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                     <mods:roleTerm type="text">author</mods:roleTerm>
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                  <mods:namePart>Torres Cabestany, Pascual</mods:namePart>
               </mods:name>
               <mods:name>
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                  <mods:namePart>Sancho Saldaña, Agustín</mods:namePart>
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                  <mods:namePart>Gil-Sánchez, Anna</mods:namePart>
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                     <mods:roleTerm type="text">author</mods:roleTerm>
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                  <mods:namePart>Peralta, Silvia</mods:namePart>
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               <mods:name>
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                     <mods:roleTerm type="text">author</mods:roleTerm>
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                  <mods:namePart>Solana Moga, M. José</mods:namePart>
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               <mods:name>
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                     <mods:roleTerm type="text">author</mods:roleTerm>
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                  <mods:namePart>Bakkioui, Sofian</mods:namePart>
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               <mods:name>
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                     <mods:roleTerm type="text">author</mods:roleTerm>
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                  <mods:namePart>González Mingot, Cristina</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Quibus, Laura</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Ruiz Fernández, Emilio</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>San Pedro‑Murillo, Eduardo</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Brieva Ruiz, Luis</mods:namePart>
               </mods:name>
               <mods:originInfo>
                  <mods:dateIssued encoding="iso8601">2023</mods:dateIssued>
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               <mods:identifier type="none"/>
               <mods:abstract>Background
Most people with Multiple Sclerosis (pwMS) are subjected to immunomodulatory disease-modifying treatments (DMTs). As a result, immune responses to COVID-19 vaccinations could be compromised. There are few data on cellular immune responses to the use of COVID-19 vaccine boosters in pwMS under a broad spectrum of DMTs.
Methods
In this prospective study, we analysed cellular immune responses to SARS-CoV-2 mRNA booster vaccinations in 159 pwMS with DMT, including: ocrelizumab, rituximab, fingolimod, alemtuzumab, dimethyl fumarate, glatiramer acetate, teriflunomide, natalizumab and cladribine.
Results
DMTs, and particularly fingolimod, interact with cellular responses to COVID-19 vaccination. One booster dose does not increase cellular immunity any more than two doses, except in the cases of natalizumab and cladribine. SARS-CoV-2 infection combined with two doses of vaccine resulted in a greater cellular immune response, but this was not observed after supplementary booster jabs. Ocrelizumab-treated pwMS who had previously received fingolimod did not develop cellular immunity, even after receiving a booster. The time after MS diagnosis and disability status negatively correlated with cellular immunity in ocrelizumab-treated pwMS in a booster dose cohort.
Conclusions
After two doses of SARS-CoV-2 vaccination, a high response yield was achieved, except in patients who had received fingolimod. The effects of fingolimod on cellular immunity persisted for more than 2 years after a change to ocrelizumab (which, in contrast, conserved cellular immunity). Our results confirmed the need to find alternative protective measures for fingolimod-treated people and to consider the possible failure to provide protection against SARS-CoV-2 when switching from fingolimod to ocrelizumab.</mods:abstract>
               <mods:language>
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               <mods:accessCondition type="useAndReproduction">cc-by (c) Pascual Torres et al., 2023 Attribution 4.0 International info:eu-repo/semantics/openAccess http://creativecommons.org/licenses/by/4.0/</mods:accessCondition>
               <mods:subject>
                  <mods:topic>Multiple sclerosis</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Cellular immune response</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>COVID-19 vaccines</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Immunomodulating drugs</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Booster revaccination</mods:topic>
               </mods:subject>
               <mods:titleInfo>
                  <mods:title>A prospective study of cellular immune response to booster COVID‑19 vaccination in multiple sclerosis patients treated with a broad spectrum of disease‑modifying therapies</mods:title>
               </mods:titleInfo>
               <mods:genre>info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion</mods:genre>
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