1
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Kostinov M, Svitich O, Chuchalin A, Abramova N, Osiptsov V, Khromova E, Pakhomov D, Tatevosov V, Vlasenko A, Gainitdinova V, Mashilov K, Kryukova N, Baranova I, Kostinov A. Changes in nasal, pharyngeal and salivary secretory IgA levels in patients with COVID-19 and the possibility of correction of their secretion using combined intranasal and oral administration of a pharmaceutical containing antigens of opportunistic microorganisms. Drugs Context 2023; 12:2022-10-4. [PMID: 37342460 PMCID: PMC10278444 DOI: 10.7573/dic.2022-10-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 05/08/2023] [Indexed: 06/23/2023] Open
Abstract
Background Although extensive research has been conducted on the role of local immunity in patients with SARS-CoV-2, little is known about the production and concentrations of secretory IgA (SIgA) in different mucosal compartments. This article aims to assess the secretion of SIgA in the nasal and pharyngeal compartments and saliva of patients with COVID-19 and to investigate the possibility and efficiency of correction of their secretion using combined intranasal and oral administration of a pharmaceutical containing antigens of opportunistic microorganisms. Methods This study included 78 inpatients, aged between 18 and 60 years, who had confirmed COVID-19 with moderate lung involvement. The control group (n=45) received basic therapy, and the treatment group (n=33) was additionally administered the bacteria-based pharmaceutical Immunovac VP4 from day 1 to day 10 of hospitalization. SIgA levels were measured by ELISA at baseline and on days 14 and 30. Results No systemic or local reactions associated with Immunovac VP4 were reported. We observed a statistically significant reduction in the duration of fever and hospitalization in patients who received Immunovac VP4 compared with those from the control group (p=0.03 and p=0.05, respectively). Changes over time in SIgA levels in nasal swabs were found to be significantly different in the two treatment groups (F=7.9, p[78.0]<0.001). On day 14 of observation, patients in the control group showed a statistically significant reduction in SIgA levels from baseline (p=0.02), whereas patients in the Immunovac VP4 group had stable SIgA levels (p=0.07). On day 30 after the start of treatment, there was a statistically significant increase in SIgA levels in the Immunovac VP4 group compared with baseline (from 77.7 (40.5-98.7) μg/L to 113.4 (39.8-156.7) μg/L; p=0.05) and the levels measured on day 14 (from 60.2 (23.3-102.9) μg/L to 113.4 (39.8-156.7) μg/L; p=0.03). The control group showed a statistically significant decrease in levels of nasal SIgA (to 37.3) on day 30 (p=0.007 for comparison with baseline values and p=0.04 for comparison with levels measured on day 14). Changes over time in SIgA levels measured in pharyngeal swabs were also different between the two treatment groups, and this difference reached statistical significance (F=6.5, p[73.0]=0.003). In the control group, this parameter did not change throughout the study (p=0.17 for a comparison between the levels measured on day 14 and the baseline values, and p=0.12 for a comparison between the levels measured on day 30 and the baseline values). In the Immunovac VP4 group, there was a statistically significant increase from baseline in SIgA levels on study day 30: from 1.5 (0.2-16.5) μg/L to 29.8 (3.6-106.8) μg/L (p=0.02). Changes over time in salivary SIgA did not show a significant difference between study groups (F=0.3, p[66.3]=0.75). Conclusion As part of combination therapy, the bacteria-based immunostimulant agent Immunovac VP4 increases SIgA levels in the nasal and pharyngeal compartments and induces clinical improvement. Induced mucosal immunity is central to the prevention of respiratory infections, particularly in patients with post-COVID-19 syndrome.
