Immunosuppressive therapy selectively modulates B‐cell responses in patients with rheumatic and musculoskeletal diseases receiving the inactivated COVID‐19 vaccine

Background Immunosuppressive medication reduces the immunogenicity of coronavirus disease 2019 (COVID-19) vaccines in patients with rheumatic and musculoskeletal diseases (RMDs). However, underlying mechanism remains unclear. The primary aim our study was to dissect impact immunosuppressive on cellular humoral immune responses RMD receiving inactivated COVID-19 vaccine. Methods A total 28 five healthy controls (HCs) two doses vaccine (Sinovac-CoronaVac) were prospectively enrolled. Blood samples collected before vaccination (Week 0) one week after second 5). Neutralizing antibody (nAb) titers autoantibody measured by a pseudovirus-based neutralization assay enzyme-linked immunosorbent assay, respectively. CD4+ T-cell CD19+ B-cell subsets serum cytokines analyzed flow cytometry. Results immunogenic HCs vaccination, but nAb lower than those HCs. Only systemic lupus erythematosus (SLE) had notably increased titers. Remarkably, IgG+CD27+, IgG+IgG1+, IgG+IgG1− B cells reduced, whereas IgG−IgG1+ cells, IgA IgG markedly increased. Tfh cell Tfr produced not flare rate low comparable titers, unchanged T pro-inflammatory (interleukin [IL]-6, IL-17, interferon-γ, tumor necrosis factor-α) vaccination. Conclusions therapy decreased maintained selectively modulating Optimization treatment regimen might ensure durable robust response.