泪液中的新型冠状病毒2（SARS-CoV-2）RNA和抗体。
SARS-CoV-2 RNA and antibodies in tear fluid.
作者信息
Muyldermans Astrid, Bjerke Maria, Demuyser Thomas, De Geyter Deborah, Wybo Ingrid, Soetens Oriane, Weets Ilse, Kuijpers Robert, Allard Sabine D, Piérard Denis, Raus Peter P M
机构信息
Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Laboratory of Neurochemistry, Department of Clinical Biology and Center for Neurosciences, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
出版信息
BMJ Open Ophthalmol. 2021 Apr 30;6(1):e000733. doi: 10.1136/bmjophth-2021-000733. eCollection 2021.
BACKGROUND/AIMS: SARS-CoV-2 is highly contagious. More evidence concerning extrapulmonary transmission routes such as the eyes is urgently needed. Although the humoral immune response is important in the viral containment, the local response in tears has not yet been studied. The aim of our study was twofold: to assess the prevalence of both SARS-CoV-2 RNA and antibodies in tear fluid.
METHODS
In a first series, nasopharyngeal sampling and tear sampling by Schirmer test strips were performed in 26 acutely ill patients with COVID-19 to assess the presence of SARS-CoV-2 RNA by reverse transcription PCR. In a second series, IgG and IgA responses to SARS-CoV-2 spike protein in serum and tear fluid of convalescent individuals (n=22) were compared with control individuals (n=15) by ELISA.
RESULTS
SARS-CoV-2 RNA was detected in tears of 7/26 (26.9%) patients with COVID-19. None of them had ocular symptoms. Convalescent individuals displayed a significant higher ratio of IgG (p<0.0001) and IgA (p=0.0068) in tears compared with control individuals. A sensitivity of 77.3% and specificity of 93.3% was observed for IgG, and 59.1% and 100% for IgA.
CONCLUSIONS
Our results demonstrate the presence of SARS-CoV-2 RNA and a local IgG and IgA immune response in tear fluid. These data confirm the possibility of SARS-CoV-2 transmission through tear fluid and the importance of the eye as a first defence against SARS-CoV-2, indicating the potential of tears as a non-invasive surrogate for serum in monitoring the host immune response.
背景/目的：严重急性呼吸综合征冠状病毒2（SARS-CoV-2）具有高度传染性。迫切需要更多关于眼等肺外传播途径的证据。尽管体液免疫反应在控制病毒方面很重要，但泪液中的局部反应尚未得到研究。我们研究的目的有两个：评估泪液中SARS-CoV-2 RNA和抗体的流行情况。
方法
在第一个系列中，对26例急性COVID-19患者进行鼻咽采样和用泪液试纸条进行泪液采样，通过逆转录聚合酶链反应评估SARS-CoV-2 RNA的存在情况。在第二个系列中，通过酶联免疫吸附测定法（ELISA），比较康复个体（n = 22）血清和泪液中针对SARS-CoV-2刺突蛋白的IgG和IgA反应与对照个体（n = 15）的情况。
结果
在26例COVID-19患者中，7例（26.9%）的泪液中检测到SARS-CoV-2 RNA。他们均无眼部症状。与对照个体相比，康复个体泪液中IgG（p<0.0001）和IgA（p = 0.0068）的比例显著更高。观察到IgG的敏感性为77.3%，特异性为93.3%；IgA的敏感性为59.1%，特异性为100%。
结论
我们的结果表明泪液中存在SARS-CoV-2 RNA以及局部IgG和IgA免疫反应。这些数据证实了SARS-CoV-2通过泪液传播的可能性以及眼睛作为抵御SARS-CoV-2第一道防线的重要性，表明泪液作为监测宿主免疫反应的血清非侵入性替代物的潜力。
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