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Ferentinos P, Snape D, Koivula F, Faustini S, Nicholson-Little A, Stacey M, Gifford R, Parsons I, Lamb L, Greeves J, O'Hara J, Cunningham AF, Woods D, Richter A, O'Shea MK. Validation of dried blood spot sampling for detecting SARS-CoV-2 antibodies and total immunoglobulins in a large cohort of asymptomatic young adults. J Immunol Methods 2023; 518:113492. [PMID: 37201783 DOI: 10.1016/j.jim.2023.113492] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Detecting antibody responses following infection with SARS-CoV-2 is necessary for sero-epidemiological studies and assessing the role of specific antibodies in disease, but serum or plasma sampling is not always viable due to logistical challenges. Dried blood spot sampling (DBS) is a cheaper, simpler alternative and samples can be self-collected and returned by post, reducing risk for SARS-CoV-2 exposure from direct patient contact. The value of large-scale DBS sampling for the assessment of serological responses to SARS-CoV-2 has not been assessed in depth and provides a model for examining the logistics of using this approach to other infectious diseases. The ability to measure specific antigens is attractive for remote outbreak situations where testing may be limited or for patients who require sampling after remote consultation. METHODS We compared the performance of SARS-CoV-2 anti-spike and anti-nucleocapsid antibody detection from DBS samples with matched serum collected by venepuncture in a large population of asymptomatic young adults (N = 1070) living and working in congregate settings (military recruits, N = 625); university students, N = 445). We also compared the effect of self-sampling (ssDBS) with investigator-collected samples (labDBS) on assay performance, and the quantitative measurement of total IgA, IgG and IgM between DBS eluates and serum. RESULTS Baseline seropositivity for anti-Spike IgGAM antibody was significantly higher among university students than military recruits. Strong correlations were observed between matched DBS and serum samples in both university students and recruits for the anti-spike IgGAM assay. Minimal differences were found in results by ssDBS and labDBS and serum by Bland Altman and Cohen kappa analyses. LabDBS achieved 82.0% sensitivity and 98.2% specificity and ssDBS samples 86.1% sensitivity and 96.7% specificity for detecting anti-Spike IgGAM antibodies relative to serum samples. For anti-SARS-CoV-2 nucleocapsid IgG there was qualitatively 100% agreement between serum and DBS samples and weak correlation in ratio measurements. Strong correlations were observed between serum and DBS-derived total IgG, IgA, and IgM. CONCLUSIONS This is the largest validation of DBS against paired serum for SARS-CoV-2 specific antibody measurement and we have shown that DBS retains performance from prior smaller studies. There were no significant differences regarding DBS collection methods, suggesting that self-collected samples are a viable sampling collection method. These data offer confidence that DBS can be employed more widely as an alternative to classical serology.
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Affiliation(s)
- P Ferentinos
- Research Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett University, UK
| | - D Snape
- Research Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett University, UK
| | - F Koivula
- Department of Army Health and Performance Research, Andover, Hampshire, UK
| | - S Faustini
- Clinical Immunology Service, University of Birmingham, Birmingham, UK
| | - A Nicholson-Little
- Research Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett University, UK
| | - M Stacey
- Research Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett University, UK; Research & Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, UK
| | - R Gifford
- Research Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett University, UK; Research & Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, UK
| | - I Parsons
- Research Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett University, UK; Research & Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, UK
| | - L Lamb
- Research & Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, UK
| | - J Greeves
- Department of Army Health and Performance Research, Andover, Hampshire, UK
| | - J O'Hara
- Research Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett University, UK
| | - A F Cunningham
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - D Woods
- Research Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett University, UK; Research & Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, UK
| | - A Richter
- Clinical Immunology Service, University of Birmingham, Birmingham, UK; Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - M K O'Shea
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK; Research & Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, UK.