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Affiliation(s)
- Mikhail Kostinov
- Laboratory of Preventive Vaccination and Immunotherapy of Allergic Diseases, I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, Russian Federation
- Department of Epidemiology and Modern Technologies of Vaccination, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Oksana Svitich
- I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, Russian Federation
| | - Alexander Chuchalin
- Department of Hospital Therapy of the Faculty of Pediatrics, Pirogov Russian National Research Medical University (Pirogov Medical University), Moscow, Russian Federation
- Research Institute of Pulmonology, Moscow, Russian Federation
| | - Natalya Abramova
- Laboratory of Molecular Immunology, I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, Russian Federation
| | - Valery Osiptsov
- The Main Military Clinical Hospital of the National Guard Troops of the Russian Federation, Moscow, Russian Federation
| | - Ekaterina Khromova
- Laboratory of Preventive Vaccination and Immunotherapy of Allergic Diseases, I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, Russian Federation
| | - Dmitry Pakhomov
- Laboratory of Preventive Vaccination and Immunotherapy of Allergic Diseases, I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, Russian Federation
| | - Vitaly Tatevosov
- The Main Military Clinical Hospital of the National Guard Troops of the Russian Federation, Moscow, Russian Federation
| | - Anna Vlasenko
- Medical Cybernetics and Informatics Department, Novokuznetsk State Institute of Advanced Training of Physicians – Branch of the “Russian Medical Academy of Continuous Professional Education”, Novokuznetsk, Russian Federation
| | - Vilia Gainitdinova
- Pulmonology Department of the I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Kirill Mashilov
- Laboratory of Preventive Vaccination and Immunotherapy of Allergic Diseases, I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, Russian Federation
| | - Nadezhda Kryukova
- Department of Hospital Therapy of the Faculty of Pediatrics, Pirogov Russian National Research Medical University (Pirogov Medical University), Moscow, Russian Federation
| | - Irina Baranova
- Department of Hospital Therapy of the Faculty of Pediatrics, Pirogov Russian National Research Medical University (Pirogov Medical University), Moscow, Russian Federation
| | - Anton Kostinov
- Allergodiagnostics Laboratory, I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, Russian Federation
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2
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Lu X, Guo Z, Li ZN, Holiday C, Liu F, Jefferson S, Gross FL, Tzeng WP, Kumar A, York IA, Uyeki TM, Tumpey T, Stevens J, Levine MZ. Low quality antibody responses in critically ill patients hospitalized with pandemic influenza A(H1N1)pdm09 virus infection. Sci Rep 2022; 12:14971. [PMID: 36056075 PMCID: PMC9440095 DOI: 10.1038/s41598-022-18977-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/23/2022] [Indexed: 12/02/2022] Open
Abstract
Although some adults infected with influenza 2009 A(H1N1)pdm09 viruses mounted high hemagglutination inhibition (HAI) antibody response, they still suffered from severe disease, or even death. Here, we analyzed antibody profiles in patients (n = 31, 17-65 years) admitted to intensive care units (ICUs) with lung failure and invasive mechanical ventilation use due to infection with A(H1N1)pdm09 viruses during 2009-2011. We performed a comprehensive analysis of the quality and quantity of antibody responses using HAI, virus neutralization, biolayer interferometry, enzyme-linked-lectin and enzyme-linked immunosorbent assays. At time of the ICU admission, 45% (14/31) of the patients had HAI antibody titers ≥ 80 in the first serum (S1), most (13/14) exhibited narrowly-focused HAI and/or anti-HA-head binding antibodies targeting single epitopes in or around the receptor binding site. In contrast, 42% (13/31) of the patients with HAI titers ≤ 10 in S1 had non-neutralizing anti-HA-stem antibodies against A(H1N1)pdm09 viruses. Only 19% (6/31) of the patients showed HA-specific IgG1-dominant antibody responses. Three of 5 fatal patients possessed highly focused cross-type HAI antibodies targeting the (K130 + Q223)-epitopes with extremely low avidity. Our findings suggest that narrowly-focused low-quality antibody responses targeting specific HA-epitopes may have contributed to severe infection of the lower respiratory tract.
