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Bixby B, Vrba L, Lenka J, Oshiro MM, Watts GS, Hughes T, Erickson H, Chopra M, Knepler JL, Knox KS, Jarnagin L, Alalawi R, Kala M, Bernert R, Routh J, Roe DJ, Garland LL, Futscher BW, Nelson MA. Cell-free DNA methylation analysis as a marker of malignancy in pleural fluid. Sci Rep 2024; 14:2939. [PMID: 38316884 PMCID: PMC10844328 DOI: 10.1038/s41598-024-53132-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/23/2023] [Accepted: 01/29/2024] [Indexed: 02/07/2024] Open
Abstract
Diagnosis of malignant pleural effusion (MPE) is made by cytological examination of pleural fluid or histological examination of pleural tissue from biopsy. Unfortunately, detection of malignancy using cytology has an overall sensitivity of 50%, and is dependent upon tumor load, volume of fluid assessed, and cytopathologist experience. The diagnostic yield of pleural fluid cytology is also compromised by low abundance of tumor cells or when morphology is obscured by inflammation or reactive mesothelial cells. A reliable molecular marker that may complement fluid cytology for the diagnosis of malignant pleural effusion is needed. The purpose of this study was to establish a molecular diagnostic approach based on pleural effusion cell-free DNA methylation analysis for the differential diagnosis of malignant pleural effusion and benign pleural effusion. This was a blind, prospective case-control biomarker study. We recruited 104 patients with pleural effusion for the study. We collected pleural fluid from patients with: MPE (n = 48), indeterminate pleural effusion in subjects with known malignancy or IPE (n = 28), and benign PE (n = 28), and performed the Sentinel-MPE liquid biopsy assay. The methylation level of Sentinel-MPE was markedly higher in the MPE samples compared to BPE control samples (p < 0.0001) and the same tendency was observed relative to IPE (p = 0.004). We also noted that the methylation signal was significantly higher in IPE relative to BPE (p < 0.001). We also assessed the diagnostic efficiency of the Sentinel-MPE test by performing receiver operating characteristic analysis (ROC). For the ROC analysis we combined the malignant and indeterminate pleural effusion groups (n = 76) and compared against the benign group (n = 28). The detection sensitivity and specificity of the Sentinel-MPE test was high (AUC = 0.912). The Sentinel-MPE appears to have better performance characteristics than cytology analysis. However, combining Sentinel-MPE with cytology analysis could be an even more effective approach for the diagnosis of MPE. The Sentinel-MPE test can discriminate between BPE and MPE. The Sentinel-MPE liquid biopsy test can detect aberrant DNA in several different tumor types. The Sentinel-MPE test can be a complementary tool to cytology in the diagnosis of MPE.
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Affiliation(s)
- Billie Bixby
- Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, USA
| | | | - Jyoti Lenka
- Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, USA
| | - Marc M Oshiro
- Boyer Liver Institute, Department of Medicine, University of Arizona, Tucson, USA
| | - George S Watts
- Department of Pharmacology and Toxicology, University of Arizona, Tucson, USA
| | - Trina Hughes
- Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, USA
| | - Heidi Erickson
- Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, USA
| | - Madhav Chopra
- Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, USA
| | - James L Knepler
- Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, USA
| | - Kenneth S Knox
- Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of Arizona, Phoenix, USA
| | - Lisa Jarnagin
- Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of Arizona, Phoenix, USA
| | - Raed Alalawi
- Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of Arizona, Phoenix, USA
| | - Mrinalini Kala
- Department of Internal Medicine, University of Arizona, Phoenix, USA
| | | | | | - Denise J Roe
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| | - Linda L Garland
- Hematology Oncology, Department of Medicine, University of Arizona, Tucson, USA
| | - Bernard W Futscher
- Department of Pharmacology and Toxicology, University of Arizona, Tucson, USA
| | - Mark A Nelson
- Department of Pathology, University of Arizona, Tucson, AZ, 85724, USA.
