People with autoimmune diseases - where the immune system does not work properly - need the corona vaccine. But does it protect them enough? And what if their disease flares up because of the vaccine? Amsterdam UMC is starting a study with 5,000 patients.

And what if their disease flares up because of the vaccine? Amsterdam UMC is starting a study with 5,000 patients.

The immune system is our defence against pathogens such as bacteria, viruses or parasites. With an autoimmune disease, this same defence system turns against healthy parts of the body, causing damage to tissues and organs. Examples of such diseases are rheumatoid arthritis, multiple sclerosis (MS), Crohn's disease, psoriasis and myasthenia gravis. People with these conditions often take medicines that suppress the immune system to minimise damage to tissues. Whether a shot against corona is equally effective in combination with these medicines is unknown. In addition, patients are concerned about the effect of the vaccine on their illness. "We rely on information about vaccination in healthy people," says Professor of Paediatric Immunology Taco Kuijpers. "That also applies to the pricks we get in our childhood, by the way. But now we have the unique opportunity to do research in groups of people with various autoimmune diseases." Which drugs do you use to suppress the immune system enough to keep the disease at bay, while vaccination still generates enough antibodies? And how long do the immune memory cells remain that can recognise the coronavirus? At a distance The study to find out is preceded by a major logistical operation, says Kuijpers. "Our department has pallets full of finger prick kits that will soon be sent to the participants in our study. For most of them, everything happens remotely. They don't have to come to the hospital." For Kuijpers and fellow researchers Filip Eftimov and Luuk Wieske (Department of Neurology) an exciting period begins. Within a few weeks, they expect, the first people with an autoimmune disease will be invited for vaccination against the coronavirus. They want to follow 5,000 of them to see how they respond to the shot. Divided on the basis of medication Participants in the study take a little blood several times over a year by pricking their finger and sending it to the Sanquin blood bank. The bank checks the amount of antibodies in their blood. Every two months, the participants complete an online questionnaire about their health. The timing of this is carefully tuned to the time of vaccination. A smaller group of participants is asked to collect blood more often so that the researchers can track certain immune cells. In the past few months, Sanquin has worked hard to set up state-of-the-art provisions for this purpose. Among the 5,000 participants will also be people who have not been vaccinated. They are needed to correctly interpret any flare-ups of the autoimmune disease and to check whether they are related to the vaccination. In addition, the researchers divided the patients into groups based on their medication, and into a group that did not use anti-resistance drugs. In this way, after the vaccination, they can see how the immune system reacts under different circumstances: is it influenced by the immune-suppressing medication or by the disease itself? Blueprint "Ultimately, this research will provide a kind of blueprint that will allow us to predict how successful a vaccine will be in combination with certain medication," says Eftimov. "We hope to be able to give concrete advice along the lines of 'continue medication, it's safe and effective' or 'stop the medication for two to four weeks to maximise the effect of the vaccination' or 'go for a third shot after that many weeks'. Kuijpers: "We are going to learn a lot from this. We will make the results public soon, three to four months after the start of this study." Government financier ZonMw has earmarked 2.5 million euros for the study. Eftimov, Kuijpers and co-researcher Marieke van Ham (Sanquin) are doing the study together with colleagues from the T2B (Target to B) consortium. This was established in 2018 to investigate the role of B cells (part of the immune system) in autoimmune diseases. The current study is part of a research programme investigating the effect of covid-19 vaccination in different groups of vulnerable patients. These include people with cancer, patients who underwent a kidney or lung transplant and people with congenital immune disorders. Share this Researchers Taco Kuijpers Research programmes Infectious Diseases Inflammatory Diseases At a distance Distributed on the basis of medication Blueprint