacol

Specialties Allergy & Immunology
Neurology
Pharmacology

Date 2023 Mar 17

PMID 36929282

Authors

Martin K R Svacina

Anika Meissner

Finja Schweitzer

Alina Sprenger-Svacina

Ines Klein

Hauke Wustenberg

Felix Kohle

Helene L Walter

Michael Schroeter

Helmar C Lehmann

Affiliations

Soon will be listed here.

Abstract

Availability of COVID-19 mRNA vaccine for patients with chronic inflammatory demyelinating polyneuropathy (CIDP) treated with intravenous immunoglobulin (IVIg) raises the question of whether COVID-19 mRNA vaccine influences disease activity or IVIg-mediated immunomodulation in CIDP. In this exploratory study, blood samples of CIDP patients on IVIg treatment were longitudinally analyzed before and after vaccination with a COVID-19 mRNA vaccine. A total of 44 samples of eleven patients were characterized at four timepoints by ELISA and flow cytometry in terms of immunomarkers for disease activity and IVIg-immunomodulation. Apart from a significantly lower expression of CD32b on naïve B cells after vaccination, no significant alteration of immunomarkers for CIDP or IVIg-mediated immunomodulation was observed. Our exploratory study suggests that COVID-19 mRNA vaccine does not have a relevant impact on immune activity in CIDP. In addition, immunomodulatory effects of IVIg in CIDP are not altered by COVID-19 mRNA vaccine. This study was registered in the German clinical trial register (DRKS00025759). Overview over the study design. Blood samples of CIDP patients on recurrent IVIg treatment and vaccination with a COVID-19 mRNA vaccine were obtained at four timepoints for cytokine ELISA and flow cytometry, to assess key cytokines and cellular immunomarkers for disease activity and IVIg-immunomodulation in CIDP.

References

Boruchov A, Heller G, Veri M, Bonvini E, Ravetch J, Young J . Activating and inhibitory IgG Fc receptors on human DCs mediate opposing functions. J Clin Invest. 2005; 115(10):2914-23. PMC: 1201664. DOI: 10.1172/JCI24772. View

Doneddu P, Spina E, Briani C, Fabrizi G, Manganelli F, Nobile-Orazio E . Acute and chronic inflammatory neuropathies and COVID-19 vaccines: Practical recommendations from the task force of the Italian Peripheral Nervous System Association (ASNP). J Peripher Nerv Syst. 2021; 26(2):148-154. DOI: 10.1111/jns.12435. View

Jordan S . Innate and adaptive immune responses to SARS-CoV-2 in humans: relevance to acquired immunity and vaccine responses. Clin Exp Immunol. 2021; 204(3):310-320. PMC: 8013613. DOI: 10.1111/cei.13582. View

Kajii M, Kobayashi F, Kashihara J, Yuuki T, Kubo Y, Nakae T . Intravenous immunoglobulin preparation attenuates neurological signs in rat experimental autoimmune neuritis with the suppression of macrophage inflammatory protein -1α expression. J Neuroimmunol. 2013; 266(1-2):43-8. DOI: 10.1016/j.jneuroim.2013.10.011. View

Karnell J, Dimasi N, Karnell 3rd F, Fleming R, Kuta E, Wilson M . CD19 and CD32b differentially regulate human B cell responsiveness. J Immunol. 2014; 192(4):1480-90. PMC: 3918864. DOI: 10.4049/jimmunol.1301361. View

Lahoz Fernandez P, Miranda Pereira J, Fonseca Risso I, Silva P, Freitas Barboza I, Vieira Silveira C . Guillain-Barre syndrome following COVID-19 vaccines: A scoping review. Acta Neurol Scand. 2021; 145(4):393-398. DOI: 10.1111/ane.13575. View

Lehmann H, Burke D, Kuwabara S . Chronic inflammatory demyelinating polyneuropathy: update on diagnosis, immunopathogenesis and treatment. J Neurol Neurosurg Psychiatry. 2019; 90(9):981-987. DOI: 10.1136/jnnp-2019-320314. View

Mason A, Anver H, Lwin M, Holroyd C, Faust S, Edwards C . Lupus, vaccinations and COVID-19: What we know now. Lupus. 2021; 30(10):1541-1552. DOI: 10.1177/09612033211024355. View

Mata S, Corzani S, Biagiotti R, Piacentini S, Siracusa G, Giudizi M . Influence of impaired T- and B-cell compartments on efficacy of IVIg in dysimmune neuropathies. Eur J Neurol. 2007; 14(10):1147-53. DOI: 10.1111/j.1468-1331.2007.01929.x. View

10.