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Bixby B, Vrba L, Lenka J, Oshiro M, Watts GS, Hughes T, Erickson H, Chopra M, Knepler JL, Knox KS, Jarnagin L, Alalawi R, Kala M, Bernert R, Routh J, Roe DJ, Garland LL, Futscher BW, Nelson MA. Cell-Free DNA Methylation Analysis as a Marker of Malignancy in Pleural Fluid. Res Sq 2023:rs.3.rs-3390107. [PMID: 37886511 PMCID: PMC10602127 DOI: 10.21203/rs.3.rs-3390107/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Background Diagnosis of malignant pleural effusion (MPE) is made by cytological examination of pleural fluid or histological examination of pleural tissue from biopsy. Unfortunately, detection of malignancy using cytology has an overall sensitivity of 50%, and is dependent upon tumor load, volume of fluid assessed, and cytopathologist experience. The diagnostic yield of pleural fluid cytology is also compromised by low abundance of tumor cells or when morphology is obscured by inflammation or reactive mesothelial cells. A reliable molecular marker that may complement fluid cytology malignant pleural effusion diagnosis is needed. The purpose of this study was to establish a molecular diagnostic approach based on pleural effusion cell-free DNA methylation analysis for the differential diagnosis of malignant pleural effusion and benign pleural effusion. Results This was a blind, prospective case-control biomarker study. We recruited 104 patients with pleural effusion for the study. We collected pleural fluid from patients with: MPE (n = 48), PPE (n = 28), and benign PE (n = 28), and performed the Sentinel-MPE liquid biopsy assay. The methylation level of Sentinel-MPE was markedly higher in the MPE samples compared to BPE control samples (p < 0.0001) and the same tendency was observed relative to PPE (p = 0.004). We also noted that the methylation signal was significantly higher in PPE relative to BPE (p < 0.001). We also assessed the diagnostic efficiency of the Sentinel-MPE test by performing receiver operating characteristic analysis (ROC). For the ROC analysis we combined the malignant and paramalignant groups (n = 76) and compared against the benign group (n = 28). The detection sensitivity and specificity of the Sentinel-MPE test was high (AUC = 0.912). The Sentinel-MPE appears to have better performance characteristics than cytology analysis. However, combining Sentinel-MPE with cytology analysis could be an even more effective approach for the diagnosis of MPE. Conclusions The Sentinel-MPE test can discriminate between BPE and MPE. The Sentinel-MPE liquid biopsy test can detect aberrant DNA in several different tumor types. The Sentinel-MPE test can be a complementary tool to cytology in the diagnosis of MPE.
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Harris DT, Badowski M, Jernigan B, Sprissler R, Edwards T, Cohen R, Paul S, Merchant N, Weinkauf CC, Bime C, Erickson HE, Bixby B, Parthasarathy S, Chaudhary S, Natt B, Cristan E, El Aini T, Rischard F, Campion J, Chopra M, Insel M, Sam A, Knepler JL, Knox K, Mosier J, Spier C, Dake MD. SARS-CoV-2 Rapid Antigen Testing of Symptomatic and Asymptomatic Individuals on the University of Arizona Campus. Biomedicines 2021; 9:539. [PMID: 34066047 PMCID: PMC8150898 DOI: 10.3390/biomedicines9050539] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/29/2021] [Accepted: 05/05/2021] [Indexed: 01/29/2023] Open
Abstract
SARS-CoV-2, the cause of COVID19, has caused a pandemic that has infected more than 80 M and killed more than 1.6 M persons worldwide. In the US as of December 2020, it has infected more than 32 M people while causing more than 570,000 deaths. As the pandemic persists, there has been a public demand to reopen schools and university campuses. To consider these demands, it is necessary to rapidly identify those individuals infected with the virus and isolate them so that disease transmission can be stopped. In the present study, we examined the sensitivity of the Quidel Rapid Antigen test for use in screening both symptomatic and asymptomatic individuals at the University of Arizona from June to August 2020. A total of 885 symptomatic and 1551 asymptomatic subjects were assessed by antigen testing and real-time PCR testing. The sensitivity of the test for both symptomatic and asymptomatic persons was between 82 and 90%, with some caveats.
