Departamento de Biociências e Tecnologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, GO, Brazil.
Laboratório de Imunogenética, Instituto Butantan, São Paulo, SP, Brazil.
Front Immunol. 2023 Oct 9;14:1206979. doi: 10.3389/fimmu.2023.1206979. eCollection 2023.
Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces rapid production of IgM, IgA, and IgG antibodies directed to multiple viral antigens that may have impact diverse clinical outcomes.
We evaluated IgM, IgA, and IgG antibodies directed to the nucleocapsid (NP), IgA and IgG to the Spike protein and to the receptor-binding domain (RBD), and the presence of neutralizing antibodies (nAb), in a cohort of unvaccinated SARS-CoV-2 infected individuals, in the first 30 days of post-symptom onset (PSO) (T1).
This study included 193 coronavirus disease 2019 (COVID-19) participants classified as mild, moderate, severe, critical, and fatal and 27 uninfected controls. In T1, we identified differential antibody profiles associated with distinct clinical presentation. The mild group presented lower levels of anti-NP IgG, and IgA (vs moderate and severe), anti-NP IgM (vs severe, critical and fatal), anti-Spike IgA (vs severe and fatal), and anti-RBD IgG (vs severe). The moderate group presented higher levels of anti-RBD IgA, comparing with severe group. The severe group presented higher levels of anti-NP IgA (vs mild and fatal) and anti-RBD IgG (vs mild and moderate). The fatal group presented higher levels of anti-NP IgM and anti-Spike IgA (vs mild), but lower levels of anti-NP IgA (vs severe). The levels of nAb was lower just in mild group compared to severe, critical, and fatal groups, moreover, no difference was observed among the more severe groups. In addition, we studied 82 convalescent individuals, between 31 days to 6 months (T2) or more than 6 months (T3), PSO, those: 12 mild, 26 moderate, and 46 severe plus critical. The longitudinal analyzes, for the severe plus critical group showed lower levels of anti-NP IgG, IgA and IgM, anti-Spike IgA in relation T3. The follow-up in the fatal group, reveals that the levels of anti-spike IgG increased, while anti-NP IgM levels was decreased along the time in severe/critical and fatal as well as anti-NP IgG and IgA in several/critical groups.
In summary, the anti-NP IgA and IgG lower levels and the higher levels of anti-RBD and anti-Spike IgA in fatal compared to survival group of individuals admitted to the intensive care unit (ICU). Collectively, our data discriminate death from survival, suggesting that anti-RBD IgA and anti-Spike IgA may play some deleterious effect, in contrast with the potentially protective effect of anti-NP IgA and IgG in the survival group.
感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）会迅速产生针对多种病毒抗原的 IgM、IgA 和 IgG 抗体，这些抗体可能对不同的临床结局产生影响。
我们评估了未接种 SARS-CoV-2 感染个体在症状出现后 30 天内（T1）针对核衣壳（NP）的 IgM、IgA 和 IgG、针对刺突蛋白和受体结合域（RBD）的 IgA 和 IgG 以及中和抗体（nAb）的水平。
这项研究包括 193 名 2019 年冠状病毒病（COVID-19）患者，分为轻症、中度、重症、危重症和死亡，以及 27 名未感染的对照。在 T1 时，我们发现与不同临床表现相关的不同抗体谱。轻症组的抗-NP IgG 和 IgA 水平较低（与中重度相比），抗-NP IgM 水平较低（与重度、危重症和死亡相比），抗-Spike IgA 水平较低（与重度和死亡相比），抗-RBD IgG 水平较低（与重度相比）。中度组的抗-RBD IgA 水平高于重度组。重度组的抗-NP IgA 水平较高（与轻症和死亡相比），抗-RBD IgG 水平较高（与轻症和中度相比）。死亡组的抗-NP IgM 和抗-Spike IgA 水平较高（与轻症相比），但抗-NP IgA 水平较低（与重度相比）。与重度、危重症和死亡组相比，轻度组的 nAb 水平较低，而且在较重的组中没有发现差异。此外，我们研究了 82 名康复个体，在症状出现后 31 天至 6 个月（T2）或 6 个月以上（T3）。这些个体分为 12 名轻症、26 名中度和 46 名重症加危重症。对重症加危重症组的纵向分析显示，抗-NP IgG、IgA 和 IgM、抗-Spike IgA 的水平在 T3 时较低。对死亡组的随访显示，抗刺突 IgG 水平增加，而抗-NP IgM 水平在重症/危重症和死亡组以及重症/危重症组中下降。
总之，与入住重症监护病房（ICU）的存活组相比，死亡组的抗-NP IgA 和 IgG 水平较低，抗-RBD 和抗-Spike IgA 水平较高。总的来说，我们的数据区分了死亡和存活，提示抗-RBD IgA 和抗-Spike IgA 可能产生一些有害作用，而抗-NP IgA 和 IgG 对存活组可能具有潜在的保护作用。
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