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Van Rompay KKA, Olstad KJ, Sammak RL, Dutra J, Watanabe JK, Usachenko JL, Immareddy R, Roh JW, Verma A, Shaan Lakshmanappa Y, Schmidt BA, Di Germanio C, Rizvi N, Liu H, Ma ZM, Stone M, Simmons G, Dumont LJ, Allen AM, Lockwood S, Pollard RE, Ramiro de Assis R, Yee JL, Nham PB, Ardeshir A, Deere JD, Jain A, Felgner PL, Coffey LL, Iyer SS, Hartigan-O’Connor DJ, Busch MP, Reader JR. Early post-infection treatment of SARS-CoV-2 infected macaques with human convalescent plasma with high neutralizing activity had no antiviral effects but moderately reduced lung inflammation. PLoS Pathog 2022; 18:e1009925. [PMID: 35443018 PMCID: PMC9060337 DOI: 10.1371/journal.ppat.1009925] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 05/02/2022] [Accepted: 03/24/2022] [Indexed: 11/24/2022] Open
Abstract
Early in the SARS-CoV-2 pandemic, there was a high level of optimism based on observational studies and small controlled trials that treating hospitalized patients with convalescent plasma from COVID-19 survivors (CCP) would be an important immunotherapy. However, as more data from controlled trials became available, the results became disappointing, with at best moderate evidence of efficacy when CCP with high titers of neutralizing antibodies was used early in infection. To better understand the potential therapeutic efficacy of CCP, and to further validate SARS-CoV-2 infection of macaques as a reliable animal model for testing such strategies, we inoculated 12 adult rhesus macaques with SARS-CoV-2 by intratracheal and intranasal routes. One day later, 8 animals were infused with pooled human CCP with a high titer of neutralizing antibodies (RVPN NT50 value of 3,003), while 4 control animals received normal human plasma. Animals were monitored for 7 days. Animals treated with CCP had detectable but low levels of antiviral antibodies after infusion. In comparison to the control animals, CCP-treated animals had similar levels of viral RNA in upper and lower respiratory tract secretions, similar detection of viral RNA in lung tissues by in situ hybridization, but lower amounts of infectious virus in the lungs. CCP-treated animals had a moderate, but statistically significant reduction in interstitial pneumonia, as measured by comprehensive lung histology. Thus overall, therapeutic benefits of CCP were marginal and inferior to results obtained earlier with monoclonal antibodies in this animal model. By highlighting strengths and weaknesses, data of this study can help to further optimize nonhuman primate models to provide proof-of-concept of intervention strategies, and guide the future use of convalescent plasma against SARS-CoV-2 and potentially other newly emerging respiratory viruses.
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Affiliation(s)
- Koen K. A. Van Rompay
- California National Primate Research Center, University of California, Davis, California, United States of America
- Department of Pathology, Microbiology and Immunology, University of California, Davis, California, United States of America
| | - Katherine J. Olstad
- California National Primate Research Center, University of California, Davis, California, United States of America
- Department of Pathology, Microbiology and Immunology, University of California, Davis, California, United States of America
| | - Rebecca L. Sammak
- California National Primate Research Center, University of California, Davis, California, United States of America
| | - Joseph Dutra
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, California, United States of America
| | - Jennifer K. Watanabe
- California National Primate Research Center, University of California, Davis, California, United States of America
| | - Jodie L. Usachenko
- California National Primate Research Center, University of California, Davis, California, United States of America
| | - Ramya Immareddy
- California National Primate Research Center, University of California, Davis, California, United States of America
| | - Jamin W. Roh
- Center for Immunology and Infectious Diseases, University of California, Davis, California, United States of America
- Graduate Group in Immunology, University of California, Davis, California, United States of America
| | - Anil Verma
- Center for Immunology and Infectious Diseases, University of California, Davis, California, United States of America
| | - Yashavanth Shaan Lakshmanappa
- Center for Immunology and Infectious Diseases, University of California, Davis, California, United States of America
| | - Brian A. Schmidt
- Center for Immunology and Infectious Diseases, University of California, Davis, California, United States of America
| | - Clara Di Germanio
- Vitalant Research Institute, San Francisco, California, United States of America
| | - Nabeela Rizvi
- Vitalant Research Institute, San Francisco, California, United States of America
| | - Hongwei Liu
- Department of Pathology, Microbiology and Immunology, University of California, Davis, California, United States of America
| | - Zhong-Min Ma
- California National Primate Research Center, University of California, Davis, California, United States of America
| | - Mars Stone
- Vitalant Research Institute, San Francisco, California, United States of America
| | - Graham Simmons
- Vitalant Research Institute, San Francisco, California, United States of America