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Affiliation(s)
- David T. Harris
- Biorepository, College of Medicine-Tucson, University of Arizona Health Sciences, University of Arizona, Tucson, AZ 85724, USA; (M.B.); (B.J.)
- Department of Immunobiology & Medicine, College of Medicine-Tucson, University of Arizona Health Sciences, University of Arizona, Tucson, AZ 85724, USA
| | - Michael Badowski
- Biorepository, College of Medicine-Tucson, University of Arizona Health Sciences, University of Arizona, Tucson, AZ 85724, USA; (M.B.); (B.J.)
| | - Brandon Jernigan
- Biorepository, College of Medicine-Tucson, University of Arizona Health Sciences, University of Arizona, Tucson, AZ 85724, USA; (M.B.); (B.J.)
| | - Ryan Sprissler
- College of Medicine-Tucson, University of Arizona Genetics Core, University of Arizona, Tucson, AZ 85724, USA; (R.S.); (T.E.)
| | - Taylor Edwards
- College of Medicine-Tucson, University of Arizona Genetics Core, University of Arizona, Tucson, AZ 85724, USA; (R.S.); (T.E.)
| | - Randall Cohen
- Department of Athletic, University of Arizona, Tucson, AZ 85724, USA; (R.C.); (S.P.)
| | - Stephen Paul
- Department of Athletic, University of Arizona, Tucson, AZ 85724, USA; (R.C.); (S.P.)
| | - Nirav Merchant
- Data Science Institute, University of Arizona, Tucson, AZ 85724, USA;
| | - Craig C. Weinkauf
- Department of Surgery, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA;
| | - Christian Bime
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Heidi E. Erickson
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Billie Bixby
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Sairam Parthasarathy
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Sachin Chaudhary
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Bhupinder Natt
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Elaine Cristan
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Tammer El Aini
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Franz Rischard
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Janet Campion
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Madhav Chopra
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Michael Insel
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Afshin Sam
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - James L. Knepler
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Kenneth Knox
- Department of Medicine, University of Arizona-Phoenix, Phoenix, AZ 85724, USA;
| | - Jarrod Mosier
- Department of Emergency Medicine, College of Medicine-Tucson, Tucson, AZ 85724, USA;
| | - Catherine Spier
- Department of Pathology, University of Arizona College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA;
| | - Michael D. Dake
- Office of the Senior Vice-President for Health Sciences, University of Arizona, Tucson, AZ 85724, USA;
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Ripperger TJ, Uhrlaub JL, Watanabe M, Wong R, Castaneda Y, Pizzato HA, Thompson MR, Bradshaw C, Weinkauf CC, Bime C, Erickson HL, Knox K, Bixby B, Parthasarathy S, Chaudhary S, Natt B, Cristan E, El Aini T, Rischard F, Campion J, Chopra M, Insel M, Sam A, Knepler JL, Capaldi AP, Spier CM, Dake MD, Edwards T, Kaplan ME, Scott SJ, Hypes C, Mosier J, Harris DT, LaFleur BJ, Sprissler R, Nikolich-Žugich J, Bhattacharya D. Orthogonal SARS-CoV-2 Serological Assays Enable Surveillance of Low-Prevalence Communities and Reveal Durable Humoral Immunity. Immunity 2020; 53:925-933.e4. [PMID: 33129373 PMCID: PMC7554472 DOI: 10.1016/j.immuni.2020.10.004] [Citation(s) in RCA: 239] [Impact Index Per Article: 59.8] [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: 07/31/2020] [Revised: 10/01/2020] [Accepted: 10/05/2020] [Indexed: 12/21/2022]
Abstract
We conducted a serological study to define correlates of immunity against SARS-CoV-2. Compared to those with mild coronavirus disease 2019 (COVID-19) cases, individuals with severe disease exhibited elevated virus-neutralizing titers and antibodies against the nucleocapsid (N) and the receptor binding domain (RBD) of the spike protein. Age and sex played lesser roles. All cases, including asymptomatic individuals, seroconverted by 2 weeks after PCR confirmation. Spike RBD and S2 and neutralizing antibodies remained detectable through 5-7 months after onset, whereas α-N titers diminished. Testing 5,882 members of the local community revealed only 1 sample with seroreactivity to both RBD and S2 that lacked neutralizing antibodies. This fidelity could not be achieved with either RBD or S2 alone. Thus, inclusion of multiple independent assays improved the accuracy of antibody tests in low-seroprevalence communities and revealed differences in antibody kinetics depending on the antigen. We conclude that neutralizing antibodies are stably produced for at least 5-7 months after SARS-CoV-2 infection.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Neutralizing/blood
