Assuntos
Adalimumab/imunologia , Anticorpos Anti-Idiotípicos/sangue , Doença de Crohn/tratamento farmacológico , Cadeias alfa de HLA-DQ/genética , Haplótipos , Infliximab/imunologia , Polimorfismo Genético , Inibidores do Fator de Necrose Tumoral/imunologia , Adalimumab/efeitos adversos , Doença de Crohn/sangue , Doença de Crohn/diagnóstico , Doença de Crohn/imunologia , Epitopos , Cadeias alfa de HLA-DQ/imunologia , Humanos , Infliximab/efeitos adversos , Resultado do Tratamento , Inibidores do Fator de Necrose Tumoral/efeitos adversosRESUMO
Since the beginning of the pandemic, patients with inflammatory bowel diseases [IBD] have been considered at high risk for infection and complications of COVID-19. IBD patients and patients taking immunosuppressive therapy were excluded from clinical phase III vaccine trials, complicating the assessment of effectiveness of these new vaccines. From past experience we know that adapted vaccination strategies may be appropriate in some IBD patients to optimise immunogenicity. We review current evidence on SARS-CoV-2 vaccination relevant to IBD patients, including immune responses from humoral to cellular, emerging data on new variants, and off-label vaccination schemes. We also identify clinical and scientific knowledge gaps that can be translated into both large-scale population-based studies and targeted vaccine studies to describe the precise immune responses induced by SARS-CoV-2 vaccines in IBD patients. We strongly endorse the recommendation of vaccinating IBD patients to ensure maximal protection from COVID-19 both for the individual and the community.