| | - Larry J. Dumont
- Vitalant Research Institute, Denver, Colorado; University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - A. Mark Allen
- California National Primate Research Center, University of California, Davis, California, United States of America
| | - Sarah Lockwood
- California National Primate Research Center, University of California, Davis, California, United States of America
| | - Rachel E. Pollard
- School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - Rafael Ramiro de Assis
- Vaccine Research and Development Center, Department of Physiology and Biophysics, School of Medicine, University of California, Irvine, California, United States of America
| | - JoAnn L. Yee
- California National Primate Research Center, University of California, Davis, California, United States of America
| | - Peter B. Nham
- California National Primate Research Center, University of California, Davis, California, United States of America
| | - Amir Ardeshir
- California National Primate Research Center, University of California, Davis, California, United States of America
| | - Jesse D. Deere
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, California, United States of America
| | - Aarti Jain
- Vaccine Research and Development Center, Department of Physiology and Biophysics, School of Medicine, University of California, Irvine, California, United States of America
| | - Philip L. Felgner
- Vaccine Research and Development Center, Department of Physiology and Biophysics, School of Medicine, University of California, Irvine, California, United States of America
| | - Lark L. Coffey
- Department of Pathology, Microbiology and Immunology, University of California, Davis, California, United States of America
| | - Smita S. Iyer
- California National Primate Research Center, University of California, Davis, California, United States of America
- Department of Pathology, Microbiology and Immunology, University of California, Davis, California, United States of America
- Center for Immunology and Infectious Diseases, University of California, Davis, California, United States of America
| | - Dennis J. Hartigan-O’Connor
- California National Primate Research Center, University of California, Davis, California, United States of America
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, California, United States of America
| | - Michael P. Busch
- Vitalant Research Institute, San Francisco, California, United States of America
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - J. Rachel Reader
- California National Primate Research Center, University of California, Davis, California, United States of America
- Department of Pathology, Microbiology and Immunology, University of California, Davis, California, United States of America
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Ginsburg AS, Braima de Sa A, Nankabirwa V, Co R, Murungi J, Kim MO, Brim R, Namiiro F, Namugga O, Hartigan-O’Connor DJ, Roberts SB, Flaherman V. Randomized controlled trial of early, small-volume formula supplementation among newborns: A study protocol. PLoS One 2022; 17:e0263129. [PMID: 35120150 PMCID: PMC8815972 DOI: 10.1371/journal.pone.0263129] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 12/06/2021] [Indexed: 11/19/2022] Open
Abstract
Childhood undernutrition is a major health burden worldwide that increases childhood morbidity and mortality and causes impairment in infant growth and developmental delays that can persist into adulthood. The first weeks and months after birth are critical to the establishment of healthy growth and development during childhood. The World Health Organization recommends immediate and exclusive breastfeeding (EBF). In infants for whom EBF may not meet nutritional and caloric demands, early, daily, small-volume formula supplementation along with breastfeeding may more effectively avoid underweight wasting and stunting in early infancy than breastfeeding alone. The primary objective of this randomized controlled trial is to evaluate the efficacy of formula for 30 days among low birth weight (LBW) infants <6 hours of age and those not LBW with weights <2600 grams at 4 days of age. We will compare breastfeeding and formula (up to 59 milliliters administered daily) through 30 days of infant age vs recommendations for frequent EBF without supplementation, and test the hypothesis that formula increases weight-for-age z-score at 30 days of infant age. The trial will enroll and randomize 324 mother-infant pairs in Guinea-Bissau and Uganda, and follow them for 6 months for outcomes including growth, intestinal microbiota, breastfeeding duration, infant dietary intake, and adverse events. Conservatively estimating 20% loss to follow up, this sample size provides ≥80% power per weight stratum for intervention group comparison to detect a difference of 0.20 with respect to the outcome of WAZ at day 30. This trial was approved by the University of California, San Francisco Institutional Review Board (19-29405); the Guinea-Bissau National Committee on Ethics in Health (Comite Nacional de Etica na Saude, 075/CNES/INASA/2020); the Higher Degrees, Research and Ethics Committee of Makerere University (871); and the Uganda National Council of Science and Technology (HS1226ES). We plan to disseminate study results in peer-reviewed journals and international conferences. Trial registration number: NCT04704076.
