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Ravlić S, Kurtović T, Cvetko Krajinović L, Hećimović A, Miloš M, Mateljak Lukačević S, Markotić A, Halassy B. What can neutralizing antibodies tell us about the quality of immunity in COVID-19 convalescents and vaccinees? Hum Vaccin Immunother 2023; 19:2270310. [PMID: 37905722 PMCID: PMC10760325 DOI: 10.1080/21645515.2023.2270310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/10/2023] [Indexed: 11/02/2023] Open
Abstract
During the SARS-CoV-2 pandemic, the lack of standardized measurements of the immune response after vaccination or recovery from COVID-19 resulted in incomparable results and hindered correlation establishment. Prioritizing reliable and standardized methods to monitor pathogen-specific immunity is crucial, not only during the COVID-19 pandemic but also for future outbreaks. During our study of the humoral immune response, we used a SARS-CoV-2 wild-type neutralization assay, ensuring the measurement of the immune response directed to all SARS-CoV-2 antigens in their proper conformation. A head-to-head comparison of the neutralizing antibody (NAb) responses elicited by four vaccines used in Europe during 2021 (BNT162b2, mRNA-1273, ChAdOx nCoV-19, and Ad26.COV2.S) and their comparison to NAb responses in convalescents showed that while the amount was comparable, NAbs induced by natural infection were of higher quality. Namely, NAbs produced by disease were better activators of the complement system than NAbs induced by vaccination. Furthermore, the contribution of spike protein-specific IgGs to the SARS-CoV-2 neutralization was lower in convalescents compared to vaccinees, indicating that those who recovered from COVID-19 were armed with antibodies of additional specificities and/or classes that contributed to virus neutralization. These findings suggest that a higher stringency of public policy measures targeting individuals who have recovered from COVID-19, in comparison to those who have been vaccinated, may not have been fully justified.
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Affiliation(s)
- Sanda Ravlić
- Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Zagreb, Croatia
- Center of Excellence for Virus Immunology and Vaccines, CERVirVac, Zagreb, Croatia
| | - Tihana Kurtović
- Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Zagreb, Croatia
- Center of Excellence for Virus Immunology and Vaccines, CERVirVac, Zagreb, Croatia
| | - Lidija Cvetko Krajinović
- Center of Excellence for Virus Immunology and Vaccines, CERVirVac, Zagreb, Croatia
- Research Department, University Hospital for Infectious Diseases “Dr. Fran Mihaljević”, Zagreb, Croatia
| | - Ana Hećimović
- Service for Transfusion Medicine, Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| | - Marija Miloš
- Clinical Department of Laboratory Diagnostic, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Sanja Mateljak Lukačević
- Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Zagreb, Croatia
- Center of Excellence for Virus Immunology and Vaccines, CERVirVac, Zagreb, Croatia
| | - Alemka Markotić
- Center of Excellence for Virus Immunology and Vaccines, CERVirVac, Zagreb, Croatia
- Research Department, University Hospital for Infectious Diseases “Dr. Fran Mihaljević”, Zagreb, Croatia
| | - Beata Halassy
- Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Zagreb, Croatia
- Center of Excellence for Virus Immunology and Vaccines, CERVirVac, Zagreb, Croatia
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Moritz CP, Do LD, Tholance Y, Vallayer PB, Rogemond V, Joubert B, Ferraud K, La Marca C, Camdessanché JP, Honnorat J, Antoine JC. Conformation-stabilizing ELISA and cell-based assays reveal patient subgroups targeting three different epitopes of AGO1 antibodies. Front Immunol 2022; 13:972161. [DOI: 10.3389/fimmu.2022.972161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 10/06/2022] [Indexed: 11/13/2022] Open
Abstract
Autoantibodies (Abs) are biomarkers for many disease conditions and are increasingly used to facilitate diagnosis and treatment decisions. To guarantee high sensitivity and specificity, the choice of their detection method is crucial. Via cell-based assays, we recently found 21 patients with neurological diseases positive for antibodies against argonaute (AGO), 10 of which having a neuropathy (NP). Here, we established a simple and conformation-sensitive ELISA with the aim to distinguish between AGO1 Abs against conformational epitopes and non-conformational epitopes and to reveal further characteristics of AGO1 antibodies in NP and autoimmune disease (AID). In a retrospective multicenter case/control and observational study, we tested 434 patients with NP, 274 disease controls with AID, and 116 healthy controls (HC) for AGO1 Abs via conformation-stabilizing ELISA. Seropositive patients were also tested for conformation-specificity via comparative denaturing/stabilizing ELISA (CODES-ELISA), CBA positivity, AGO1 titers and IgG subclasses, and AGO2 reactivity. These parameters were statistically compared among different epitope-specific patient groups. We found Abs in 44 patients, including 28/434 (6.5%) NP, 16/274 (5.8%) AID, and 0/116 (0%) HC. Serum reactivity was consistently higher for AGO1 than AGO2. Globally among the 44 AGO1 Abs-positive patients, 42 were also tested in CBA for AGO1 Abs positivity and 15 (35.7%) were positive. Furthermore, 43 were tested for conformation-specificity and 32 (74.4%) bound a conformational epitope. Among the subgroups of highly positive patients (ELISA z-score >14) with sera binding conformational epitopes (n=23), 14 patient sera were also CBA positive and 9 bound a second conformational but CBA-inaccessible epitope. A third, non-conformational epitope was bound by 11/43 (15.6%). Among the epitope-specific patient subgroups, we found significant differences regarding the Abs titers, IgG subclass, and AGO2 reactivity. When comparing AGO1 Abs-positive NP versus AID patients, we found the conformation-specific and CBA inaccessible epitope significantly more frequently in AID patients. We conclude that 1) conformational ELISA was more sensitive than CBA in detecting AGO1 Abs, 2) serum reactivity is higher for AGO1 than for AGO2 at least for NP patients, 3) AGO1 Abs might be a marker-of-interest in 6.5% of NP patients, 4) distinguishing epitopes might help finding different patient subgroups.
