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The immune response to COVID-19 vaccines may be strengthened by certain medications for inflammatory bowel disease. Antonio Perez/Chicago Tribune/Tribune News Service via Getty Images
  • Inflammatory bowel disease (IBD) is a digestive disorder that can be both chronic and debilitating.
  • Experts are working to understand how to best help those with IBD navigate challenges related to COVID-19.
  • Two recent studies found that people with IBD taking certain medications may have an elevated T-cell immune response after receiving the vaccination against COVID-19.

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Inflammatory bowel disease (IBD) impacts as many as 3 million adults in the United States alone.

Medical professionals are constantly working to develop the best possible treatment plans for people with IBD. One area of concern has been how COVID-19 vaccinations impact people with the condition.

Two recent studies published in IBDand Frontiers in Immunology report that certain IBD medications might enhance the T-cell immune response from COVID-19 vaccination.

IBD is a blanket term that consists of two conditions: Crohn’s disease and ulcerative colitis. Both conditions are characterized by chronic inflammation in the digestive tract inflammation, which can damage the body’s digestive system.

People with IBD may experience flares of various symptoms, such as persistent diarrhea, abdominal pain, blood or mucus in the stool, and weight loss. Treatment options will vary based on a person’s symptoms and the damage to the digestive tract.

Doctors may use one or several medications to help prevent IBD flares and manage related symptoms.

One option is using anti-tumor necrosis factor (TNF) medications, also called tumor necrosis factor inhibitors. These medications help to suppress the body’s inflammatory and immune responses.

Dr. Jonathan G. Braun, a study author who is affiliated with Cedars Sinai Medical Center in Los Angeles, explained to Medical News Today:

“Anti-TNF therapy has transformed the treatment of Crohn’s disease and is used by more than 500,000 patients in the U.S. Prior studies have shown that anti-TNF somewhat reduces the antibody response to COVID vaccines, which protects against initial infection.”

However, the latest research indicates these medications may actually have a positive impact in aiding the body’s response to the COVID-19 vaccine, specifically in the T-cells that help regulate how the body responds to and fights infections.

Both recent studies involved participants with IBD who received vaccinations against COVID-19. Researchers specifically looked at the response of participants’ T cells.

The study published in IBD found that participants taking anti-TNF medications had an enhanced T-cell response.

The study in Frontiers in Immunology found that participants had a much higher T-cell receptor response after vaccination than before vaccination. They further observed that the type of T-cell response was impacted by the type of anti-TNF medication participants were taking. In particular, those taking adalimumab developed a strong response.

Dr. Braun explained:

“These new studies were a surprise because they indicated that anti-TNF increases T cells, the other part of the vaccine response which eradicates [the] virus once it has established infection. This is important because the T cell response reduces disease severity and the risk of hospitalization or death.”

Dr. Arturo Casadevall, an infectious disease expert at John Hopkins University in Baltimore, commented to MNT with his thoughts on the studies as well:

“These papers show that some immunocompromised patients retain strong immune responses to vaccination, and they reinforce the need for a more specialized approach to the different populations with impaired immunity. In other words, when it comes to vaccine responsiveness and vulnerability to SARS-CoV-2, some immunocompromised patients may have adequate protection with the caveat that it is important to correlate T cell responses with protection.”

Both studies were not without limitations.

For example, the study published in IBD focused only on participants with IBD and lacked racial diversity. The population utilized and researchers’ use of only one T-cell response assay are further limitations. Thus, study results cannot be generalized.

The Frontiers in Immunology study noted that there could be a difference in the immune response from the vaccine versus actual infection with SARS-CoV-2. The majority of participants were female. And the complete T-cell response might not have been observed because of the use of peripheral blood in the analysis.

But overall, the studies provide some evidence that people receiving anti-TNF therapy for IBD can mount an immune response when it comes to the actions of their T-cells. The data may further guide recommendations for vaccination among people with IBD. Further, the study authors think their findings may lead to the development of T-cell response tests that could be used to monitor vaccine outcomes.

Dr. Braun further explained in a recent press release the following:

“This should be important reassurance to vaccinated IBD patients who are receiving treatment; their therapies may be offering important protection from serious illness or hospitalization if they get a breakthrough infection. It should also encourage them and their doctors to maintain their treatment during this phase of the pandemic and to keep up with their booster shots.”

The studies further emphasize the importance of looking at more than the antibody response when it comes to groups with specific disorders such as IBD.

Dr. Casadevall explained:

“To date, much of the work on understanding immune correlates to vaccination has focused on measuring antibody immunity because that is relatively easy to do. However, we need more research to understand the other aspects of the immune system that are activated in response to vaccines, and this data suggests that each type of immunosuppressed condition needs to be studied individually. We should not make the mistake of putting all the immunocompromised patients into one category basket since they can be very different in terms of their residual immunity, response to vaccines, and susceptibility to COVID-19.”