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Affiliation(s)
| | | | - Victoria Nankabirwa
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
- Department of Global Public Health and Primary Care, Centre for Intervention Science in Maternal and Child Health (CISMAC), Centre for International Health, University of Bergen, Bergen, Norway
| | - Raimundo Co
- International Partnership for Human Development, Bissau, Guinea-Bissau
| | - Joanitta Murungi
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Mi-Ok Kim
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States of America
| | - Rachel Brim
- Department of Pediatrics, University of California, San Francisco, CA, United States of America
| | - Flavia Namiiro
- Mulago Specialized Women’s and Neonatal Hospital, Kampala, Uganda
| | - Olive Namugga
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
- Department of Global Public Health and Primary Care, Centre for Intervention Science in Maternal and Child Health (CISMAC), Centre for International Health, University of Bergen, Bergen, Norway
| | - Dennis J. Hartigan-O’Connor
- Department of Medical Microbiology and Immunology and the California National Primate Research Center, University of California, Davis, CA, United States of America
- Division of Experimental Medicine, University of California, San Francisco, CA, United States of America
| | - Susan B. Roberts
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States of America
| | - Valerie Flaherman
- Department of Pediatrics, University of California, San Francisco, CA, United States of America
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Deere JD, Carroll TD, Dutra J, Fritts L, Sammak RL, Yee JL, Olstad KJ, Reader JR, Kistler A, Kamm J, Di Germanio C, Shaan Lakshmanappa Y, Elizaldi SR, Roh JW, Simmons G, Watanabe J, Pollard RE, Usachenko J, Immareddy R, Schmidt BA, O’Connor SL, DeRisi J, Busch MP, Iyer SS, Van Rompay KKA, Hartigan-O’Connor DJ, Miller CJ. SARS-CoV-2 Infection of Rhesus Macaques Treated Early with Human COVID-19 Convalescent Plasma. Microbiol Spectr 2021; 9:e0139721. [PMID: 34817208 PMCID: PMC8612156 DOI: 10.1128/spectrum.01397-21] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 10/22/2021] [Indexed: 12/15/2022] Open
Abstract
Human clinical studies investigating use of convalescent plasma (CP) for treatment of coronavirus disease 2019 (COVID-19) have produced conflicting results. Outcomes in these studies may vary at least partly due to different timing of CP administration relative to symptom onset. The mechanisms of action of CP include neutralizing antibodies but may extend beyond virus neutralization to include normalization of blood clotting and dampening of inflammation. Unresolved questions include the minimum therapeutic titer in the CP units or CP recipient as well as the optimal timing of administration. Here, we show that treatment of macaques with CP within 24 h of infection does not reduce viral shedding in nasal or lung secretions compared to controls and does not detectably improve any clinical endpoint. We also demonstrate that CP administration does not impact viral sequence diversity in vivo, although the selection of a viral sequence variant in both macaques receiving normal human plasma was suggestive of immune pressure. Our results suggest that CP, administered to medium titers, has limited efficacy, even when given very early after infection. Our findings also contribute information important for the continued development of the nonhuman primate model of COVID-19. These results should inform interpretation of clinical studies of CP in addition to providing insights useful for developing other passive immunotherapies and vaccine strategies. IMPORTANCE Antiviral treatment options for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain very limited. One treatment that was explored beginning early in the pandemic (and that is likely to be tested early in future pandemics) is plasma collected from people who have recovered from coronavirus disease 2019 (COVID-19), known as convalescent plasma (CP). We tested if CP reduces viral shedding or disease in a nonhuman primate model. Our results demonstrate that administration of CP 1 day after SARS-CoV-2 infection had no significant impact on viral loads, clinical disease, or sequence diversity, although treatment with normal human plasma resulted in selection of a specific viral variant. Our results demonstrate that passive immunization with CP, even during early infection, provided no significant benefit in a nonhuman primate model of SARS-CoV-2 infection.
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Affiliation(s)
- Jesse D. Deere
- Department of Medical Microbiology and Immunology, School of Medicine, University of California Davis, Davis, California, USA
| | - Timothy D. Carroll
- Center for Immunology and Infectious Diseases, University of California Davis, Davis, California, USA
- California National Primate Research Center, University of California Davis, Davis, California, USA
| | - Joseph Dutra
- Department of Medical Microbiology and Immunology, School of Medicine, University of California Davis, Davis, California, USA
| | - Linda Fritts
- Center for Immunology and Infectious Diseases, University of California Davis, Davis, California, USA
| | - Rebecca Lee Sammak
- California National Primate Research Center, University of California Davis, Davis, California, USA
| | - JoAnn L. Yee
- California National Primate Research Center, University of California Davis, Davis, California, USA
| | - Katherine J. Olstad
- California National Primate Research Center, University of California Davis, Davis, California, USA
| | - J. Rachel Reader
- California National Primate Research Center, University of California Davis, Davis, California, USA
| | - Amy Kistler
- Chan Zuckerberg Biohub, San Francisco, California, USA
| | - Jack Kamm
- Chan Zuckerberg Biohub, San Francisco, California, USA