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Ravlić S, Hećimović A, Kurtović T, Ivančić Jelečki J, Forčić D, Slović A, Kurolt IC, Mačak Šafranko Ž, Mušlin T, Rnjak D, Jakšić O, Sorić E, Džepina G, Đaković Rode O, Kujavec Šljivac K, Vuk T, Jukić I, Markotić A, Halassy B. Is Better Standardization of Therapeutic Antibody Quality in Emerging Diseases Epidemics Possible? Front Immunol 2022; 13:816159. [PMID: 35273599 PMCID: PMC8902244 DOI: 10.3389/fimmu.2022.816159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/02/2022] [Indexed: 01/01/2023] Open
Abstract
During the ongoing COVID-19 epidemic many efforts have gone into the investigation of the SARS-CoV-2–specific antibodies as possible therapeutics. Currently, conclusions cannot be drawn due to the lack of standardization in antibody assessments. Here we describe an approach of establishing antibody characterisation in emergent times which would, if followed, enable comparison of results from different studies. The key component is a reliable and reproducible assay of wild-type SARS-CoV-2 neutralisation based on a banking system of its biological components - a challenge virus, cells and an anti-SARS-CoV-2 antibody in-house standard, calibrated to the First WHO International Standard immediately upon its availability. Consequently, all collected serological data were retrospectively expressed in an internationally comparable way. The neutralising antibodies (NAbs) among convalescents ranged from 4 to 2869 IU mL-1 in a significant positive correlation to the disease severity. Their decline in convalescents was on average 1.4-fold in a one-month period. Heat-inactivation resulted in 2.3-fold decrease of NAb titres in comparison to the native sera, implying significant complement activating properties of SARS-CoV-2 specific antibodies. The monitoring of NAb titres in the sera of immunocompromised COVID-19 patients that lacked their own antibodies evidenced the successful transfusion of antibodies by the COVID-19 convalescent plasma units with NAb titres of 35 IU mL-1 or higher.
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Affiliation(s)
- Sanda Ravlić
- Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Zagreb, Croatia.,Center of Excellence for Virus Immunology and Vaccines (CERVirVac), Zagreb, Croatia
| | - Ana Hećimović
- Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| | - Tihana Kurtović
- Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Zagreb, Croatia.,Center of Excellence for Virus Immunology and Vaccines (CERVirVac), Zagreb, Croatia
| | - Jelena Ivančić Jelečki
- Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Zagreb, Croatia.,Center of Excellence for Virus Immunology and Vaccines (CERVirVac), Zagreb, Croatia
| | - Dubravko Forčić
- Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Zagreb, Croatia.,Center of Excellence for Virus Immunology and Vaccines (CERVirVac), Zagreb, Croatia
| | - Anamarija Slović
- Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Zagreb, Croatia.,Center of Excellence for Virus Immunology and Vaccines (CERVirVac), Zagreb, Croatia
| | - Ivan Christian Kurolt
- Center of Excellence for Virus Immunology and Vaccines (CERVirVac), Zagreb, Croatia.,Research Department, University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
| | - Željka Mačak Šafranko
- Center of Excellence for Virus Immunology and Vaccines (CERVirVac), Zagreb, Croatia.,Research Department, University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
| | - Tatjana Mušlin
- Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| | - Dina Rnjak
- Clinics for Pulmonary Diseases, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ozren Jakšić
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
| | - Ena Sorić
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
| | - Gorana Džepina
- Department for Transfusion Medicine, University Hospital Dubrava, Zagreb, Croatia
| | - Oktavija Đaković Rode
- Department for Clinical Microbiology, University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia.,School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Kristina Kujavec Šljivac
- Clinical Institute for Transfusion Medicine, Clinical University Hospital Centre Osijek, Osijek, Croatia
| | - Tomislav Vuk
- Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| | - Irena Jukić
- Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| | - Alemka Markotić
- Center of Excellence for Virus Immunology and Vaccines (CERVirVac), Zagreb, Croatia.,Research Department, University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia.,School of Medicine, Catholic University of Croatia, Zagreb, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Beata Halassy
- Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Zagreb, Croatia.,Center of Excellence for Virus Immunology and Vaccines (CERVirVac), Zagreb, Croatia
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Rnjak D, Ravlić S, Šola AM, Halassy B, Šemnički J, Šuperba M, Hećimović A, Kurolt IC, Kurtović T, Mačak Šafranko Ž, Polančec D, Bendelja K, Mušlin T, Jukić I, Vuk T, Zenić L, Artuković M. COVID-19 convalescent plasma as long-term therapy in immunodeficient patients? Transfus Clin Biol 2021; 28:264-270. [PMID: 33901641 PMCID: PMC8064810 DOI: 10.1016/j.tracli.2021.04.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 04/16/2021] [Indexed: 02/07/2023]
Abstract
Objectives The patients with hematological malignancies are a vulnerable group to COVID-19, due to the immunodeficiency resulting from the underlying disease and oncological treatment that significantly impair cellular and humoral immunity. Here we report on a beneficial impact of a passive immunotherapy with convalescent plasma to treat a prolonged, active COVID-19 infection in a patient with a history of nasopharyngeal diffuse large B-cell lymphoma treated with the therapy inducing substantial impairment of particularly humoral arm of immune system. The specific aim was to quantify SARS-CoV2 neutralizing antibodies in a patient plasma during the course of therapy. Materials and methods Besides the standard of care treatment and monitoring, neutralizing antibody titers in patient's serum samples, calibrated according to the First WHO International Standard for anti-SARS-CoV-2 immunoglobulin (human), were quantified in a time-dependent manner. During the immunotherapy period peripheral blood flow cytometry immunophenotyping was conducted to characterize lymphocyte subpopulations. Results The waves of clinical improvements and worsening coincided with transfused neutralizing antibodies rises and drops in the patient's systemic circulation, proving their contribution in controlling the disease progress. Besides the patient's lack of own humoral immune system, immunophenotyping analysis revealed also the reduced level of helper T-lymphocytes and immune exhaustion of monocytes. Conclusion Therapeutic approach based on convalescent plasma transfusion transformed a prolonged, active COVID-19 infection into a manageable chronic disease.
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Affiliation(s)
- D Rnjak
- Special Hospital for Pulmonary Diseases, Rockefellerova 3, 10000 Zagreb, Croatia.
| | - S Ravlić
- University of Zagreb, Centre for Research and Knowledge Transfer in Biotechnology, Rockefellerova 10, 10000 Zagreb, Croatia; Centre of Excellence for Virus Immunology and Vaccines, Zagreb, Croatia.
| | - A-M Šola
- Special Hospital for Pulmonary Diseases, Rockefellerova 3, 10000 Zagreb, Croatia
| | - B Halassy
- University of Zagreb, Centre for Research and Knowledge Transfer in Biotechnology, Rockefellerova 10, 10000 Zagreb, Croatia; Centre of Excellence for Virus Immunology and Vaccines, Zagreb, Croatia
| | - J Šemnički
- Special Hospital for Pulmonary Diseases, Rockefellerova 3, 10000 Zagreb, Croatia
| | - M Šuperba
- Special Hospital for Pulmonary Diseases, Rockefellerova 3, 10000 Zagreb, Croatia
| | - A Hećimović
- Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| | - I-C Kurolt
- University Hospital for Infectious Diseases Dr. Fran Mihaljević, Zagreb, Croatia; Centre of Excellence for Virus Immunology and Vaccines, Zagreb, Croatia
| | - T Kurtović
- University of Zagreb, Centre for Research and Knowledge Transfer in Biotechnology, Rockefellerova 10, 10000 Zagreb, Croatia; Centre of Excellence for Virus Immunology and Vaccines, Zagreb, Croatia
| | - Ž Mačak Šafranko
- University Hospital for Infectious Diseases Dr. Fran Mihaljević, Zagreb, Croatia; Centre of Excellence for Virus Immunology and Vaccines, Zagreb, Croatia
| | - D Polančec
- Srebrnjak Children's Hospital, Zagreb, Croatia
| | - K Bendelja
- University of Zagreb, Centre for Research and Knowledge Transfer in Biotechnology, Rockefellerova 10, 10000 Zagreb, Croatia
| | - T Mušlin
- Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| | - I Jukić
- Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| | - T Vuk
- Croatian Institute of Transfusion Medicine, Zagreb, Croatia
| | - L Zenić
- Srebrnjak Children's Hospital, Zagreb, Croatia
| | - M Artuković
- Special Hospital for Pulmonary Diseases, Rockefellerova 3, 10000 Zagreb, Croatia
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