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Affiliation(s)
- Xiuhua Lu
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, MS H17-5, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Zhu Guo
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, MS H17-5, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Zhu-Nan Li
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, MS H17-5, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Crystal Holiday
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, MS H17-5, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Feng Liu
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, MS H17-5, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Stacie Jefferson
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, MS H17-5, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - F Liaini Gross
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, MS H17-5, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Wen-Ping Tzeng
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, MS H17-5, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Anand Kumar
- Section of Infectious Diseases, University of Manitoba, Winnipeg, Canada
| | - Ian A York
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, MS H17-5, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, MS H17-5, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Terrence Tumpey
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, MS H17-5, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - James Stevens
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, MS H17-5, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Min Z Levine
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, MS H17-5, 1600 Clifton Road, Atlanta, GA, 30329, USA.
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3
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Fröberg J, Gillard J, Philipsen R, Lanke K, Rust J, van Tuijl D, Teelen K, Bousema T, Simonetti E, van der Gaast-de Jongh CE, Bos M, van Kuppeveld FJ, Bosch BJ, Nabuurs-Franssen M, van der Geest-Blankert N, van Daal C, Huynen MA, de Jonge MI, Diavatopoulos DA. SARS-CoV-2 mucosal antibody development and persistence and their relation to viral load and COVID-19 symptoms. Nat Commun 2021; 12:5621. [PMID: 34556667 PMCID: PMC8460778 DOI: 10.1038/s41467-021-25949-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 09/08/2021] [Indexed: 12/27/2022] Open
Abstract
Although serological studies have shown that antibodies against SARS-CoV-2 play an important role in protection against (re)infection, the dynamics of mucosal antibodies during primary infection and their potential impact on viral load and the resolution of disease symptoms remain unclear. During the first pandemic wave, we assessed the longitudinal nasal antibody response in index cases with mild COVID-19 and their household contacts. Nasal and serum antibody responses were analysed for up to nine months. Higher nasal receptor binding domain and spike protein-specific antibody levels at study inclusion were associated with lower viral load. Older age was correlated with more frequent COVID-19 related symptoms. Receptor binding domain and spike protein-specific mucosal antibodies were associated with the resolution of systemic, but not respiratory symptoms. Finally, receptor binding domain and spike protein-specific mucosal antibodies remained elevated up to nine months after symptom onset.
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Affiliation(s)
- Janeri Fröberg
- Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Laboratory of Medical Immunology, Section Paediatric Infectious Diseases, 6525 GA, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands
| | - Joshua Gillard
- Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Laboratory of Medical Immunology, Section Paediatric Infectious Diseases, 6525 GA, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands
- Centre for molecular and Biomolecular Informatics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Centre Nijmegen, 6525 GA, Nijmegen, The Netherlands
| | - Ria Philipsen
- Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Laboratory of Medical Immunology, Section Paediatric Infectious Diseases, 6525 GA, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands
- RTC CS Radboud Technology Center Clinical Studies, Radboudumc, Nijmegen, The Netherlands
| | - Kjerstin Lanke
- Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands
| | - Joyce Rust
- Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Laboratory of Medical Immunology, Section Paediatric Infectious Diseases, 6525 GA, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands
- RTC CS Radboud Technology Center Clinical Studies, Radboudumc, Nijmegen, The Netherlands
| | - Diana van Tuijl
- Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Laboratory of Medical Immunology, Section Paediatric Infectious Diseases, 6525 GA, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands
- RTC CS Radboud Technology Center Clinical Studies, Radboudumc, Nijmegen, The Netherlands
| | - Karina Teelen
- Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands
| | - Teun Bousema
- Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands
| | - Elles Simonetti
- Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Laboratory of Medical Immunology, Section Paediatric Infectious Diseases, 6525 GA, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands
| | - Christa E van der Gaast-de Jongh
- Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Laboratory of Medical Immunology, Section Paediatric Infectious Diseases, 6525 GA, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands
| | - Mariska Bos
- Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Laboratory of Medical Immunology, Section Paediatric Infectious Diseases, 6525 GA, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands
| | - Frank J van Kuppeveld
- Utrecht University, Faculty of Veterinary Medicine, Department of Biomolecular Health Sciences, Division Infectious Diseases and Immunology, Utrecht, The Netherlands
| | - Berend-Jan Bosch
- Utrecht University, Faculty of Veterinary Medicine, Department of Biomolecular Health Sciences, Division Infectious Diseases and Immunology, Utrecht, The Netherlands
| | - Marrigje Nabuurs-Franssen
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | | | - Charlotte van Daal
- Department of Occupational Health, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Martijn A Huynen
- Centre for molecular and Biomolecular Informatics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Centre Nijmegen, 6525 GA, Nijmegen, The Netherlands
| | - Marien I de Jonge
- Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Laboratory of Medical Immunology, Section Paediatric Infectious Diseases, 6525 GA, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands
| | - Dimitri A Diavatopoulos
- Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Laboratory of Medical Immunology, Section Paediatric Infectious Diseases, 6525 GA, Nijmegen, The Netherlands.
- Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands.
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4
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Kamat D, Kamat A, Mathur A. Immune Responses in Patients with COVID-19: An Overview. Pediatr Ann 2021; 50:e222-e226. [PMID: 34044706 DOI: 10.3928/19382359-20210421-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Since late 2019, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has resulted in more than 143 million confirmed infections and more than 3 million deaths worldwide (as of publication time). In this article, we discuss current knowledge of immune responses that confer protection to more than 80% of the people who have been infected and possible mechanisms by which the virus escapes immune surveillance in people who develop severe disease and those who die from the disease. We also discuss the differences in the immune responses by which, in most children, the infection results in only mild disease, although causing severe disease in some adults. Understanding these differences in both the innate and adaptive immune responses among these people can lead to the development of biotherapeutic treatment modalities that could modulate immune responses to offer protection against SARS-CoV-2 and block the ability of the virus to cause severe disease or death in humans. [Pediatr Ann. 2021;50(5):e222-e226.].
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5
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Tunheim G, Laake I, Robertson AH, Waalen K, Hungnes O, Naess LM, Cox RJ, Mjaaland S, Trogstad L. Antibody levels in a cohort of pregnant women after the 2009 influenza A(H1N1) pandemic: Waning and association with self-reported severity and duration of illness. Influenza Other Respir Viruses 2018; 13:191-200. [PMID: 30536590 PMCID: PMC6379636 DOI: 10.1111/irv.12623] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 11/05/2018] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND A population-based pregnancy cohort was established in Norway to study potential effects of exposure to the 2009 influenza pandemic or pandemic vaccination during pregnancy. OBJECTIVES We studied maternal A(H1N1)pdm09-specific hemagglutination inhibition (HI)-titer levels and waning in women with influenza-like illness (ILI) in pregnancy compared to vaccinated women. Moreover, we studied the association between HI-titers and self-reported severity and duration of ILI. METHODS HI-titers against the pandemic virus were measured in maternal blood samples obtained at birth, 3-9 months after exposure, and linked with information about pregnancy, influenza and vaccination from national registries and a cohort questionnaire. RESULTS Among 1821 pregnant women included, 43.7% were unvaccinated and 19.3% of these had ILI. HI-titers were low (geometric mean titer (GMT) 11.3) in the unvaccinated women with ILI. Higher HI-titers (GMT 37.8) were measured in the vaccinated women. Estimated HI-titer waning was similar for vaccinated women and women with ILI. Most ILI episodes were moderate and lasted 3-5 days. Women with ILI reporting specific influenza symptoms such as fever or cough had higher HI-titers than women without these symptoms. Women who reported being "very ill" or illness duration of >5 days had higher HI-titers than women reporting less severe illness or illness of shorter duration, respectively. CONCLUSIONS Antibody waning was similar in vaccinated women and women with ILI. More severe ILI or longer duration of illness was associated with higher HI-titers. Most unvaccinated pregnant women with ILI had low HI-titers, probably due to moderate illness and HI-titer waning between exposure and sampling.
