University of Rochester Medical Center, Clinical Microbiology, Department of Pathology and Laboratory Medicine, Rochester, New York, USA.
University of Rochester Medical Center, Department of Pathology and Laboratory Medicine, Rochester, New York, USA.
J Clin Microbiol. 2021 Jan 21;59(2). doi: 10.1128/JCM.02489-20.
The coronavirus disease 2019 (COVID-19) pandemic has highlighted the challenges inherent to the serological detection of a novel pathogen such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Serological tests can be used diagnostically and for surveillance, but their usefulness depends on their throughput, sensitivity, and specificity. Here, we describe a multiplex fluorescent microsphere-based assay, 3Flex, that can detect antibodies to three major SARS-CoV-2 antigens-spike (S) protein, the spike ACE2 receptor-binding domain (RBD), and nucleocapsid (NP). Specificity was assessed using 213 prepandemic samples. Sensitivity was measured and compared to that of the Abbott Architect SARS-CoV-2 IgG assay using serum samples from 125 unique patients equally binned (25) into 5 time intervals (≤5, 6 to 10, 11 to 15, 16 to 20, and ≥21 days from symptom onset). With samples obtained at ≤5 days from symptom onset, the 3Flex assay was more sensitive (48.0% versus 32.0%), but the two assays performed comparably using serum obtained ≥21 days from symptom onset. A larger collection (= 534) of discarded sera was profiled from patients (= 140) whose COVID-19 course was characterized through chart review. This revealed the relative rise, peak (S, 23.8; RBD, 23.6; NP, 16.7 [in days from symptom onset]), and decline of the antibody response. Considerable interperson variation was observed with a subset of extensively sampled intensive care unit (ICU) patients. Using soluble ACE2, inhibition of antibody binding was demonstrated for S and RBD, and not for NP. Taking the data together, this study described the performance of an assay built on a flexible and high-throughput serological platform that proved adaptable to the emergence of a novel infectious agent.
2019 年冠状病毒病(COVID-19)大流行凸显了血清学检测新型病原体(如严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2))固有存在的挑战。血清学检测可用于诊断和监测,但它们的有效性取决于其通量、敏感性和特异性。在这里,我们描述了一种基于多重荧光微球的检测方法,即 3Flex,它可以检测到针对三种主要 SARS-CoV-2 抗原的抗体-刺突(S)蛋白、刺突 ACE2 受体结合域(RBD)和核衣壳(NP)。使用 213 份大流行前样本评估了特异性。使用从 125 名具有独特症状患者(分为 5 个时间间隔(≤5、6 至 10、11 至 15、16 至 20 和≥21 天从症状发作开始)的血清样本,测量并比较了 3Flex 检测与 Abbott Architect SARS-CoV-2 IgG 检测的敏感性。在症状发作后≤5 天获得的样本中,3Flex 检测更敏感(48.0%比 32.0%),但使用≥21 天从症状发作开始获得的血清样本,两种检测方法的性能相当。从(140 名)患者的病历中提取了(534 份)较大的废弃血清样本,这些患者的 COVID-19 病程通过病历回顾进行了描述。这揭示了抗体反应的相对上升、峰值(S,23.8;RBD,23.6;NP,16.7[从症状发作开始的天数])和下降。在一组经过广泛采样的重症监护病房(ICU)患者中观察到相当大的个体间差异。使用可溶性 ACE2,证明了 S 和 RBD 抗体结合的抑制作用,但 NP 则没有。综合考虑这些数据,本研究描述了一种建立在灵活和高通量血清学平台上的检测方法的性能,该方法证明适应了新型传染病原体的出现。
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