Abstract
Background Individuals with sarcoidosis are at higher risk for infection owing to underlying disease pathogenesis and need for immunosuppressive treatment. Current knowledge as to how subjects with sarcoidosis respond to different forms of vaccination is limited. We examined quantitative and functional antibody response to COVID-19 vaccination in infection-naive subjects with and without sarcoidosis.
Methods Our prospective cohort study recruited 14 subjects with biopsy-proven sarcoidosis and 27 age-gender matched controls who underwent a 2-shot series of the BNT162b2 mRNA vaccine at the University of Illinois at Chicago. Baseline, 4-week, and 6-month trimer spike protein IgG and neutralising antibody (nAb) titers were assessed. Correlation and multivariate regression analysis was conducted.
Results Sarcoidosis subjects had a significant increase in short term antibody production to a level comparable to controls, however IgG titers significantly declined back to baseline levels by 6 months. Corresponding neutralising assays revealed robust nAb titers in sarcoidosis subjects that persisted at 6 months. A significant and strong correlation between IgG and nAb titers across all time points was observed in the control group. However within the sarcoidosis group, a significant but weak correlation between antibody levels was found. Overall, IgG levels were poor predictors of nAb titers at short or long term time points.
Conclusions Sarcoidosis subjects exhibit nAb induced by the BNT162b2 mRNA SARS-CoV-2 vaccine at levels comparable to controls that persists at 6 months. Trimer IgG levels are poor predictors of nAb in subjects with sarcoidosis. Studies of further antibody immunoglobulins and subtypes warrant investigation.
Footnotes
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Conflict of interest: Richard M. Novak reports the following relationships outside the submitted work; grants or contracts received from Janssen; consulting fees received from Gilead and Viiv. The remaining authors have nothing to disclose.
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- Received January 13, 2022.
- Accepted August 19, 2022.
- Copyright ©The authors 2022
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