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Faustini SE, Jossi SE, Perez‐Toledo M, Shields AM, Allen JD, Watanabe Y, Newby ML, Cook A, Willcox CR, Salim M, Goodall M, Heaney JL, Marcial‐Juarez E, Morley GL, Torlinska B, Wraith DC, Veenith TV, Harding S, Jolles S, Ponsford MJ, Plant T, Huissoon A, O'Shea MK, Willcox BE, Drayson MT, Crispin M, Cunningham AF, Richter AG. Development of a high-sensitivity ELISA detecting IgG, IgA and IgM antibodies to the SARS-CoV-2 spike glycoprotein in serum and saliva. Immunology 2021; 164:135-147. [PMID: 33932228 PMCID: PMC8242512 DOI: 10.1111/imm.13349] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 11/19/2020] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 12/12/2022] Open
Abstract
Detecting antibody responses during and after SARS-CoV-2 infection is essential in determining the seroepidemiology of the virus and the potential role of antibody in disease. Scalable, sensitive and specific serological assays are essential to this process. The detection of antibody in hospitalized patients with severe disease has proven relatively straightforward; detecting responses in subjects with mild disease and asymptomatic infections has proven less reliable. We hypothesized that the suboptimal sensitivity of antibody assays and the compartmentalization of the antibody response may contribute to this effect. We systematically developed an ELISA, optimizing different antigens and amplification steps, in serum and saliva from non-hospitalized SARS-CoV-2-infected subjects. Using trimeric spike glycoprotein, rather than nucleocapsid, enabled detection of responses in individuals with low antibody responses. IgG1 and IgG3 predominate to both antigens, but more anti-spike IgG1 than IgG3 was detectable. All antigens were effective for detecting responses in hospitalized patients. Anti-spike IgG, IgA and IgM antibody responses were readily detectable in saliva from a minority of RT-PCR confirmed, non-hospitalized symptomatic individuals, and these were mostly subjects who had the highest levels of anti-spike serum antibodies. Therefore, detecting antibody responses in both saliva and serum can contribute to determining virus exposure and understanding immune responses after SARS-CoV-2 infection.
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Affiliation(s)
- Sian E. Faustini
- Institute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUK
| | - Sian E. Jossi
- Institute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUK
| | | | - Adrian M. Shields
- Institute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUK
| | - Joel D. Allen
- School of Biological SciencesUniversity of SouthamptonSouthamptonUK
| | - Yasunori Watanabe
- School of Biological SciencesUniversity of SouthamptonSouthamptonUK
- Department of BiochemistryOxford Glycobiology InstituteUniversity of OxfordOxfordUK
| | - Maddy L. Newby
- School of Biological SciencesUniversity of SouthamptonSouthamptonUK
| | | | - Carrie R. Willcox
- Institute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUK
| | - Mahboob Salim
- Institute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUK
| | - Margaret Goodall
- Institute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUK
| | - Jennifer L. Heaney
- Institute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUK
| | | | | | - Barbara Torlinska
- Institute of Applied Health ResearchUniversity of BirminghamBirminghamUK
| | - David C. Wraith
- Institute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUK
| | - Tonny V. Veenith
- Department of Critical Care MedicineUniversity Hospitals Birmingham NHS TrustBirminghamUK
| | | | | | | | - Tim Plant
- Institute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUK
| | - Aarnoud Huissoon
- Institute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUK
- Department of ImmunologyUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | - Matthew K. O'Shea
- Institute of Microbiology and InfectionUniversity of BirminghamBirminghamUK
| | - Benjamin E. Willcox
- Institute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUK
| | - Mark T. Drayson
- Institute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUK
| | - Max Crispin
- School of Biological SciencesUniversity of SouthamptonSouthamptonUK
| | - Adam F. Cunningham
- Institute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUK
| | - Alex G. Richter
- Institute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUK
