Kosiyakul P.Jitprapaikulsan J.Uawithya E.Wongprompitak P.Chaimayo C.Horthongkham N.Angkasekwinai N.Tisavipat N.Prayoonwiwat N.Rattanathamsakul N.Boonyapisit K.Kumutpongpanich T.Sangsai O.Aueaphatthanawong K.Budkum J.Siritho S.Mahidol University2024-03-062024-03-062024-01-01Siriraj Medical Journal Vol.76 No.2 (2024) , 69-79https://repository.li.mahidol.ac.th/handle/123456789/97479Objective: The effects of immunotherapies on the immune response to various regimens of SARS-CoV-2 vaccines in patients with autoimmune neurological disease have been demonstrated in limited data. Thus, we evaluated the immune responses in each platform of COVID-19 vaccination between patients with autoimmune neurological disease and a healthy population. Materials and Methods: We conducted a prospective observational study. We collected serum from patients with autoimmune neurological diseases to perform serological methods using anti-RBD IgG assay, neutralizing antibodies assay, and interferon SARS-CoV-2 immunoassay. Serological response level was analyzed by platforms of vaccines and types of immune modifying therapy. Results: Fifty-eight patients had tested for an anti-RBD IgG response, and those receiving no immunotherapy/ healthy controls had the highest median anti-RBD IgG levels amongst immunotherapy statuses. Rituximab in those who received inactivated or mRNA vaccine regimens had the lowest antibody level compared with other immunotherapies. In vector-based vaccine regimens, significant reductions of anti-RBD IgG response were observed in all other immunotherapy groups except for azathioprine, with the greatest difference seen compared to rituximab. Thirty-five patients with positive anti-RBD responses were further tested for neutralizing antibodies. The mRNA vaccine regimen demonstrated the highest inhibition percentage among the Delta and Omicron variants. Twenty-two patients were tested for T cell responses, with no significant difference in T-cell activity across all groups. Conclusion: We have demonstrated a significant decrease in antibody response against SARS-CoV-2 in patients with autoimmune neurological diseases receiving immunotherapies compared to a healthy population, especially for patients taking rituximab.MedicineArticleSCOPUS10.33192/smj.v76i2.2666382-s2.0-8518592647022288082