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Faustini SE, Cook A, Hill H, Al-Taei S, Heaney J, Efstathiou E, Tanner C, Townsend N, Ahmed Z, Dinally M, Hoque M, Goodall M, Stamataki Z, Plant T, Chapple I, Cunningham AF, Drayson MT, Shields AM, Richter AG. Saliva antiviral antibody levels are detectable but correlate poorly with serum antibody levels following SARS-CoV-2 infection and/or vaccination. J Infect 2023; 87:328-335. [PMID: 37543310 DOI: 10.1016/j.jinf.2023.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 07/12/2023] [Accepted: 07/29/2023] [Indexed: 08/07/2023]
Abstract
The importance of salivary SARS-CoV-2 antibodies, following infection and vaccination, has not been fully established. 875 healthcare workers were sampled during the first wave in 2020 and 66 longitudinally in response to Pfizer BioNTech 162b2 vaccination. We measured SARS-CoV-2 total IgGAM and individual IgG, IgA and IgM antibodies. IgGAM seroprevalence was 39.9%; however, only 34.1% of seropositive individuals also had salivary antibodies. Infection generated serum IgG antibodies in 51.4% and IgA antibodies in 34.1% of individuals. In contrast, the salivary antibody responses were dominated by IgA (30.9% and 12% generating IgA and IgG antibodies, respectively). Post 2nd vaccination dose, in serum, 100% of infection naïve individuals had IgG and 82.8% had IgA responses; in saliva, 65.5% exhibited IgG and 55.2% IgA antibodies. Prior infection enhanced the vaccine antibody response in serum but no such difference was observed in saliva. Strong neutralisation responses were seen for serum 6 months post 2nd-vaccination dose (median 87.1%) compared to low neutralisation responses in saliva (median 1%). Intramuscular vaccination induces significant serum antibodies and to a lesser extent, salivary antibodies; however, salivary antibodies are typically non-neutralising. This study provides further evidence for the need of mucosal vaccines to elicit nasopharyngeal/oral protection. Although saliva is an attractive non-invasive sero-surveillance tool, due to distinct differences between systemic and oral antibody responses, it cannot be used as a proxy for serum antibody measurement.
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Affiliation(s)
- Siân E Faustini
- University of Birmingham, Clinical Immunology Service, United Kingdom.
| | - Alex Cook
- University of Birmingham, Institute of Immunology and Immunotherapy, United Kingdom; The Binding Site Ltd, United Kingdom
| | - Harriet Hill
- University of Birmingham, Institute of Immunology and Immunotherapy, United Kingdom
| | - Saly Al-Taei
- University of Birmingham, Clinical Immunology Service, United Kingdom
| | - Jennifer Heaney
- University of Birmingham, Clinical Immunology Service, United Kingdom
| | - Elena Efstathiou
- University of Birmingham, Clinical Immunology Service, United Kingdom
| | - Chloe Tanner
- University of Birmingham, Clinical Immunology Service, United Kingdom
| | - Neal Townsend
- University of Birmingham, Clinical Immunology Service, United Kingdom
| | - Zahra Ahmed
- University of Birmingham, Clinical Immunology Service, United Kingdom
| | - Mohammad Dinally
- University of Birmingham, Clinical Immunology Service, United Kingdom
| | - Madeeha Hoque
- University of Birmingham, Clinical Immunology Service, United Kingdom
| | - Margaret Goodall
- University of Birmingham, Clinical Immunology Service, United Kingdom
| | - Zania Stamataki
- University of Birmingham, Institute of Immunology and Immunotherapy, United Kingdom
| | - Timothy Plant
- University of Birmingham, Clinical Immunology Service, United Kingdom
| | - Iain Chapple
- Periodontal Research Group, Institute of Clinical Sciences, University of Birmingham, United Kingdom; University of Birmingham, School of Dentistry, United Kingdom; Birmingham Biomedical Research Centre, United Kingdom
| | - Adam F Cunningham
- University of Birmingham, Institute of Immunology and Immunotherapy, United Kingdom
| | - Mark T Drayson
- University of Birmingham, Clinical Immunology Service/QE UHB Hospital Trust, United Kingdom
| | - Adrian M Shields
- University of Birmingham, Clinical Immunology Service/QE UHB Hospital Trust, United Kingdom
| | - Alex G Richter
- University of Birmingham, Clinical Immunology Service/QE UHB Hospital Trust, United Kingdom.
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Ganelin-Cohen E, Tartakovsky E, Klepfish E, Golderman S, Rozenberg A, Kaplan B. Personalized Disease Monitoring in Pediatric Onset Multiple Sclerosis Using the Saliva Free Light Chain Test. Front Immunol 2022; 13:821499. [PMID: 35450065 PMCID: PMC9016751 DOI: 10.3389/fimmu.2022.821499] [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: 11/24/2021] [Accepted: 03/11/2022] [Indexed: 12/15/2022] Open
Abstract
Background Development of new safe methods of monitoring disease activity in the pediatric onset multiple sclerosis (POMS) is a challenging task, especially when trying to refrain from frequent MRI usage. In our recent study, the saliva immunoglobulin free light chains (FLC) were suggested as biomarkers to discriminate between remission and active MS in adults. Objectives To assess utility of saliva FLC measurements for monitoring disease activity in POMS. Methods We used semiquantitative Western blot analysis to detect immunoreactive FLC monomers and dimers and to calculate the intensity of their bands. Statistical tests included Firth logistic regression analysis suitable for small sample sizes, and Spearman's non-parametric correlation. Results In naive POMS patients, the saliva levels of FLC in relapse were significantly higher than those in remission. Significant correlation was found between FLC levels (monomers, dimers or both) and the load of enhanced lesions in MRI scans. FLC levels may be reduced under treatment, especially as result of corticosteroids therapy. Follow-up of individual patients showed the correspondence of changes in the FLC levels to MRI findings. Conclusions Our results show the potential of the non-invasive saliva FLC test, as a new tool for monitoring the disease activity in POMS.
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Affiliation(s)
- Esther Ganelin-Cohen
- Institute of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | | | - Sizilia Golderman
- Heller Institute of Medical Research, Sheba Medical Center, Ramat Gan, Israel
| | - Ayal Rozenberg
- Department of Neurology, Rambam Health Care Campus, Haifa, Israel
| | - Batia Kaplan
- Heller Institute of Medical Research, Sheba Medical Center, Ramat Gan, Israel
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