| | | | | | - Sonny R. Elizaldi
- Center for Immunology and Infectious Diseases, University of California Davis, Davis, California, USA
| | - Jamin W. Roh
- Center for Immunology and Infectious Diseases, University of California Davis, Davis, California, USA
| | - Graham Simmons
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jennifer Watanabe
- California National Primate Research Center, University of California Davis, Davis, California, USA
| | - Rachel E. Pollard
- California National Primate Research Center, University of California Davis, Davis, California, USA
| | - Jodie Usachenko
- California National Primate Research Center, University of California Davis, Davis, California, USA
| | - Ramya Immareddy
- California National Primate Research Center, University of California Davis, Davis, California, USA
| | - Brian A. Schmidt
- Center for Immunology and Infectious Diseases, University of California Davis, Davis, California, USA
| | - Shelby L. O’Connor
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Wisconsin National Primate Research Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Joseph DeRisi
- Chan Zuckerberg Biohub, San Francisco, California, USA
- Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, California, USA
| | - Michael P. Busch
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
| | - Smita S. Iyer
- Center for Immunology and Infectious Diseases, University of California Davis, Davis, California, USA
- California National Primate Research Center, University of California Davis, Davis, California, USA
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California Davis, Davis, California, USA
| | - Koen K. A. Van Rompay
- California National Primate Research Center, University of California Davis, Davis, California, USA
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California Davis, Davis, California, USA
| | - Dennis J. Hartigan-O’Connor
- Department of Medical Microbiology and Immunology, School of Medicine, University of California Davis, Davis, California, USA
- California National Primate Research Center, University of California Davis, Davis, California, USA
| | - Christopher J. Miller
- Center for Immunology and Infectious Diseases, University of California Davis, Davis, California, USA
- California National Primate Research Center, University of California Davis, Davis, California, USA
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California Davis, Davis, California, USA
- Department of Internal Medicine, Division of Infectious Diseases, School of Medicine, University of California Davis, Davis, California, USA
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4
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Van Rompay KK, Olstad KJ, Sammak RL, Dutra J, Watanabe JK, Usachenko JL, Immareddy R, Roh JW, Verma A, Shaan Lakshmanappa Y, Schmidt BA, Di Germanio C, Rizvi N, Stone M, Simmons G, Dumont LJ, Allen AM, Lockwood S, Pollard RE, de Assis RR, Yee JL, Nham PB, Ardeshir A, Deere JD, Patterson J, Jain A, Felgner PL, Iyer SS, Hartigan-O’Connor DJ, Busch MP, Reader JR. Early post-infection treatment of SARS-CoV-2 infected macaques with human convalescent plasma with high neutralizing activity reduces lung inflammation. bioRxiv 2021:2021.09.01.458520. [PMID: 34494025 PMCID: PMC8423222 DOI: 10.1101/2021.09.01.458520] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Early in the SARS-CoV-2 pandemic, there was a high level of optimism based on observational studies and small controlled trials that treating hospitalized patients with convalescent plasma from COVID-19 survivors (CCP) would be an important immunotherapy. However, as more data from controlled trials became available, the results became disappointing, with at best moderate evidence of efficacy when CCP with high titers of neutralizing antibodies was used early in infection. To better understand the potential therapeutic efficacy of CCP, and to further validate SARS-CoV-2 infection of macaques as a reliable animal model for testing such strategies, we inoculated 12 adult rhesus macaques with SARS-CoV-2 by intratracheal and intranasal routes. One day later, 8 animals were infused with pooled human CCP with a high titer of neutralizing antibodies (RVPN NT 50 value of 3,003), while 4 control animals received normal human plasma. Animals were monitored for 7 days. Animals treated with CCP had detectable levels of antiviral antibodies after infusion. In comparison to the control animals, they had similar levels of virus replication in the upper and lower respiratory tract, but had significantly reduced interstitial pneumonia, as measured by comprehensive lung histology. By highlighting strengths and weaknesses, data of this study can help to further optimize nonhuman primate models to provide proof-of-concept of intervention strategies, and guide the future use of convalescent plasma against SARS-CoV-2 and potentially other newly emerging respiratory viruses. AUTHOR SUMMARY The results of treating SARS-CoV-2 infected hospitalized patients with COVID-19 convalescent plasma (CCP), collected from survivors of natural infection, have been disappointing. The available data from various studies indicate at best moderate clinical benefits only when CCP with high titer of neutralizing antibodies was infused early in infection. The macaque model of SARS-CoV-2 infection can be useful to gain further insights in the value of CCP therapy. In this study, animals were infected with SARS-CoV-2 and the next day, were infused with pooled human convalescent plasma, selected to have a very high titer of neutralizing antibodies. While administration of CCP did not result in a detectable reduction in virus replication in the respiratory tract, it significantly reduced lung inflammation. These data, combined with the results of monoclonal antibody studies, emphasize the need to use products with high titers of neutralizing antibodies, and guide the future development of CCP-based therapies.