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Affiliation(s)
- Gro Tunheim
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.,K. G. Jebsen Centre for Influenza Vaccine Research, University of Oslo, Oslo, Norway
| | - Ida Laake
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Anna Hayman Robertson
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Kristian Waalen
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Olav Hungnes
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Lisbeth M Naess
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Rebecca J Cox
- K. G. Jebsen Centre for Influenza Vaccine Research, University of Oslo, Oslo, Norway.,The Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Research and Development, Haukeland University Hospital, Bergen, Norway
| | - Siri Mjaaland
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.,K. G. Jebsen Centre for Influenza Vaccine Research, University of Oslo, Oslo, Norway
| | - Lill Trogstad
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
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6
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Mesman AW, Westerhuis BM, Ten Hulscher HI, Jacobi RH, de Bruin E, van Beek J, Buisman AM, Koopmans MP, van Binnendijk RS. Influenza virus A(H1N1)2009 antibody-dependent cellular cytotoxicity in young children prior to the H1N1 pandemic. J Gen Virol 2016; 97:2157-2165. [PMID: 27412007 DOI: 10.1099/jgv.0.000552] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Pre-existing immunity played a significant role in protection during the latest influenza A virus H1N1 pandemic, especially in older age groups. Structural similarities were found between A(H1N1)2009 and older H1N1 virus strains to which humans had already been exposed. Broadly cross-reactive antibodies capable of neutralizing the A(H1N1)2009 virus have been implicated in this immune protection in adults. We investigated the serological profile of a group of young children aged 9 years (n=55), from whom paired blood samples were available, just prior to the pandemic wave (March 2009) and shortly thereafter (March 2010). On the basis of A(H1N1)2009 seroconversion, 27 of the 55 children (49 %) were confirmed to be infected between these two time points. Within the non-infected group of 28 children (51 %), high levels of seasonal antibodies to H1 and H3 HA1 antigens were detected prior to pandemic exposure, reflecting past infection with H1N1 and H3N2, both of which had circulated in The Netherlands prior to the pandemic. In some children, this reactivity coincided with specific antibody reactivity against A(H1N1)2009. While these antibodies were not able to neutralize the A(H1N1)2009 virus, they were able to mediate antibody-dependent cellular cytotoxicity (ADCC) in vitro upon interaction with the A(H1N1)2009 virus. This finding suggests that cross-reactive antibodies could contribute to immune protection in children via ADCC.
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Affiliation(s)
- Annelies W Mesman
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Brenda M Westerhuis
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Hinke I Ten Hulscher
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Ronald H Jacobi
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Erwin de Bruin
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.,Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Josine van Beek
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Annemarie M Buisman
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Marion P Koopmans
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.,Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Robert S van Binnendijk
- Centre for Infectious Disease Control (Cib), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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7
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Mohn KGI, Cox RJ, Tunheim G, Berdal JE, Hauge AG, Jul-Larsen Å, Peters B, Oftung F, Jonassen CM, Mjaaland S. Immune Responses in Acute and Convalescent Patients with Mild, Moderate and Severe Disease during the 2009 Influenza Pandemic in Norway. PLoS One 2015; 10:e0143281. [PMID: 26606759 PMCID: PMC4659565 DOI: 10.1371/journal.pone.0143281] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Accepted: 11/03/2015] [Indexed: 01/31/2023] Open
Abstract
