Factors Associated with Impaired Humoral Immune Response to mRNA Vaccines in Patients with Inflammatory Bowel Disease: A Matched-Cohort Analysis from the RisCoin Study.

ingentiumby ingentium

In Clinical Literature.

Publication date: Jun 23, 2025

Background/Objectives: The SARS-CoV-2 pandemic challenged patients with inflammatory bowel disease (IBD) under immunosuppressive therapies. We used data from the RisCoin cohort to investigate factors associated with a poor immune response to mRNA vaccination in these patients. Methods: From 4115 RisCoin participants, we matched 110 IBD patients by age and time interval since the second mRNA vaccination with 306 healthcare workers (HCW) without comorbidities (HCW-healthy) and 292 with medical conditions (HCW-plus); all were SARS-CoV-2 infection nacEFve. Basic questionnaires collected data on medication, COVID-19 vaccinations and side-effects, dietary patterns, lifestyle factors, and self-perceived stress. Main outcomes included anti-spike immunoglobulin levels and antibody-mediated live-virus neutralization immunity (NT) to the Omicron BA. 1 variant (threshold NT ≥ 10 defined as IC50 values ≥1:10 serum dilution) after the second (baseline) and third vaccinations. Results: At baseline, IBD patients treated with anti-TNF but not those under vedolizumab or ustekinumab therapy had lower anti-spike levels compared to HCW-healthy and HCW-plus (166 versus 1384 and 1258 BAU/mL, respectively; p < 0. 0001). Anti-TNF compared to vedolizumab/ustekinumab-treated patients reached NT titers above threshold in 17% versus 64%, respectively, and HCW-subgroups in 73% and 79% (all p < 0. 0001). Current smokers showed a four to five times increased risk for non-neutralizing immunity compared to non-smokers. After the third vaccination, NT titers did not reach threshold in 15% anti-TNF compared to 5% vedolizumab/ustekinumab-treated patients and none of HCW (p < 0. 01). Patients with IBD reported fewer clinical symptoms after vaccination. Perceived stress was not increased. Conclusions: Our findings support individualized schedules for mRNA-based vaccines in IBD patients with different immunosuppressive therapies and enforcement of non-smoking.

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Concepts Keywords
Immunosuppressive anti-spike antibodies
Live perceived stress questionnaire
Mrna SARS-CoV-2
Vaccinations virus neutralizing immunity
Workers

Semantics

Type Source Name
disease IDO humoral immune response
disease MESH Inflammatory Bowel Disease
pathway KEGG Inflammatory bowel disease
disease IDO immune response
disease MESH SARS-CoV-2 infection
pathway REACTOME SARS-CoV-2 Infection
disease MESH lifestyle factors
drug DRUGBANK Vedolizumab
drug DRUGBANK Ustekinumab
disease MESH Infection
drug DRUGBANK Coenzyme M
disease MESH ulcerative colitis
disease IDO immunosuppression
disease MESH inflammation
disease IDO cell
disease IDO blood
disease MESH influenza
disease MESH allergies
pathway REACTOME Vitamins
drug DRUGBANK Ethanol
disease MESH restlessness
disease MESH breakthrough infection
disease IDO assay
disease MESH viral infection
drug DRUGBANK Infliximab
drug DRUGBANK Adalimumab
drug DRUGBANK Golimumab
disease MESH autoimmune disease
disease MESH diabetes mellitus
disease MESH dyslipidemia
disease MESH malignancy
disease MESH overweight
disease MESH obesity
disease MESH conjunctivitis
disease MESH morbidities
disease MESH cardiovascular disease
disease MESH pulmonary disease
disease MESH hypothyroidism
disease MESH chronic renal disease
disease MESH renal insufficiency
disease MESH gastrointestinal disease
disease MESH neurological disorder
disease MESH drug allergy
disease MESH food allergy
disease MESH pollen allergy
disease MESH anaphylaxis

Original Article

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