Glucocorticoids selectively affect the memory T cell response to SARS-Cov2 spike in vaccinated and post-infected patients with systemic lupus erythematosus

Yves Renaudineau; Chloé Bost; Florence Abravanel; Jacques Izopet; Antoine Blancher; Nicolas Congy; Emmanuel Treiner; Laurent Sailler

doi:10.1016/j.jtauto.2023.100200

Glucocorticoids selectively affect the memory T cell response to SARS-Cov2 spike in vaccinated and post-infected patients with systemic lupus erythematosus

J Transl Autoimmun. 2023:6:100200. doi: 10.1016/j.jtauto.2023.100200. Epub 2023 Apr 6.

Authors

Yves Renaudineau^{1

2}, Chloé Bost^{1

2}, Florence Abravanel^{2

3}, Jacques Izopet^{2

3}, Antoine Blancher^{1

4}, Nicolas Congy^{1

4}, Emmanuel Treiner^{1

2}, Laurent Sailler⁵

Affiliations

¹ Immunology Department Laboratory, Institut Fédératif de Biologie, Toulouse University Hospital Center, France.
² INFINITy, Toulouse Institute for Infectious and Inflammatory Diseases, INSERM U1291, CNRS U5051, University Toulouse III, Toulouse, France.
³ Virology Department Laboratory, Institut Fédératif de Biologie, Toulouse University Hospital Center, France.
⁴ CRCT, INSERM UMR 1037, University Toulouse III, Toulouse, France.
⁵ Internal Medicine, University Toulouse III, Toulouse, France.

Abstract

Immune response to vaccines and pathogens remains unclear in patients with systemic lupus erythematosus (SLE). To investigate this, a single-center retrospective study was conducted with 47 SLE patients vaccinated against COVID-19, including 13 who subsequently developed an asymptomatic/mild disease. As compared to controls, post-vaccine response against Spike was reduced in SLE patients when considering both memory T-cells in a whole blood interferon gamma release assay (IGRA-S) and IgG anti-Spike antibody (Ab) responses. The SLE-associated defective IGRA-S response was associated with a serum albumin level below 40 g/L and with the use of glucocorticoids, while a defective IgG anti-Spike Ab response was associated with lower levels of anti-dsDNA and anti-SSA/Ro 52 kDa Abs. IGRA-S and IgG anti-Spike responses were independent from SLE activity and clinical phenotype, low complement, hypergammaglobulinemia, and lymphopenia. As compared to controls, SLE patients showed a rapid decay of anti-Spike T-cell memory and stable IgG anti-Spike Ab responses. In conclusion, both T cell and humoral anti-Spike responses were independently affected in our SLE patients cohort, which supports the exploration of both responses in the follow-up of SLE patients and especially in those receiving glucocorticoids.

Keywords: Antibody; COVID-19; Interferon gamma release assay; Nucleocapsid; Spike; Systemic lupus erythematosus.