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Hu F, Chen F, Ou Z, Fan Q, Tan X, Wang Y, Pan Y, Ke B, Li L, Guan Y, Mo X, Wang J, Wang J, Luo C, Wen X, Li M, Ren P, Ke C, Li J, Lei C, Tang X, Li F. A compromised specific humoral immune response against the SARS-CoV-2 receptor-binding domain is related to viral persistence and periodic shedding in the gastrointestinal tract. Cell Mol Immunol 2020; 17:1119-1125. [PMID: 33037400 PMCID: PMC7546387 DOI: 10.1038/s41423-020-00550-2] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 08/29/2020] [Indexed: 12/23/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been redetected after discharge in some coronavirus disease 2019 (COVID-19) patients. The reason for the recurrent positivity of the test and the potential public health concern due to this occurrence are still unknown. Here, we analyzed the viral data and clinical manifestations of 289 domestic Chinese COVID-19 patients and found that 21 individuals (7.3%) were readmitted for hospitalization after detection of SARS-CoV-2 after discharge. First, we experimentally confirmed that the virus was involved in the initial infection and was not a secondary infection. In positive retests, the virus was usually found in anal samples (15 of 21, 71.4%). Through analysis of the intracellular viral subgenomic messenger RNA (sgmRNA), we verified that positive retest patients had active viral replication in their gastrointestinal tracts (3 of 16 patients, 18.7%) but not in their respiratory tracts. Then, we found that viral persistence was not associated with high viral titers, delayed viral clearance, old age, or more severe clinical symptoms during the first hospitalization. In contrast, viral rebound was associated with significantly lower levels of and slower generation of viral receptor-binding domain (RBD)-specific IgA and IgG antibodies. Our study demonstrated that the positive retest patients failed to create a robust protective humoral immune response, which might result in SARS-CoV-2 persistence in the gastrointestinal tract and possibly in active viral shedding. Further exploration of the mechanism underlying the rebound in SARS-CoV-2 in this population will be crucial for preventing virus spread and developing effective vaccines.
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Affiliation(s)
- Fengyu Hu
- Guangzhou Eighth People's Hospital, Guangzhou, 510440, China
| | - Fengjuan Chen
- Guangzhou Eighth People's Hospital, Guangzhou, 510440, China
| | - Zhihua Ou
- Shenzhen Key Laboratory of Unknown Pathogen Identification, BGI-Shenzhen, Shenzhen, 518083, China
| | - Qinghong Fan
- Guangzhou Eighth People's Hospital, Guangzhou, 510440, China
| | - Xinghua Tan
- Guangzhou Eighth People's Hospital, Guangzhou, 510440, China
| | - Yaping Wang
- Guangzhou Eighth People's Hospital, Guangzhou, 510440, China
| | - Yuejun Pan
- Guangzhou Eighth People's Hospital, Guangzhou, 510440, China
| | - Bixia Ke
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Linghua Li
- Guangzhou Eighth People's Hospital, Guangzhou, 510440, China
| | - Yujuan Guan
- Guangzhou Eighth People's Hospital, Guangzhou, 510440, China
| | - Xiaoneng Mo
- Guangzhou Eighth People's Hospital, Guangzhou, 510440, China
| | - Jian Wang
- Guangzhou Eighth People's Hospital, Guangzhou, 510440, China
| | - Jinlin Wang
- Guangzhou Eighth People's Hospital, Guangzhou, 510440, China
| | - Chun Luo
- Guangzhou Eighth People's Hospital, Guangzhou, 510440, China
| | - Xueliang Wen
- Guangzhou Eighth People's Hospital, Guangzhou, 510440, China
| | - Min Li
- Shenzhen Key Laboratory of Unknown Pathogen Identification, BGI-Shenzhen, Shenzhen, 518083, China
- BGI Education Center, University of Chinese Academy of Sciences, Shenzhen, 518083, China
| | - Peidi Ren
- Shenzhen Key Laboratory of Unknown Pathogen Identification, BGI-Shenzhen, Shenzhen, 518083, China
| | - Changwen Ke
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Junhua Li
- Shenzhen Key Laboratory of Unknown Pathogen Identification, BGI-Shenzhen, Shenzhen, 518083, China
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou, 510006, China
| | - Chunliang Lei
- Guangzhou Eighth People's Hospital, Guangzhou, 510440, China.
| | - Xiaoping Tang
- Guangzhou Eighth People's Hospital, Guangzhou, 510440, China.
| | - Feng Li
- Guangzhou Eighth People's Hospital, Guangzhou, 510440, China.
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Fretland AJ, Devanaboyina US, Nangju NA, Leff MA, Xiao GH, Webb SJ, Doll MA, Hein DW. DNA adduct levels and absence of tumors in female rapid and slow acetylator congenic hamsters administered the rat mammary carcinogen 2-amino-1-methyl-6-phenylimidazo[4,5-b] pyridine. J Biochem Mol Toxicol 2001; 15:26-33. [PMID: 11170312 DOI: 10.1002/1099-0461(2001)15:1<26::aid-jbt3>3.0.co;2-s] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
N-acetyltransferases (EC 2.3.1.5) catalyze O-acetylation of heterocyclic amine carcinogens to DNA-reactive electrophiles that bind and mutate DNA. An acetylation polymorphism exists in humans and Syrian hamsters regulated by N-acetyltransferase-2 (NAT2) genotype. Some human epidemiological studies suggest a role for NAT2 phenotype in predisposition to cancers related to heterocyclic amine exposures, including breast cancer. 2-Amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) is a heterocyclic amine carcinogen prevalent in the human environment and induces a high incidence of mammary tumors in female rats. PhIP-induced carcinogenesis was examined in female rapid and slow acetylator Syrian hamsters congenic at the NAT2 locus. In both rapid and slow acetylators, PhIP-DNA adduct levels were highest in pancreas, lower in heart, small intestine, and colon, and lowest in mammary gland and liver. Metabolic activation of N-hydroxy-PhIP by O-acetyltransferase was highest in mammary epithelial cells, lower in liver and colon, and lowest in pancreas. Metabolic activation of N-hydroxy-PhIP by O-sulfotransferase was low in liver and colon and below the limit of detection in mammary epithelial cells and pancreas. Unlike the rat, PhIP did not induce breast or any other tumors in female rapid and slow acetylator congenic hamsters administered high-dose PhIP (10 doses of 75 mg/kg) and a high-fat diet.
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Affiliation(s)
- A J Fretland
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, KY 40292, USA
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