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Affiliation(s)
- Koen K.A. Van Rompay
- California National Primate Research Center, University of California, Davis, CA 95616
- Department of Pathology, Microbiology and Immunology, University of California, Davis, CA 95616
| | - Katherine J. Olstad
- California National Primate Research Center, University of California, Davis, CA 95616
- Department of Pathology, Microbiology and Immunology, University of California, Davis, CA 95616
| | - Rebecca L. Sammak
- California National Primate Research Center, University of California, Davis, CA 95616
| | - Joseph Dutra
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, CA 95616
| | - Jennifer K. Watanabe
- California National Primate Research Center, University of California, Davis, CA 95616
| | - Jodie L. Usachenko
- California National Primate Research Center, University of California, Davis, CA 95616
| | - Ramya Immareddy
- California National Primate Research Center, University of California, Davis, CA 95616
| | - Jamin W. Roh
- Center for Immunology and Infectious Diseases, University of California, Davis, CA 95616
- Graduate Group in Immunology, University of California, Davis, CA 95616
| | - Anil Verma
- Center for Immunology and Infectious Diseases, University of California, Davis, CA 95616
| | | | - Brian A. Schmidt
- Center for Immunology and Infectious Diseases, University of California, Davis, CA 95616
| | | | - Nabeela Rizvi
- Vitalant Research Institute, San Francisco, CA 94118
| | - Mars Stone
- Vitalant Research Institute, San Francisco, CA 94118
| | | | - Larry J. Dumont
- Vitalant Research Institute, Denver, CO 80230; University of Colorado School of Medicine, Aurora, CO 80045
| | - A. Mark Allen
- California National Primate Research Center, University of California, Davis, CA 95616
| | - Sarah Lockwood
- California National Primate Research Center, University of California, Davis, CA 95616
| | - Rachel E. Pollard
- School of Veterinary Medicine, University of California, Davis, CA 95616
| | - Rafael Ramiro de Assis
- Vaccine Research and Development Center, Department of Physiology and Biophysics, School of Medicine, University of California, Irvine, CA 92697
| | - JoAnn L. Yee
- California National Primate Research Center, University of California, Davis, CA 95616
| | - Peter B. Nham
- California National Primate Research Center, University of California, Davis, CA 95616
| | - Amir Ardeshir
- California National Primate Research Center, University of California, Davis, CA 95616
| | - Jesse D. Deere
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, CA 95616
| | - Jean Patterson
- Translational Research Section, Virology Branch, DMID/NIAID/NIH, MD 20852
| | - Aarti Jain
- Vaccine Research and Development Center, Department of Physiology and Biophysics, School of Medicine, University of California, Irvine, CA 92697
| | - Philip L. Felgner
- Vaccine Research and Development Center, Department of Physiology and Biophysics, School of Medicine, University of California, Irvine, CA 92697
| | - Smita S. Iyer
- California National Primate Research Center, University of California, Davis, CA 95616
- Department of Pathology, Microbiology and Immunology, University of California, Davis, CA 95616
- Center for Immunology and Infectious Diseases, University of California, Davis, CA 95616
| | - Dennis J. Hartigan-O’Connor
- California National Primate Research Center, University of California, Davis, CA 95616
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, CA 95616
| | - Michael P. Busch
- Vitalant Research Institute, San Francisco, CA 94118
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, 94118
| | - J. Rachel Reader
- California National Primate Research Center, University of California, Davis, CA 95616
- Department of Pathology, Microbiology and Immunology, University of California, Davis, CA 95616
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5
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Ravindran R, McReynolds C, Yang J, Hammock BD, Ikram A, Ali A, Bashir A, Zohra T, Chang WLW, Hartigan-O’Connor DJ, Rashidi HH, Khan IH. Immune response dynamics in COVID-19 patients to SARS-CoV-2 and other human coronaviruses. PLoS One 2021; 16:e0254367. [PMID: 34242356 PMCID: PMC8270414 DOI: 10.1371/journal.pone.0254367] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 06/24/2021] [Indexed: 11/18/2022] Open
Abstract
COVID-19 serological test must have high sensitivity as well as specificity to rule out cross-reactivity with common coronaviruses (HCoVs). We have developed a quantitative multiplex test, measuring antibodies against spike (S) proteins of SARS-CoV-2, SARS-CoV, MERS-CoV, and common human coronavirus strains (229E, NL63, OC43, HKU1), and nucleocapsid (N) protein of SARS-CoV viruses. Receptor binding domain of S protein of SARS-CoV-2 (S-RBD), and N protein, demonstrated sensitivity (94% and 92.5%, respectively) in COVID-19 patients (n = 53), with 98% specificity in non-COVID-19 respiratory-disease (n = 98), and healthy-controls (n = 129). Anti S-RBD and N antibodies appeared five to ten days post-onset of symptoms, peaking at approximately four weeks. The appearance of IgG and IgM coincided while IgG subtypes, IgG1 and IgG3 appeared soon after the total IgG; IgG2 and IgG4 remained undetectable. Several inflammatory cytokines/chemokines were found to be elevated in many COVID-19 patients (e.g., Eotaxin, Gro-α, CXCL-10 (IP-10), RANTES (CCL5), IL-2Rα, MCP-1, and SCGF-b); CXCL-10 was elevated in all. In contrast to antibody titers, levels of CXCL-10 decreased with the improvement in patient health suggesting it as a candidate for disease resolution. Importantly, anti-N antibodies appear before S-RBD and differentiate between vaccinated and infected people-current vaccines (and several in the pipeline) are S protein-based.