Nimmerjahn F, Ravetch J . Fc-receptors as regulators of immunity. Adv Immunol. 2007; 96:179-204. DOI: 10.1016/S0065-2776(07)96005-8. View

11.

Press R, Pashenkov M, Jin J, Link H . Aberrated levels of cerebrospinal fluid chemokines in Guillain-Barré syndrome and chronic inflammatory demyelinating polyradiculoneuropathy. J Clin Immunol. 2003; 23(4):259-67. DOI: 10.1023/a:1024532715775. View

12.

Ritter C, Forster D, Albrecht P, Hartung H, Kieseier B, Lehmann H . IVIG regulates BAFF expression in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). J Neuroimmunol. 2014; 274(1-2):225-9. DOI: 10.1016/j.jneuroim.2014.06.007. View

13.

Sanvito L, Makowska A, Gregson N, Nemni R, Hughes R . Circulating subsets and CD4(+)CD25(+) regulatory T cell function in chronic inflammatory demyelinating polyradiculoneuropathy. Autoimmunity. 2009; 42(8):667-77. DOI: 10.3109/08916930903140907. View

14.

Svacina M, Roth P, Bobylev I, Sprenger A, Zhang G, Sheikh K . Changes of Serum IgG Dimer Levels after Treatment with IVIg in Guillain-Barré Syndrome. J Neuroimmune Pharmacol. 2019; 14(4):642-648. DOI: 10.1007/s11481-019-09871-0. View

15.

Tackenberg B, Jelcic I, Baerenwaldt A, Oertel W, Sommer N, Nimmerjahn F . Impaired inhibitory Fcgamma receptor IIB expression on B cells in chronic inflammatory demyelinating polyneuropathy. Proc Natl Acad Sci U S A. 2009; 106(12):4788-92. PMC: 2660764. DOI: 10.1073/pnas.0807319106. View

16.

Takai T, Ono M, Hikida M, Ohmori H, Ravetch J . Augmented humoral and anaphylactic responses in Fc gamma RII-deficient mice. Nature. 1996; 379(6563):346-9. DOI: 10.1038/379346a0. View

17.

van den Bergh P, Hadden R, Bouche P, Cornblath D, Hahn A, Illa I . European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force of the European Federation of Neurological Societies and the.... Eur J Neurol. 2010; 17(3):356-63. DOI: 10.1111/j.1468-1331.2009.02930.x. View

18.

Van den Bergh P, van Doorn P, Hadden R, Avau B, Vankrunkelsven P, Allen J . European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint Task Force-Second revision. J Peripher Nerv Syst. 2021; 26(3):242-268. DOI: 10.1111/jns.12455. View

19.

Veri M, Gorlatov S, Li H, Burke S, Johnson S, Stavenhagen J . Monoclonal antibodies capable of discriminating the human inhibitory Fcgamma-receptor IIB (CD32B) from the activating Fcgamma-receptor IIA (CD32A): biochemical, biological and functional characterization. Immunology. 2007; 121(3):392-404. PMC: 2265948. DOI: 10.1111/j.1365-2567.2007.02588.x. View

20.

Wiertsema S, Veenhoven R, Walraven V, Uiterwaal C, Schilder A, Rijkers G . Pneumococcal vaccine efficacy for mucosal pneumococcal infections depends on Fcgamma receptor IIa polymorphism. Vaccine. 2005; 24(6):792-7. DOI: 10.1016/j.vaccine.2005.08.029. View