{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:26:26Z","timestamp":1760149586693,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T00:00:00Z","timestamp":1692489600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Aims: Although the World Health Organization declared the end of the public health emergency of international concern focusing on COVID-19 in May 2023, this bothersome virus continues to mutate, and the possibility of the emergence of mutant strains with high infectivity and severe disease rates has not disappeared. Thus, medical evidence must be accumulated, which is indispensable for protecting both patients under immunosuppressive treatments and the healthy population. This study examined SARS-CoV-2 vaccination responses in Japanese patients with autoimmune hepatitis (AIH) compared with healthy controls. Methods: This observational study registered 22 patients with histologically diagnosed AIH and 809 healthy controls in our hospital. Their Elecsys anti-SARS-CoV-2 spike antibody concentrations before and after vaccination were evaluated. Results: In this study, 72.7% and 18.2% of patients with AIH received steroids and azathioprine, respectively. Significant negative correlations were found between age and anti-SARS-CoV-2 spike antibody concentration in both groups; however, no sex differences were found. Although anti-SARS-CoV-2 spike antibody concentration was drastically augmented after the second vaccination (p &lt; 0.05) in the AIH group, these levels were significantly lower than those in the controls (p &lt; 0.05). In the age- and sex-matched analysis, the population ratio with a minimum response (\u2264100 binding antibody units (BAU\/mL) was higher among patients with AIH than among controls 26 weeks after the second vaccination (44% vs. 7%, p &lt; 0.05). Conclusions: The anti-SARS-CoV-2 spike antibody concentration in AIH patients was significantly lower than that in controls after the second vaccination. Continued and widespread vaccination, particularly for patients requiring medical immunomodulation, is recommended.<\/jats:p>","DOI":"10.3390\/jcm12165411","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T01:46:56Z","timestamp":1692582416000},"page":"5411","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["SARS-CoV-2 Vaccination Response in Japanese Patients with Autoimmune Hepatitis: Results of Propensity Score-Matched Case\u2013Control Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Kei","family":"Moriya","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Nara Prefecture General Medical Center, Nara 630-8581, Japan"},{"name":"Department of Gastroenterology, Nara Medical University, Nara 634-8521, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoko","family":"Nakakita","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Nara Prefecture General Medical Center, Nara 630-8581, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natsuki","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Nara Prefecture General Medical Center, Nara 630-8581, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuya","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nara Prefecture General Medical Center, Nara 630-8581, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Komeda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nara Prefecture General Medical Center, Nara 630-8581, Japan"},{"name":"Department of Gastroenterology, Nara Medical University, Nara 634-8521, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junichi","family":"Hanatani","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nara Prefecture General Medical Center, Nara 630-8581, Japan"},{"name":"Department of Gastroenterology, Nara Medical University, Nara 634-8521, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Kaya","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nara Prefecture General Medical Center, Nara 630-8581, Japan"},{"name":"Department of Gastroenterology, Nara Medical University, Nara 634-8521, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinsaku","family":"Nagamatsu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nara Prefecture General Medical Center, Nara 630-8581, Japan"},{"name":"Department of Gastroenterology, Nara Medical University, Nara 634-8521, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nara Prefecture General Medical Center, Nara 630-8581, Japan"},{"name":"Department of Gastroenterology, Nara Medical University, Nara 634-8521, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masakazu","family":"Uejima","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nara Medical University, Nara 634-8521, Japan"},{"name":"Department of Diabetes and Endocrinology, Nara Prefecture General Medical Center, Nara 630-8581, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumihiko","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Nara Prefecture General Medical Center, Nara 630-8581, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,20]]},"reference":[{"doi-asserted-by":"crossref","unstructured":"Takahashi, A., Moriya, K., Ohira, H., Arinaga-Hino, T., Zeniya, M., Torimura, T., Abe, M., Takaki, A., Kang, J.