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Affiliation(s)
- Resmi Ravindran
- Department of Pathology and Laboratory Medicine, University of California, Davis, CA, United States of America
| | - Cindy McReynolds
- Department of Entomology and Nematology, University of California, Davis, CA, United States of America
| | - Jun Yang
- Department of Entomology and Nematology, University of California, Davis, CA, United States of America
| | - Bruce D. Hammock
- Department of Entomology and Nematology, University of California, Davis, CA, United States of America
| | - Aamer Ikram
- National Institutes of Health, Rawalpindi, Pakistan
| | - Amna Ali
- National Institutes of Health, Rawalpindi, Pakistan
| | - Adnan Bashir
- National Institutes of Health, Rawalpindi, Pakistan
| | | | - W. L. William Chang
- California National Primate Research Center, University of California, Davis, CA, United States of America
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, CA, United States of America
| | | | - Hooman H. Rashidi
- Department of Pathology and Laboratory Medicine, University of California, Davis, CA, United States of America
| | - Imran H. Khan
- Department of Pathology and Laboratory Medicine, University of California, Davis, CA, United States of America
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Van Rompay KKA, Olstad KJ, Sammak RL, Dutra J, Watanabe JK, Usachenko JL, Immareddy R, Verma A, Shaan Lakshmanappa Y, Schmidt BA, Roh JW, Elizaldi SR, Allen AM, Muecksch F, Lorenzi JCC, Lockwood S, Pollard RE, Yee JL, Nham PB, Ardeshir A, Deere JD, Patterson J, Dang Q, Hatziioannou T, Bieniasz PD, Iyer SS, Hartigan-O’Connor DJ, Nussenzweig MC, Reader JR. Early treatment with a combination of two potent neutralizing antibodies improves clinical outcomes and reduces virus replication and lung inflammation in SARS-CoV-2 infected macaques. PLoS Pathog 2021; 17:e1009688. [PMID: 34228761 PMCID: PMC8284825 DOI: 10.1371/journal.ppat.1009688] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 07/16/2021] [Accepted: 06/03/2021] [Indexed: 01/08/2023] Open
Abstract
There is an urgent need for effective therapeutic interventions against SARS-CoV-2, including new variants that continue to arise. Neutralizing monoclonal antibodies have shown promise in clinical studies. We investigated the therapeutic efficacy of a combination of two potent monoclonal antibodies, C135-LS and C144-LS that carry half-life extension mutations, in the rhesus macaque model of COVID-19. Twelve young adult macaques (three groups of four animals) were inoculated intranasally and intra-tracheally with a high dose of SARS-CoV-2 and 24 hours later, treated intravenously with a high (40 mg/kg) or low (12 mg/kg) dose of the C135-LS and C144-LS antibody combination, or a control monoclonal antibody. Animals were monitored for 7 days. Compared to the control animals, animals treated with either dose of the anti-SARS-CoV-2 antibodies showed similarly improved clinical scores, lower levels of virus replication in upper and lower respiratory tract, and significantly reduced interstitial pneumonia, as measured by comprehensive lung histology. In conclusion, this study provides proof-of-concept in support of further clinical development of these monoclonal antibodies against COVID-19 during early infection.