Increased understanding of immune responses influencing clinical severity during pandemic influenza infection is important for improved treatment and vaccine development. In this study we recruited 46 adult patients during the 2009 influenza pandemic and characterized humoral and cellular immune responses. Those included were either acute hospitalized or convalescent patients with different disease severities (mild, moderate or severe). In general, protective antibody responses increased with enhanced disease severity. In the acute patients, we found higher levels of TNF-α single-producing CD4+T-cells in the severely ill as compared to patients with moderate disease. Stimulation of peripheral blood mononuclear cells (PBMC) from a subset of acute patients with peptide T-cell epitopes showed significantly lower frequencies of influenza specific CD8+ compared with CD4+ IFN-γ T-cells in acute patients. Both T-cell subsets were predominantly directed against the envelope antigens (HA and NA). However, in the convalescent patients we found high levels of both CD4+ and CD8+ T-cells directed against conserved core antigens (NP, PA, PB, and M). The results indicate that the antigen targets recognized by the T-cell subsets may vary according to the phase of infection. The apparent low levels of cross-reactive CD8+ T-cells recognizing internal antigens in acute hospitalized patients suggest an important role for this T-cell subset in protective immunity against influenza.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Neutralizing/immunology
- Antibodies, Viral/immunology
- Cytokines/metabolism
- Epitopes, T-Lymphocyte/immunology
- Female
- Host-Pathogen Interactions/immunology
- Humans
- Immunity
- Immunity, Cellular
- Immunity, Humoral
- Immunoglobulin G/immunology
- Influenza A Virus, H1N1 Subtype/immunology
- Influenza A virus/immunology
- Influenza, Human/diagnosis
- Influenza, Human/epidemiology
- Influenza, Human/immunology
- Male
- Middle Aged
- Neutralization Tests
- Norway/epidemiology
- Pandemics
- Prospective Studies
- Severity of Illness Index
- T-Lymphocyte Subsets/immunology
- T-Lymphocyte Subsets/metabolism
- Young Adult
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Affiliation(s)
- Kristin G.-I. Mohn
- The Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
- Infectious Diseases Unit, Department of Internal Medicine, Haukeland University Hospital, Bergen, Norway
- K.G. Jebsen Centre for Influenza Vaccine Research, Department of Clinical Science, University of Bergen, Bergen, and The Norwegian Institute of Public Health, Oslo, Norway
- * E-mail: (KGIM); (SM)
| | - Rebecca Jane Cox
- The Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Research & Development, Haukeland University Hospital, Bergen, Norway
- K.G. Jebsen Centre for Influenza Vaccine Research, Department of Clinical Science, University of Bergen, Bergen, and The Norwegian Institute of Public Health, Oslo, Norway
| | - Gro Tunheim
- Division of Infectious Disease Control, Department of Bacteriology and Immunology, Norwegian Institute of Public Health, Oslo, Norway
- K.G. Jebsen Centre for Influenza Vaccine Research, Department of Clinical Science, University of Bergen, Bergen, and The Norwegian Institute of Public Health, Oslo, Norway
| | - Jan Erik Berdal
- Department of Infectious Diseases, Akershus University Hospital, Nordbyhagen, Norway
| | - Anna Germundsson Hauge
- Section for Virology, Department of Laboratory Services, Norwegian Veterinary Institute, Oslo, Norway
- Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Åsne Jul-Larsen
- The Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Bjoern Peters
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology, La Jolla, California, United States of America
| | - Fredrik Oftung
- Division of Infectious Disease Control, Department of Bacteriology and Immunology, Norwegian Institute of Public Health, Oslo, Norway
- K.G. Jebsen Centre for Influenza Vaccine Research, Department of Clinical Science, University of Bergen, Bergen, and The Norwegian Institute of Public Health, Oslo, Norway
| | - Christine Monceyron Jonassen
- Genetic Unit, Department of Multidisciplinary Laboratory Medicine and Medical Biochemistry, Akershus University Hospital, Nordbyhagen, Norway
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Fredrikstad, Norway
- Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Siri Mjaaland
- Division of Infectious Disease Control, Department of Bacteriology and Immunology, Norwegian Institute of Public Health, Oslo, Norway
- K.G. Jebsen Centre for Influenza Vaccine Research, Department of Clinical Science, University of Bergen, Bergen, and The Norwegian Institute of Public Health, Oslo, Norway
- * E-mail: (KGIM); (SM)
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