ABSTRACT
Objective: to evaluate the immune response to the SARS-CoV-2 vaccines in adults with immune-mediated rheumatic diseases (IMRDs) in comparison to healthy individuals, observed 1-20 weeks following the fourth vaccine dose. Additionally, to evaluate the impact of immunosuppressive therapies, vaccination schedules, the time interval between vaccination and sample collection on the vaccine's immune response. Methods: We designed a longitudinal observational study conducted at the rheumatology department of Hospital de Copiapó. Neutralizing antibodies (Nabs) titers against the Wuhan and Omicron variant were analyzed between 1-20 weeks after administration of the fourth dose of the SARS-CoV-2 vaccine to 341 participants (218 IMRD patients and 123 healthy controls). 218 IMRD patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), systemic lupus erythematosus (SLE), systemic vasculitis (VS) and systemic scleroderma (SS) were analyzed. Results: Performing a comparison between the variants, Wuhan vs Omicron, we noticed that there were significant differences (p<0.05) in the level of the ID50, both for healthy controls and for patients with IMRDs. The humoral response of patients with IMRDs is significantly lower compared to healthy controls for the Omicron variant of SARS-CoV-2 (p = 0.0015). The humoral response of patients with IMRDs decreases significantly when the time interval between vaccination and sample collection is greater than 35 days. This difference was observed in the response, both for the Wuhan variant and for the Omicron variant. Conclusion: The IMRDs patients, the humoral response variation in the SARS-CoV-2 vaccine depends on doses and type of vaccine administered, the humoral response times and the treatment that these patients are receiving.
Subject(s)
Antibodies, Neutralizing , Antibodies, Viral , COVID-19 Vaccines , COVID-19 , Immunization, Secondary , Rheumatic Diseases , SARS-CoV-2 , Humans , Male , Middle Aged , Female , COVID-19/immunology , COVID-19/prevention & control , SARS-CoV-2/immunology , COVID-19 Vaccines/immunology , COVID-19 Vaccines/administration & dosage , Antibodies, Neutralizing/blood , Antibodies, Neutralizing/immunology , Rheumatic Diseases/immunology , Antibodies, Viral/blood , Antibodies, Viral/immunology , Adult , Aged , Longitudinal Studies , VaccinationABSTRACT
SUMMARY: Mast cells (MC) are cells of the immune system that regulate cell and tissue homeostasis, are found in low numbers, have an intact plasma membrane, and a cytoplasm with a wide variety of inflammatory chemical mediators. The activation or degranulation of mast cells implies the release of these chemical mediators (interleukins, cytokines, and more), causing tissue actions ranging from the activation of metalloproteinases to the development of anaphylactic hypersensitivity of different degrees, alterations in vascular permeability, and loss of cell homeostasis. This behavior would allow them to act as sentinels responding to pathophysiological processes. During the COVID-19 pandemic, in positive human patients, the available literature reports the presence and degranulation of mast cells in a generalized manner, especially in the respiratory tract. This study aimed to analyze the emerging role of MCs in the pathogenesis of diseases and their projection as biological markers in the treatment of diseases or pandemics. The analysis of human biopsies showed that MCs are observed as cells with diameters between 8 to 20 µm, and in inflamed tissues, degranulation of MCs is observed. The action of MCs degranulation was related to different inflammatory processes of autoimmune diseases. It is concluded that the potential of MC as therapeutic targets and biomarkers could raise new pharmacological targets, as supportive therapy, and possibly of great help in the treatment of future emerging pandemics such as the current monkeypox.
Los mastocitos (MC) son células del sistema inmune que regulan la homeostasis celular y tisular, se encuentran en escasas cantidades, presentan una membrana plasmática íntegra, y un citoplasma con una amplia variedad de mediadores químicos. La activación o degranulación de los mastocitos implica la liberación de estos mediadores químicos (interleuquinas, citoquina y más), provocando acciones tisulares que van desde la activación de metaloproteinasas hasta el desarrollo de hipersensibilidad anafiláctica de distinto grado, provocando la pérdida de la homeostasis celular. Durante la pandemia de la COVID-19, en pacientes humanos positivos, se informa recurrentemente la presencia y degranulación de mastocitos de manera generalizada sobre todo en las vías respiratorias. El análisis de la degranulación de los MCs podría proporcionar información que podría utilizarse en el desarrollo de tratamientos preventivos contra infecciones virales, bacterianas u otros patógenos. Este comportamiento les permitiría actuar como centinelas en respuesta a procesos fisiopatológicos. El objetivo de este trabajo fue analizar el rol emergente de los MCs en la patogenia de enfermedades y su proyección como marcadores biológicos en el tratamiento de enfermedades o pandemias. En análisis de biopsias humanas se muestran que MCs se observan como células con diámetros de entre 8 a 20 µm, en tejidos inflamados se observa degranulación de MCs. Se relacionó el accionar de degranulación de los MCs en diferentes procesos inflamatorios de enfermedades autoinmunes. Se concluye que el potencial de MC como dianas terapéuticas y biomarcadores podrían plantear nuevos objetivos farmacológicos, como terapia de apoyo, y posiblemente de gran ayuda en el tratamiento de futuras pandemias emergentes como la actual viruela del mono.