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MESH Headings
- Animals
- Antibodies, Monoclonal/blood
- Antibodies, Monoclonal/immunology
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Neutralizing/blood
- Antibodies, Neutralizing/immunology
- Antibodies, Neutralizing/therapeutic use
- Antibodies, Viral/blood
- Antibodies, Viral/immunology
- Antibodies, Viral/therapeutic use
- COVID-19/pathology
- COVID-19/therapy
- COVID-19/virology
- Disease Models, Animal
- Female
- Lung/diagnostic imaging
- Lung/pathology
- Macaca mulatta
- Male
- Multivariate Analysis
- Radiography
- Respiratory System/virology
- SARS-CoV-2/immunology
- SARS-CoV-2/physiology
- Time Factors
- Treatment Outcome
- Virus Replication/immunology
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Affiliation(s)
- Koen K. A. Van Rompay
- California National Primate Research Center, University of California, Davis, United States of America
- Department of Pathology, Microbiology and Immunology, University of California, Davis, California, United States of America
| | - Katherine J. Olstad
- California National Primate Research Center, University of California, Davis, United States of America
- Department of Pathology, Microbiology and Immunology, University of California, Davis, California, United States of America
| | - Rebecca L. Sammak
- California National Primate Research Center, University of California, Davis, United States of America
| | - Joseph Dutra
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, California, United States of America
| | - Jennifer K. Watanabe
- California National Primate Research Center, University of California, Davis, United States of America
| | - Jodie L. Usachenko
- California National Primate Research Center, University of California, Davis, United States of America
| | - Ramya Immareddy
- California National Primate Research Center, University of California, Davis, United States of America
| | - Anil Verma
- Center for Immunology and Infectious Diseases, University of California, Davis, California, United States of America
| | - Yashavanth Shaan Lakshmanappa
- Center for Immunology and Infectious Diseases, University of California, Davis, California, United States of America
| | - Brian A. Schmidt
- Center for Immunology and Infectious Diseases, University of California, Davis, California, United States of America
| | - Jamin W. Roh
- Center for Immunology and Infectious Diseases, University of California, Davis, California, United States of America
| | - Sonny R. Elizaldi
- Center for Immunology and Infectious Diseases, University of California, Davis, California, United States of America
| | - A. Mark Allen
- California National Primate Research Center, University of California, Davis, United States of America
| | - Frauke Muecksch
- Laboratory of Retrovirology, The Rockefeller University, New York, New York, United States of America
| | - Julio C. C. Lorenzi
- Laboratory of Molecular Immunology, The Rockefeller University, New York, New York, United States of America
| | - Sarah Lockwood
- California National Primate Research Center, University of California, Davis, United States of America
| | - Rachel E. Pollard
- School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - JoAnn L. Yee
- California National Primate Research Center, University of California, Davis, United States of America
| | - Peter B. Nham
- California National Primate Research Center, University of California, Davis, United States of America
| | - Amir Ardeshir
- California National Primate Research Center, University of California, Davis, United States of America
| | - Jesse D. Deere
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, California, United States of America
| | - Jean Patterson
- Translational Research Section, Virology Branch, DMID/NIAID/NIH, Rockville, Maryland, United States of America
| | - Que Dang
- Preclinical Research and Development Branch, Vaccine Research Program, DAIDS/NIAID/NIH, Rockville, Maryland, United States of America
| | - Theodora Hatziioannou
- Laboratory of Retrovirology, The Rockefeller University, New York, New York, United States of America
| | - Paul D. Bieniasz
- Laboratory of Retrovirology, The Rockefeller University, New York, New York, United States of America
- Howard Hughes Medical Institute, The Rockefeller University, New York, New York, United States of America
| | - Smita S. Iyer
- California National Primate Research Center, University of California, Davis, United States of America
- Department of Pathology, Microbiology and Immunology, University of California, Davis, California, United States of America
- Center for Immunology and Infectious Diseases, University of California, Davis, California, United States of America
| | - Dennis J. Hartigan-O’Connor
- California National Primate Research Center, University of California, Davis, United States of America
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, California, United States of America
| | - Michel C. Nussenzweig
- Laboratory of Molecular Immunology, The Rockefeller University, New York, New York, United States of America
- Howard Hughes Medical Institute, The Rockefeller University, New York, New York, United States of America
| | - J. Rachel Reader
- California National Primate Research Center, University of California, Davis, United States of America
- Department of Pathology, Microbiology and Immunology, University of California, Davis, California, United States of America
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Tarantal AF, Hartigan-O’Connor DJ, Penna E, Kreutz A, Martinez ML, Noctor SC. Fetal Rhesus Monkey First Trimester Zika Virus Infection Impacts Cortical Development in the Second and Third Trimesters. Cereb Cortex 2021; 31:2309-2321. [PMID: 33341889 PMCID: PMC8023859 DOI: 10.1093/cercor/bhaa336] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 10/18/2020] [Accepted: 10/18/2020] [Indexed: 12/28/2022] Open
Abstract
Zika virus is a teratogen similar to other neurotropic viruses, notably cytomegalovirus and rubella. The goal of these studies was to address the direct impact of Zika virus on fetal development by inoculating early gestation fetal rhesus monkeys using an ultrasound-guided approach (intraperitoneal vs. intraventricular). Growth and development were monitored across gestation, maternal samples collected, and fetal tissues obtained in the second trimester or near term. Although normal growth and anatomical development were observed, significant morphologic changes were noted in the cerebral cortex at 3-weeks post-Zika virus inoculation including massive alterations in the distribution, density, number, and morphology of microglial cells in proliferative regions of the fetal cerebral cortex; an altered distribution of Tbr2+ neural precursor cells; increased diameter and volume of blood vessels in the cortical proliferative zones; and a thinner cortical plate. At 3-months postinoculation, alterations in morphology, distribution, and density of microglial cells were also observed with an increase in blood vessel volume; and a thinner cortical plate. Only transient maternal viremia was observed but sustained maternal immune activation was detected. Overall, these studies suggest persistent changes in cortical structure result from early gestation Zika virus exposure with durable effects on microglial cells.