- Antibodies, Viral/blood
- Arizona/epidemiology
- Betacoronavirus/immunology
- Betacoronavirus/isolation & purification
- COVID-19
- COVID-19 Testing
- Clinical Laboratory Techniques/methods
- Coronavirus Infections/blood
- Coronavirus Infections/diagnosis
- Coronavirus Infections/epidemiology
- Coronavirus Infections/immunology
- Coronavirus Nucleocapsid Proteins
- Female
- Humans
- Immunity, Humoral
- Male
- Middle Aged
- Nucleocapsid Proteins/immunology
- Pandemics
- Phosphoproteins
- Pneumonia, Viral/blood
- Pneumonia, Viral/diagnosis
- Pneumonia, Viral/epidemiology
- Pneumonia, Viral/immunology
- Prevalence
- Protein Interaction Domains and Motifs
- SARS-CoV-2
- Seroepidemiologic Studies
- Spike Glycoprotein, Coronavirus/chemistry
- Spike Glycoprotein, Coronavirus/immunology
- Young Adult
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Affiliation(s)
- Tyler J Ripperger
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Jennifer L Uhrlaub
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Center on Aging, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Makiko Watanabe
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Center on Aging, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Rachel Wong
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Division of Biological and Biomedical Sciences, Washington University, St. Louis, MO, USA
| | - Yvonne Castaneda
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Center on Aging, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Hannah A Pizzato
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Division of Biological and Biomedical Sciences, Washington University, St. Louis, MO, USA
| | - Mallory R Thompson
- Department of Surgery, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Department of Cellular and Molecular Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Christine Bradshaw
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Center on Aging, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Craig C Weinkauf
- Department of Surgery, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Christian Bime
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Heidi L Erickson
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Kenneth Knox
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Department of Medicine, University of Arizona, Phoenix, Phoenix, AZ, USA
| | - Billie Bixby
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Sairam Parthasarathy
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Sachin Chaudhary
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Bhupinder Natt
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Elaine Cristan
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Tammer El Aini
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Franz Rischard
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Janet Campion
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Madhav Chopra
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Michael Insel
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Afshin Sam
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - James L Knepler
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Andrew P Capaldi
- Department of Molecular and Cellular Biology, University of Arizona, Tucson, Tucson, AZ, USA; Functional Genomics Core, University of Arizona, Tucson, AZ, USA
| | - Catherine M Spier
- Department of Pathology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Michael D Dake
- Office of the Senior Vice-President for Health Sciences, University of Arizona, Tucson, AZ, USA
| | - Taylor Edwards
- University of Arizona Genomics Core and the Arizona Research Labs, University of Arizona Genetics Core, University of Arizona, Tucson, AZ, USA
| | - Matthew E Kaplan
- Functional Genomics Core, University of Arizona, Tucson, AZ, USA
| | - Serena Jain Scott
- Division of Geriatrics, General Medicine and Palliative Care, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Cameron Hypes
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Jarrod Mosier
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - David T Harris
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Health Sciences Biobank, University of Arizona, Tucson, AZ, USA
| | | | - Ryan Sprissler
- University of Arizona Genomics Core and the Arizona Research Labs, University of Arizona Genetics Core, University of Arizona, Tucson, AZ, USA; BIO5 Institute, University of Arizona, Tucson, AZ, USA
| | - Janko Nikolich-Žugich
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Center on Aging, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; BIO5 Institute, University of Arizona, Tucson, AZ, USA.
| | - Deepta Bhattacharya
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; BIO5 Institute, University of Arizona, Tucson, AZ, USA.
