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Realizzazione, rafforzamento e ampliamento infrastrutture di ricerca pubbliche\u2014bando INFRA-P2-TECNOMED-HUB n.378-48\u201d"],"award-info":[{"award-number":["\u201cPiano Riparti Piemonte\u201d, Azione n. 173 \u201cINFRA-P. Realizzazione, rafforzamento e ampliamento infrastrutture di ricerca pubbliche\u2014bando INFRA-P2-TECNOMED-HUB n.378-48\u201d"]}],"id":[{"id":"10.13039\/501100009885","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>A relevant proportion of immunocompromised patients did not reach a detectable seroconversion after a full primary vaccination cycle against SARS-CoV-2. The effect of different immunosuppressants and the potential risks for SARS-CoV-2 infection in these subjects is largely unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients from the Rivalsa prospective, observational cohort study with planned anti SARS-CoV-2 third dose mRNA vaccination between October and December 2021 were asked to participate to this follow-up study. Patients were asked about eventual confirmed positivity to SARS-CoV-2 infection within 6 months from the third dose and to undergo a blood draw to evaluate seroconversion status after the additional vaccine shot.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>19 out of 114 patients taking part in the survey developed a confirmed SARS-CoV-2 infection; we identified mycophenolate treatment as an independent predictor of an increased risk of infection even after the third vaccine dose (OR: 5.20, 95% CI: 1.70-20.00, p=0.0053). This result is in agreement with the <jats:italic>in vitro<\/jats:italic> evidence that MMF impairs both B and T lymphocytes driven immune responses (reduction both in memory B cells producing anti-spike antibodies and in proliferating CD4+ and CD8+ T cells).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Immunocompromised patients need an additional vaccine administration to reach a detectable seroconversion, thus fostering a more personalized approach to their clinical management. Moreover, patients undergoing mycophenolate treatment show a specific increased infection risk, with respect to other immunosuppressants thus supporting a closer monitoring of their health status.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2023.1185278","type":"journal-article","created":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T17:39:51Z","timestamp":1689874791000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["SARS-CoV-2 infection risk is higher in vaccinated patients with inflammatory autoimmune diseases or liver transplantation treated with mycophenolate due to an impaired antiviral immune response: results of the extended follow up of the RIVALSA prospective 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