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Affiliation(s)
- Alice F Tarantal
- Department of Pediatrics, School of Medicine, University of California, Davis, Davis, CA 95616, USA
- Department of Cell Biology and Human Anatomy, School of Medicine, University of California, Davis, Davis, CA 95616, USA
- California National Primate Research Center, University of California, Davis, Davis, CA 95616, USA
| | - Dennis J Hartigan-O’Connor
- California National Primate Research Center, University of California, Davis, Davis, CA 95616, USA
- Department of Medical Microbiology and Immunology, School of Medicine, University of California, Davis, Davis, CA 95616, USA
| | - Elisa Penna
- Department of Psychiatry and Behavioral Science, School of Medicine, University of California, Davis, Davis, CA 95817, USA
| | - Anna Kreutz
- Department of Psychiatry and Behavioral Science, School of Medicine, University of California, Davis, Davis, CA 95817, USA
| | - Michele L Martinez
- California National Primate Research Center, University of California, Davis, Davis, CA 95616, USA
| | - Stephen C Noctor
- Department of Psychiatry and Behavioral Science, School of Medicine, University of California, Davis, Davis, CA 95817, USA
- MIND Institute, School of Medicine, University of California, Davis, Davis, CA 95817, USA
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Chin N, Méndez-Lagares G, Taft DH, Laleau V, Kieu H, Narayan NR, Roberts SB, Mills DA, Hartigan-O’Connor DJ, Flaherman VJ. Transient Effect of Infant Formula Supplementation on the Intestinal Microbiota. Nutrients 2021; 13:nu13030807. [PMID: 33804415 PMCID: PMC7998963 DOI: 10.3390/nu13030807] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 02/07/2023] Open
Abstract
Breastfeeding is the gold standard for feeding infants because of its long-term benefits to health and development, but most infants in the United States are not exclusively breastfed in the first six months. We enrolled 24 infants who were either exclusively breastfed or supplemented with formula by the age of one month. We collected diet information, stool samples for evaluation of microbiotas by 16S rRNA sequencing, and blood samples for assessment of immune development by flow cytometry from birth to 6 months of age. We further typed the Bifidobacterium strains in stool samples whose 16S rRNA sequencing showed the presence of Bifidobacteriaceae. Supplementation with formula during breastfeeding transiently changed the composition of the gut microbiome, but the impact dissipated by six months of age. For example, Bifidobacterium longum, a bacterial species highly correlated with human milk consumption, was found to be significantly different only at 1 month of age but not at later time points. No immunologic differences were found to be associated with supplementation, including the development of T-cell subsets, B cells, or monocytes. These data suggest that early formula supplementation, given in addition to breast milk, has minimal lasting impact on the gut microbiome or immunity.
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Affiliation(s)
- Ning Chin
- California National Primate Research Center, University of California, Davis, CA 95616, USA; (N.C.); (G.M.-L.); (H.K.); (N.R.N.)
- Department of Medical Microbiology and Immunology, University of California, Davis, CA 95616, USA
| | - Gema Méndez-Lagares
- California National Primate Research Center, University of California, Davis, CA 95616, USA; (N.C.); (G.M.-L.); (H.K.); (N.R.N.)
- Department of Medical Microbiology and Immunology, University of California, Davis, CA 95616, USA
| | - Diana H. Taft
- Department of Food Science and Technology, University of California, Davis, CA 95616, USA; (D.H.T.); (D.A.M.)
- Foods for Health Institute, University of California, Davis, CA 95616, USA
| | - Victoria Laleau
- Department of Pediatrics, University of California, San Francisco, CA 94143, USA; (V.L.); (V.J.F.)
| | - Hung Kieu
- California National Primate Research Center, University of California, Davis, CA 95616, USA; (N.C.); (G.M.-L.); (H.K.); (N.R.N.)
- Department of Medical Microbiology and Immunology, University of California, Davis, CA 95616, USA
| | - Nicole R. Narayan
- California National Primate Research Center, University of California, Davis, CA 95616, USA; (N.C.); (G.M.-L.); (H.K.); (N.R.N.)
| | - Susan B. Roberts
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA;
| | - David A. Mills
- Department of Food Science and Technology, University of California, Davis, CA 95616, USA; (D.H.T.); (D.A.M.)
- Foods for Health Institute, University of California, Davis, CA 95616, USA
- Department of Viticulture and Enology, University of California, Davis, CA 95616, USA
| | - Dennis J. Hartigan-O’Connor
- California National Primate Research Center, University of California, Davis, CA 95616, USA; (N.C.); (G.M.-L.); (H.K.); (N.R.N.)
- Department of Medical Microbiology and Immunology, University of California, Davis, CA 95616, USA
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, CA 94143, USA
- Correspondence:
| | - Valerie J. Flaherman
- Department of Pediatrics, University of California, San Francisco, CA 94143, USA; (V.L.); (V.J.F.)
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94143, USA
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