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5
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Ripperger TJ, Uhrlaub JL, Watanabe M, Wong R, Castaneda Y, Pizzato HA, Thompson MR, Bradshaw C, Weinkauf CC, Bime C, Erickson HL, Knox K, Bixby B, Parthasarathy S, Chaudhary S, Natt B, Cristan E, Aini TE, Rischard F, Campion J, Chopra M, Insel M, Sam A, Knepler JL, Capaldi AP, Spier CM, Dake MD, Edwards T, Kaplan ME, Scott SJ, Hypes C, Mosier J, Harris DT, LaFleur BJ, Sprissler R, Nikolich-Žugich J, Bhattacharya D. Detection, prevalence, and duration of humoral responses to SARS-CoV-2 under conditions of limited population exposure. medRxiv 2020:2020.08.14.20174490. [PMID: 32817969 PMCID: PMC7430613 DOI: 10.1101/2020.08.14.20174490] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 12/15/2022]
Abstract
We conducted an extensive serological study to quantify population-level exposure and define correlates of immunity against SARS-CoV-2. We found that relative to mild COVID-19 cases, individuals with severe disease exhibited elevated authentic virus-neutralizing titers and antibody levels against nucleocapsid (N) and the receptor binding domain (RBD) and the S2 region of spike protein. Unlike disease severity, age and sex played lesser roles in serological responses. All cases, including asymptomatic individuals, seroconverted by 2 weeks post-PCR confirmation. RBD- and S2-specific and neutralizing antibody titers remained elevated and stable for at least 2-3 months post-onset, whereas those against N were more variable with rapid declines in many samples. Testing of 5882 self-recruited members of the local community demonstrated that 1.24% of individuals showed antibody reactivity to RBD. However, 18% (13/73) of these putative seropositive samples failed to neutralize authentic SARS-CoV-2 virus. Each of the neutralizing, but only 1 of the non-neutralizing samples, also displayed potent reactivity to S2. Thus, inclusion of multiple independent assays markedly improved the accuracy of antibody tests in low seroprevalence communities and revealed differences in antibody kinetics depending on the viral antigen. In contrast to other reports, we conclude that immunity is durable for at least several months after SARS-CoV-2 infection.
