Department of Epidemiology, School of Public Health, University of Michigan, USA.
Centers of Excellence for Influenza Research and Surveillance (CEIRS), USA; Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Center for Research on Influenza Pathogenesis (CRIP), New York, NY, USA.
Vaccine. 2020 Jun 2;38(27):4221-4225. doi: 10.1016/j.vaccine.2020.04.069. Epub 2020 May 7.
We investigated humoral immune response to influenza A(H1N1)pdm infection and found 32 (22%) of the infected individuals identified by PCR failed to produce a ≥ 4-fold hemagglutinin inhibition assay (HAI) response; a subset of 18 (56%) produced an alternate antibody response (against full-length HA, HA stalk, or neuraminidase). These individuals had lower pre-existing HAI antibody titers and showed a pattern of milder illness. An additional subset of 14 (44%) did not produce an alternate antibody response, had higher pre-existing antibody titers against full-length & stalk HA, and were less sick. These findings demonstrate that some individuals mount an alternate antibody response to influenza infection. In order to design more broadly protective influenza vaccines it may be useful to target these alternate sites. These findings support that there are influenza cases currently being missed by solely implementing HAI assays, resulting in an underestimation of the global burden of influenza infection.
我们研究了甲型 H1N1 流感感染的体液免疫反应，发现通过 PCR 确定的 32 名（22%）感染者未能产生≥4 倍的血凝抑制试验（HAI）反应；其中 18 名（56%）产生了替代抗体反应（针对全长 HA、HA 茎或神经氨酸酶）。这些个体的预先存在的 HAI 抗体滴度较低，且表现出较轻的疾病模式。还有一部分 14 名（44%）未产生替代抗体反应，对全长和茎部 HA 预先存在的抗体滴度较高，且病情较轻。这些发现表明，一些人对流感感染会产生替代的抗体反应。为了设计更广泛保护的流感疫苗，针对这些替代部位可能是有用的。这些发现支持目前仅通过实施 HAI 检测会漏诊某些流感病例，从而低估了全球流感感染的负担。
