Humoral- and T-Cell-Specific Immune Responses to SARS-CoV-2 mRNA Vaccination in Patients With MS Using Different Disease-Modifying Therapies.


Journal

Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060

Informations de publication

Date de publication:
01 02 2022
Historique:
received: 07 07 2021
accepted: 04 11 2021
pubmed: 24 11 2021
medline: 5 2 2022
entrez: 23 11 2021
Statut: ppublish

Résumé

To evaluate the immune-specific response after full severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination of patients with multiple sclerosis (MS) treated with different disease-modifying drugs by the detection of both serologic and T-cell responses. Healthcare workers (HCWs) and patients with MS, having completed the 2-dose schedule of an mRNA-based vaccine against SARS-CoV-2 in the past 2-4 weeks, were enrolled from 2 parallel prospective studies conducted in Rome, Italy, at the National Institute for Infectious diseases Spallanzani-IRCSS and San Camillo Forlanini Hospital. Serologic response was evaluated by quantifying the region-binding domain (RBD) and neutralizing antibodies. Cell-mediated response was analyzed by a whole-blood test quantifying interferon (IFN)-γ response to spike peptides. Cells responding to spike stimulation were identified by fluorescence-activated cell sorting analysis. We prospectively enrolled 186 vaccinated individuals: 78 HCWs and 108 patients with MS. Twenty-eight patients with MS were treated with IFN-β, 35 with fingolimod, 20 with cladribine, and 25 with ocrelizumab. A lower anti-RBD antibody response rate was found in patients treated with ocrelizumab (40%, mRNA vaccines induce both humoral and cell-mediated specific immune responses against spike peptides in all HCWs and in the majority of patients with MS. These results carry relevant implications for managing vaccinations, suggesting promoting vaccination in all treated patients with MS. This study provides Class III data that SARS-CoV-2 mRNA vaccination induces both humoral and cell-mediated specific immune responses against viral spike proteins in a majority of patients with MS.

Sections du résumé

BACKGROUND AND OBJECTIVES
To evaluate the immune-specific response after full severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination of patients with multiple sclerosis (MS) treated with different disease-modifying drugs by the detection of both serologic and T-cell responses.
METHODS
Healthcare workers (HCWs) and patients with MS, having completed the 2-dose schedule of an mRNA-based vaccine against SARS-CoV-2 in the past 2-4 weeks, were enrolled from 2 parallel prospective studies conducted in Rome, Italy, at the National Institute for Infectious diseases Spallanzani-IRCSS and San Camillo Forlanini Hospital. Serologic response was evaluated by quantifying the region-binding domain (RBD) and neutralizing antibodies. Cell-mediated response was analyzed by a whole-blood test quantifying interferon (IFN)-γ response to spike peptides. Cells responding to spike stimulation were identified by fluorescence-activated cell sorting analysis.
RESULTS
We prospectively enrolled 186 vaccinated individuals: 78 HCWs and 108 patients with MS. Twenty-eight patients with MS were treated with IFN-β, 35 with fingolimod, 20 with cladribine, and 25 with ocrelizumab. A lower anti-RBD antibody response rate was found in patients treated with ocrelizumab (40%,
DISCUSSION
mRNA vaccines induce both humoral and cell-mediated specific immune responses against spike peptides in all HCWs and in the majority of patients with MS. These results carry relevant implications for managing vaccinations, suggesting promoting vaccination in all treated patients with MS.
CLASSIFICATION OF EVIDENCE
This study provides Class III data that SARS-CoV-2 mRNA vaccination induces both humoral and cell-mediated specific immune responses against viral spike proteins in a majority of patients with MS.

Identifiants

pubmed: 34810244
pii: WNL.0000000000013108
doi: 10.1212/WNL.0000000000013108
pmc: PMC8826460
doi:

Substances chimiques

Antibodies, Viral 0
COVID-19 Vaccines 0
RNA, Messenger 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't Comment

Langues

eng

Sous-ensembles de citation

IM

Pagination

e541-e554

Investigateurs

Daniele Lapa (D)
Massimo Francalancia (M)
Aurora Bettini (A)
Giulia Gramigna (G)
Federica Forbici (F)
Paola Gall I (P)
Alessandra Marani (A)
Adriano Possi (A)
Andrea Capri (A)
Annapaola Santoro (A)
Nicoletta Orchi (N)
Ornella Butera (O)
Saeid Najafi Fard (SN)
Linda Petrone (L)
Elisa Petruccioli (E)

Commentaires et corrections

Type : CommentOn
Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

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Auteurs

Carla Tortorella (C)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Alessandra Aiello (A)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Claudio Gasperini (C)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Chiara Agrati (C)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Concetta Castilletti (C)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Serena Ruggieri (S)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Silvia Meschi (S)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Giulia Matusali (G)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Francesca Colavita (F)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Chiara Farroni (C)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Gilda Cuzzi (G)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Eleonora Cimini (E)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Eleonora Tartaglia (E)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Valentina Vanini (V)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Luca Prosperini (L)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Shalom Haggiag (S)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Simona Galgani (S)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Maria Esmeralda Quartuccio (ME)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Andrea Salmi (A)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Federica Repele (F)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Anna Maria Gerarda Altera (AMG)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Flavia Cristofanelli (F)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Alessandra D'Abramo (A)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Nazario Bevilacqua (N)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Angela Corpolongo (A)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Vincenzo Puro (V)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Francesco Vaia (F)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Maria Rosaria Capobianchi (MR)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Giuseppe Ippolito (G)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Emanuele Nicastri (E)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy.

Delia Goletti (D)

From the Department of Neurosciences (C.T., C.G., L.P., S.H., S.G., M.E.Q.), San Camillo-Forlanini Hospital; Translational Research Unit (A.A., C.F., G.C., V.V., A.S., F.R., A.M.G.A., D.G.), Laboratory of Cellular Immunology (C.A., E.C., E.T., Flavia Cristofanelli), Laboratory of Virology (C.C., S.M., G.M., Francesca Colavita, M.R.C.), UOS Professioni Sanitarie Tecniche (V.V.), Clinical Division of Infectious Diseases (A.D.A., N.B., A.C., E.N.), UOC Emerging Infections and CRAIDS (V.P.), Health Direction (F.V.), and Scientific Direction (G.I.), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS; Department of Human Neurosciences (S.R.), Sapienza University of Rome; and Neuroimmunology Unit (S.R.), IRCSS Fondazione Santa Lucia, Rome, Italy. delia.goletti@inmi.it.

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