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Affiliation(s)
- Tyler J. Ripperger
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Jennifer L. Uhrlaub
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Center on Aging, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Makiko Watanabe
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Center on Aging, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Rachel Wong
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Division of Biological and Biomedical Sciences, Washington University, St. Louis, MO, USA
| | - Yvonne Castaneda
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Center on Aging, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Hannah A. Pizzato
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Division of Biological and Biomedical Sciences, Washington University, St. Louis, MO, USA
| | - Mallory R. Thompson
- Department of Surgery, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Department of Cellular and Molecular Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Christine Bradshaw
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Center on Aging, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Craig C. Weinkauf
- Department of Surgery, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Christian Bime
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Heidi L. Erickson
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Kenneth Knox
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Department of Medicine, University of Arizona-Phoenix, Phoenix, AZ
| | - Billie Bixby
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Sairam Parthasarathy
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Sachin Chaudhary
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Bhupinder Natt
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Elaine Cristan
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Tammer El Aini
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Franz Rischard
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Janet Campion
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Madhav Chopra
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Michael Insel
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Afshin Sam
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - James L. Knepler
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Andrew P. Capaldi
- Department of Molecular and Cellular Biology, University of Arizona – Tucson, Tucson, AZ, USA
- Functional Genomics Core, University of Arizona, Tucson, AZ
| | - Catherine M. Spier
- Department of Pathology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Michael D. Dake
- Office of the Senior Vice-President for Health Sciences, University of Arizona, Tucson, USA
| | - Taylor Edwards
- University of Arizona Genomics Core, University of Arizona, Tucson, AZ and the Arizona Research Labs, University of Arizona Genetics Core, University of Arizona, Tucson, AZ, USA
| | | | - Serena Jain Scott
- Division of Geriatrics, General Medicine and Palliative Care, Department of Medicine, University of Arizona College of Medicine-Tucson, Tucson, USA
| | - Cameron Hypes
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Department of Emergency Medicine, University of Arizona College of Medicine-Tucson, Tucson, USA
| | - Jarrod Mosier
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Department of Emergency Medicine, University of Arizona College of Medicine-Tucson, Tucson, USA
| | - David T. Harris
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Health Sciences Biobank, University of Arizona, Tucson, USA
| | | | - Ryan Sprissler
- University of Arizona Genomics Core, University of Arizona, Tucson, AZ and the Arizona Research Labs, University of Arizona Genetics Core, University of Arizona, Tucson, AZ, USA
- BIO5 Institute, University of Arizona, Tucson, USA
| | - Janko Nikolich-Žugich
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Center on Aging, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- BIO5 Institute, University of Arizona, Tucson, USA
| | - Deepta Bhattacharya
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- BIO5 Institute, University of Arizona, Tucson, USA
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Knepler JL, Mathur PN. Bronchoscopic diagnosis of infectious and inflammatory pulmonary disease. Chest Surg Clin N Am 2001; 11:723-33. [PMID: 11780292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Use of several bronchoscopic techniques can lead to the rapid and noninvasive diagnosis of many infectious and inflammatory diseases. As these and newer techniques become more widespread, bronchoscopy will continue to be an integral component of the workup of these diseases.
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Affiliation(s)
- J L Knepler
- Division of Pulmonary, Critical Care, and Occupational Medicine, Department of Medicine, Indiana University Medical Center, Indianapolis, Indiana, USA
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Abstract
Nitric oxide (.NO) attenuates hydrogen peroxide (H(2)O(2))-mediated barrier dysfunction in cultured porcine pulmonary artery endothelial cells (PAEC) (Gupta MP, Ober MD, Patterson C, Al-Hassani M, Natarajan V, and Hart, CM. Am J Physiol Lung Cell Mol Physiol 280: L116-L126, 2001). However,.NO rapidly combines with superoxide (O) to form the powerful oxidant peroxynitrite (ONOO(-)), which we hypothesized would cause PAEC monolayer barrier dysfunction. To test this hypothesis, we treated PAEC with ONOO(-) (500 microM) or 3-morpholinosydnonimine hydrochloride (SIN-1; 1-500 microM). SIN-1-mediated ONOO(-) formation was confirmed by monitoring the oxidation of dihydrorhodamine 123 to rhodamine. Both ONOO(-) and SIN-1 increased albumin clearance (P < 0.05) in the absence of cytotoxicity and altered the architecture of the cytoskeletal proteins actin and beta-catenin as detected by immunofluorescent confocal imaging. ONOO(-)-induced barrier dysfunction was partially reversible and was attenuated by cysteine. Both ONOO(-) and SIN-1 nitrated tyrosine residues, including those on beta-catenin and actin, and oxidized proteins in PAEC. The introduction of actin treated with ONOO(-) into PAEC monolayers via liposomes also resulted in barrier dysfunction. These results indicate that ONOO(-) directly alters endothelial cytoskeletal proteins, leading to barrier dysfunction.
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Affiliation(s)
- J L Knepler
- Department of Medicine, Richard L. Roudebush Veterans Affairs and Indiana University Medical Centers, Indianapolis, Indiana 46202, USA
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