-H., and Inui, A. (2018). Health-related quality of life in patients with autoimmune hepatitis: A questionnaire survey. PLoS ONE, 13.","key":"ref_1","DOI":"10.1371\/journal.pone.0204772"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.cgh.2020.05.061","article-title":"Trends in incidence of autoimmune liver diseases and increasing incidence of autoimmune hepatitis","volume":"19","author":"Lamba","year":"2021","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"14250","DOI":"10.1038\/s41598-020-71296-0","article-title":"Increasing incidence of acute autoimmune hepatitis: A nationwide survey in Japan","volume":"10","author":"Takahashi","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_4","first-page":"1022","article-title":"Epidemiology and causes of death in a Swedish cohort of patients with autoimmune hepatitis","volume":"52","author":"Marschall","year":"2017","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1002\/hep.25658","article-title":"Long-term outcome of Japanese patients with type 1 autoimmune hepatitis","volume":"56","author":"Yoshizawa","year":"2012","journal-title":"Hepatology"},{"unstructured":"World Health Organization (2023, June 30). WHO Coronavirus (COVID-19) Dashboard. Available online: https:\/\/covid19.who.int\/.","key":"ref_6"},{"unstructured":"World Health Organization (2023, June 30). Press Conferences on COVID-19 and Other Global Health Issues. Available online: https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019.","key":"ref_7"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1007\/s00535-022-01851-1","article-title":"Interim analysis of a multicenter registry study of COVID-19 patients with inflammatory bowel disease in Japan (J-COSMOS)","volume":"57","author":"Nakase","year":"2022","journal-title":"J. Gastroenterol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2439","DOI":"10.1056\/NEJMoa2027906","article-title":"Safety and immunogenicity of two RNA-Based Covid-19 vaccine candidates","volume":"383","author":"Walsh","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1920","DOI":"10.1056\/NEJMoa2022483","article-title":"An mRNA vaccine against SARS-CoV-2\u2014Preliminary report","volume":"383","author":"Jackson","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1111\/hepr.13342","article-title":"Increase trend in the prevalence and Male-to-female ratio of primary biliary cholangitis, autoimmune hepatitis, and primary sclerosing cholangitis in Japan","volume":"49","author":"Tanaka","year":"2019","journal-title":"Hepatol. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1016\/S0168-8278(99)80297-9","article-title":"International Autoimmune Hepatitis Group Report: Review of criteria for diagnosis of autoimmune hepatitis","volume":"31","author":"Alvarez","year":"1999","journal-title":"J. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1002\/ueg2.12218","article-title":"SARS-CoV-2 vaccination response in patients with autoimmune hepatitis and autoimmune cholestatic liver disease","volume":"10","author":"Duengelhoef","year":"2022","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.cgh.2021.09.003","article-title":"SARS-CoV2-specific humoral and T-cell immune response after second vaccination in liver cirrhosis and transplant patients","volume":"20","author":"Ruether","year":"2022","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"734689","DOI":"10.3389\/fimmu.2021.734689","article-title":"HLA does not impact on short-medium-term antibody response to preventive anti-SARS-cov-2 vaccine","volume":"12","author":"Ragone","year":"2021","journal-title":"Front. Immunol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1056\/NEJMc2111462","article-title":"Randomized trial of a third dose of mRNA-1273 vaccine in transplant recipients","volume":"385","author":"Hall","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"104820","DOI":"10.1016\/j.jcv.2021.104820","article-title":"Performance of the rapid high-throughput automated electrochemiluminescence immunoassay targeting total antibodies to the SARS-CoV-2 spike protein receptor binding domain in comparison to the neutralization assay","volume":"139","author":"Korva","year":"2021","journal-title":"J. Clin. Virol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.1038\/s41591-021-01540-1","article-title":"Correlates of protection against symptomatic and asymptomatic SARS-CoV-2 infection","volume":"27","author":"Feng","year":"2021","journal-title":"Nat. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1002\/hep.32337","article-title":"Postvaccination COVID-19 infection is associated with reduced mortality in patients with cirrhosis","volume":"76","author":"John","year":"2022","journal-title":"Hepatology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1002\/hep.31065","article-title":"Diagnosis and management of autoimmune hepatitis in adults and children: 2019 Practice guidance and guidelines from the American Association for the Study of Liver Diseases","volume":"72","author":"Mack","year":"2020","journal-title":"Hepatology"},{"doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (2015). EASL Clinical Practice Guidelines: Autoimmune hepatitis. J. Hepatol., 63, 971\u20131004.","key":"ref_21","DOI":"10.1016\/j.jhep.2015.06.030"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1053\/j.gastro.2020.05.032","article-title":"Corticosteroids, but not TNF antagonists, are associated with adverse COVID-19 outcomes in patients with inflammatory bowel diseases: Results from an international registry","volume":"159","author":"Brenner","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"102688","DOI":"10.1016\/j.jaut.2021.102688","article-title":"Auto-immune hepatitis following COVID vaccination","volume":"123","author":"Rela","year":"2021","journal-title":"J. Autoimmun."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1111\/liv.15092","article-title":"A typical autoimmune hepatitis case following Covid-19 mRNA vaccination. More than a coincidence?","volume":"42","author":"Goulas","year":"2022","journal-title":"Liver Int."},{"doi-asserted-by":"crossref","unstructured":"Mathew, M., John, S.B., Sebastian, J., and Ravi, M.D. (2022). COVID-19 vaccine triggered autoimmune hepatitis: Case report. Eur. J. Hosp. Pharm., ejhpharm-2022-003485.","key":"ref_25","DOI":"10.1136\/ejhpharm-2022-003485"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"102745","DOI":"10.1016\/j.jaut.2021.102745","article-title":"Autoimmune hepatitis after SARS-CoV-2 vaccine: New-onset or flare-up?","volume":"125","author":"Avci","year":"2021","journal-title":"J. Autoimmun."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1838","DOI":"10.3748\/wjg.v29.i12.1838","article-title":"Autoimmune liver diseases and SARS-CoV-2","volume":"29","author":"Sgamato","year":"2023","journal-title":"World J. Gastroenterol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/j.jhep.2023.05.020","article-title":"Morphologic and molecular analysis of liver injury after SARS-CoV-2 vaccination reveals distinct characteristics","volume":"79","author":"Uzun","year":"2023","journal-title":"J. Hepatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1100617","DOI":"10.3389\/fphar.2023.1100617","article-title":"Real-world evidence of autoimmune hepatitis following COVID-19 vaccination: A population-based pharmacovigilance analysis","volume":"14","author":"Chen","year":"2023","journal-title":"Front. Pharmacol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1111\/liv.15121","article-title":"Effects of immunosuppressive drugs on COVID-19 severity in patients with autoimmune hepatitis","volume":"42","author":"Efe","year":"2022","journal-title":"Liver Int."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"102906","DOI":"10.1016\/j.jaut.2022.102906","article-title":"SARS-CoV-2 vaccination and risk of severe COVID-19 outcomes in patients with autoimmune hepatitis","volume":"132","author":"Efe","year":"2022","journal-title":"J. Autoimmun."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2145","DOI":"10.1016\/j.cgh.2022.04.006","article-title":"SARS-CoV-2 vaccine response in patients with autoimmune hepatitis","volume":"20","author":"Schneider","year":"2022","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1111\/liv.15368","article-title":"Analysis of the humoral and cellular response after the third COVID-19 vaccination in patients with autoimmune hepatitis","volume":"43","author":"Hartl","year":"2023","journal-title":"Liver Int."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/16\/5411\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:38:00Z","timestamp":1760128680000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/16\/5411"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,20]]},"references-count":33,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["jcm12165411"],"URL":"https:\/\/doi.org\/10.3390\/jcm12165411","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2023,8,20]]}}}