Division of Infectious Disease and International Health, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Dartmouth College, Hanover, New Hampshire, USA.
J Infect Dis. 2022 Sep 28;226(7):1204-1214. doi: 10.1093/infdis/jiac065.
A longitudinal study was performed to determine the breadth, kinetics, and correlations of systemic and mucosal antibody responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
Twenty-six unvaccinated adults with confirmed coronavirus disease 2019 (COVID-19) were followed for 6 months with 3 collections of blood, nasal secretions, and stool. Control samples were obtained from 16 unvaccinated uninfected individuals. SARS-CoV-2 neutralizing and binding antibody responses were respectively evaluated by pseudovirus assays and multiplex bead arrays.
Neutralizing antibody responses to SARS-CoV-2 were detected in serum and respiratory samples for 96% (25/26) and 54% (14/26), respectively, of infected participants. Robust binding antibody responses against SARS-CoV-2 spike protein and S1, S2, and receptor binding (RBD) domains occurred in serum and respiratory nasal secretions, but not in stool samples. Serum neutralization correlated with RBD-specific immunoglobulin (Ig)G, IgM, and IgA in serum (Spearman ρ = 0.74, 0.66, and 0.57, respectively), RBD-specific IgG in respiratory secretions (ρ = 0.52), disease severity (ρ = 0.59), and age (ρ = 0.40). Respiratory mucosal neutralization correlated with RBD-specific IgM (ρ = 0.42) and IgA (ρ = 0.63).
Sustained antibody responses occurred after SARS-CoV-2 infection. Notably, there was independent induction of IgM and IgA binding antibody and neutralizing responses in systemic and respiratory compartments. These observations have implications for current vaccine strategies and understanding SARS-CoV-2 reinfection and transmission.
本纵向研究旨在确定严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染后系统和黏膜抗体应答的广度、动力学和相关性。
26 名未经疫苗接种的新冠肺炎确诊患者在 6 个月的时间里接受了 3 次血液、鼻腔分泌物和粪便采集。对照组来自 16 名未经疫苗接种的未感染者。分别通过假病毒检测和多重珠粒阵列评估 SARS-CoV-2 中和抗体和结合抗体应答。
26 名感染者的血清和呼吸道样本中分别有 96%（25/26）和 54%（14/26）检测到针对 SARS-CoV-2 的中和抗体应答。在血清和呼吸道鼻腔分泌物中均检测到针对 SARS-CoV-2 刺突蛋白及其 S1、S2 和受体结合（RBD）结构域的强结合抗体应答，但在粪便样本中未检测到。血清中和与血清中 RBD 特异性 IgG、IgM 和 IgA 呈正相关（Spearman ρ=0.74、0.66 和 0.57），与呼吸道分泌物中的 RBD 特异性 IgG 呈正相关（ρ=0.52），与疾病严重程度呈正相关（ρ=0.59），与年龄呈正相关（ρ=0.40）。呼吸道黏膜中和与 RBD 特异性 IgM（ρ=0.42）和 IgA（ρ=0.63）呈正相关。
SARS-CoV-2 感染后可产生持续的抗体应答。值得注意的是，在全身和呼吸道部位可独立诱导 IgM 和 IgA 结合抗体和中和抗体应答。这些观察结果对当前的疫苗策略以及对 SARS-CoV-2 再感染和传播的理解具有重要意义。