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Faustini SE, Jossi SE, Perez-Toledo M, Shields AM, Allen JD, Watanabe Y, Newby ML, Cook A, Willcox CR, Salim M, Goodall M, Heaney JL, Marcial-Juarez E, Morley GL, Torlinska B, Wraith DC, Veenith TV, Harding S, Jolles S, Ponsford MJ, Plant T, Huissoon A, O'Shea MK, Willcox BE, Drayson MT, Crispin M, Cunningham AF, Richter AG. Detection of antibodies to the SARS-CoV-2 spike glycoprotein in both serum and saliva enhances detection of infection. medRxiv 2020:2020.06.16.20133025. [PMID: 32588002 PMCID: PMC7310662 DOI: 10.1101/2020.06.16.20133025] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [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: 12/21/2022]
Abstract
BACKGROUND Detecting antibody responses during and after SARS-CoV-2 infection is essential in determining the seroepidemiology of the virus and the potential role of antibody in disease. Scalable, sensitive and specific serological assays are essential to this process. The detection of antibody in hospitalized patients with severe disease has proven straightforward; detecting responses in subjects with mild disease and asymptomatic infections has proven less reliable. We hypothesized that the suboptimal sensitivity of antibody assays and the compartmentalization of the antibody response may contribute to this effect. METHODS We systemically developed an ELISA assay, optimising different antigens and amplification steps, in serum and saliva from symptomatic and asymptomatic SARS-CoV-2-infected subjects. RESULTS Using trimeric spike glycoprotein, rather than nucleocapsid enabled detection of responses in individuals with low antibody responses. IgG1 and IgG3 predominate to both antigens, but more anti-spike IgG1 than IgG3 was detectable. All antigens were effective for detecting responses in hospitalized patients. Anti-spike, but not nucleocapsid, IgG, IgA and IgM antibody responses were readily detectable in saliva from non-hospitalized symptomatic and asymptomatic individuals. Antibody responses in saliva and serum were largely independent of each other and symptom reporting. CONCLUSIONS Detecting antibody responses in both saliva and serum is optimal for determining virus exposure and understanding immune responses after SARS-CoV-2 infection. FUNDING This work was funded by the University of Birmingham, the National Institute for Health Research (UK), the NIH National Institute for Allergy and Infectious Diseases, the Bill and Melinda Gates Foundation and the University of Southampton.
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Affiliation(s)
- Sian E Faustini
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, U.K
| | - Sian E Jossi
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, U.K
| | - Marisol Perez-Toledo
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, U.K
| | - Adrian M Shields
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, U.K
| | - Joel D Allen
- School of Biological Sciences, University of Southampton, Southampton SO17 1BJ, U.K
| | - Yasunori Watanabe
- School of Biological Sciences, University of Southampton, Southampton SO17 1BJ, U.K
- Oxford Glycobiology Institute, Department of Biochemistry, University of Oxford, Oxford OX1 3QU, U.K
| | - Maddy L Newby
- School of Biological Sciences, University of Southampton, Southampton SO17 1BJ, U.K
| | - Alex Cook
- Binding Site Group Ltd, Birmingham, U.K
| | - Carrie R Willcox
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, U.K
| | - Mahboob Salim
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, U.K
| | - Margaret Goodall
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, U.K
| | - Jennifer L Heaney
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, U.K
| | - Edith Marcial-Juarez
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, U.K
| | - Gabriella L Morley
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, B15 2TT, U.K
| | - Barbara Torlinska
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, U.K
| | - David C Wraith
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, U.K
| | - Tonny V Veenith
- Department of Critical Care Medicine, University Hospitals Birmingham NHS Trust, Birmingham, B15 2TH, U.K
| | | | | | | | - Tim Plant
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, U.K
| | - Aarnoud Huissoon
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, U.K
- Department of Immunology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, U.K
| | - Matthew K O'Shea
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, U.K
| | - Benjamin E Willcox
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, U.K
| | - Mark T Drayson
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, U.K
| | - Max Crispin
- School of Biological Sciences, University of Southampton, Southampton SO17 1BJ, U.K
| | - Adam F Cunningham
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, U.K
| | - Alex G Richter
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, U.K
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