# Role of Extracellular Vesicles in Crohn’s Patients on Adalimumab Who Received COVID-19 Vaccination

## TL;DR

This study explores how the SARS-CoV-2 vaccine might affect Crohn’s disease treatment and worsen symptoms through extracellular vesicles.

## Contribution

The study investigates the role of extracellular vesicles in vaccine-related disease exacerbation in Crohn’s patients.

## Key findings

- Extracellular vesicles may transport the SARS-CoV-2 Spike protein and influence intestinal permeability.
- Modulated expression of proteins like AQP8 and tight junctions is linked to disease flares in Crohn’s patients.
- Vaccine exposure may interfere with the effectiveness of Adalimumab in some Crohn’s patients.

## Abstract

Crohn’s disease (CD) is a type of inflammatory bowel disease (IBD) affecting the gastrointestinal tract that can also cause extra-intestinal complications. Following exposure to the mRNA vaccine BNT162b2 (Pfizer-BioNTech) encoding the SARS-CoV-2 Spike (S) protein, some patients experienced a lack of response to the biological drug Adalimumab and a recrudescence of the disease. In CD patients in progression, resistant to considered biological therapy, an abnormal increase in intestinal permeability was observed, more often with a modulated expression of different proteins such as Aquaporin 8 (AQP8) and in tight junctions (e.g., ZO-1, Claudin1, Claudin2, Occludin), especially during disease flares. The aim of this study is to investigate how the SARS-CoV-2 vaccine could interfere with IBD therapy and contribute to disease exacerbation. We investigated the role of the SARS-CoV-2 Spike protein, transported by extracellular vesicles (EVs), and the impact of various EVs components, namely, exosomes (EXOs) and microvesicles (MVs), in modulating the expression of molecules involved in the exacerbation of CD, which remains unknown.