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Parry H, McIlroy G, Bruton R, Ali M, Stephens C, Damery S, Otter A, McSkeane T, Rolfe H, Faustini S, Wall N, Hillmen P, Pratt G, Paneesha S, Zuo J, Richter A, Moss P. Antibody responses after first and second Covid-19 vaccination in patients with chronic lymphocytic leukaemia. Blood Cancer J 2021; 11:136. [PMID: 34330895 PMCID: PMC8323747 DOI: 10.1038/s41408-021-00528-x] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 12/15/2022] Open
Abstract
B-cell chronic lymphocytic leukaemia (CLL) is associated with immunosuppression and patients are at increased clinical risk following SARS-CoV-2 infection. Covid-19 vaccines offer the potential for protection against severe infection but relatively little is known regarding the profile of the antibody response following first or second vaccination. We studied spike-specific antibody responses following first and/or second Covid-19 vaccination in 299 patients with CLL compared with healthy donors. 286 patients underwent extended interval (10-12 week) vaccination. 154 patients received the BNT162b2 mRNA vaccine and 145 patients received ChAdOx1. Blood samples were taken either by venepuncture or as dried blood spots on filter paper. Spike-specific antibody responses were detectable in 34% of patients with CLL after one vaccine (n = 267) compared to 94% in healthy donors with antibody titres 104-fold lower in the patient group. Antibody responses increased to 75% after second vaccine (n = 55), compared to 100% in healthy donors, although titres remained lower. Multivariate analysis showed that current treatment with BTK inhibitors or IgA deficiency were independently associated with failure to generate an antibody response after the second vaccine. This work supports the need for optimisation of vaccination strategy in patients with CLL including the potential utility of booster vaccines.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Viral/blood
- Antibodies, Viral/immunology
- Antibody Formation/drug effects
- BNT162 Vaccine
- COVID-19/blood
- COVID-19/immunology
- COVID-19/prevention & control
- COVID-19 Vaccines/administration & dosage
- COVID-19 Vaccines/immunology
- Female
- Humans
- Immunization, Secondary
- Leukemia, Lymphocytic, Chronic, B-Cell/blood
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Male
- Middle Aged
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Affiliation(s)
- H Parry
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - G McIlroy
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - R Bruton
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - M Ali
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - C Stephens
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - S Damery
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - A Otter
- National infection Service, Public Health England, Porton Down, Salisbury, SP4 OJG, UK
| | - T McSkeane
- Cancer Research UK Clinical Trials Unit, University of Birmingham, B15 2TT, Birmingham, UK
| | - H Rolfe
- Cancer Research UK Clinical Trials Unit, University of Birmingham, B15 2TT, Birmingham, UK
| | - S Faustini
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - N Wall
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - P Hillmen
- St. James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK
| | - G Pratt
- Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, B15 2TH, UK
| | - S Paneesha
- Birmingham Heartlands Hospital, University Hospitals Birmingham, Bordesley Green East, B9 5SS, Birmingham, UK
| | - J Zuo
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - A Richter
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - P Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK.
- Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, B15 2TH, UK.
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Salvini A, Faustini S, Pizzi P. [Laparoscopic cholecystectomy and percutaneous echo-guided cholecystostomy. Their applications in acute cholecystitis]. Ann Ital Chir 1993; 64:219-24. [PMID: 8357152] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Laparoscopic cholecystectomy is nowadays proposed as elective treatment in acute cholecystitis; the advantages obtained with this method are comparable with those of laparoscopic cholecystectomy outside inflammatory complications. Moreover in emergency we have the advantage of better diagnostic definition and less surgical trauma. When acute cholecystitis affects high risk patients from the anesthesiologic view percutaneous US-assisted cholecystostomy is considered more valuable than the medical conservative treatment. Drainage of gallbladder is followed from a dramatic clinical improvement with more time for a laparoscopic cholecystectomy or for a percutaneous lithotripsy or eventually for the simple withdrawal of the catheter.
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Affiliation(s)
- A Salvini
- Ospedale Clinicizzato S. Donato, San Donato Milanese, Divisione di Chirurgia Generale
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Classen M, Cremer M, Faustini S, Meiser G, zum Büschenfelde M, Neuhaus H, Ott R, Pizzi P, Salvini A, Staritz M. Electromagnetic shock-wave lithotripsy of gallbladder calculi. Multicentered preliminary report on experience with 276 patients. Hepatogastroenterology 1990; 37:425-7. [PMID: 2210610] [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: 12/30/2022]
Abstract
The Lithostar Working Group reports on the first 276 patients who underwent lithotripsy of biliary calculi by means of an electromagnetic Lithotriptor (Lithostar Plus from Siemens). Some 66% (183/276) and 27% (75/276) of the patients had solitary and two or three stones, respectively while 7% (18/276) had more than three gallbladder calculi. Calcified calculi were found in 11% of the patients. On an average the patients were treated in 1.6 (range 1.4-2.15) sessions; with the exception of one user the maximal energy (setting 9) was applied. The upper limit of shock waves per session was 1500-6000 (x = 2189 +/- 1058). 17% and 48% of the patients were free from calculi after 3 and 6 months, respectively. During the follow-up period 14% of the patients complained of severe biliary pain and 1.5% suffered from pancreatitis, which was controlled by conservative treatment. In three out of five patients with a transitory cholestatic jaundice endoscopic papillotomy was necessary. Four patients underwent an elective cholecystectomy. Considering the selection of the patients, the results obtained are comparable with those found in other studies.
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Affiliation(s)
- M Classen
- II. Medizinische Klinik und Institut für Röntgendiagnostik der Technischen Universität München, FRG
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Faustini S, Salvini A, Pizzi P, Conti M, Magistretti MJ, Vescovini R. Experimental study on the action of diltiazem on detrusor muscle and clinical evaluation in patients with detrusor hyperactivity. Arzneimittelforschung 1989; 39:899-903. [PMID: 2818678] [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: 01/02/2023]
Abstract
Diltiazem added to the medium before administration of the agonist, caused a concentration-dependent antagonism of potassium chloride-induced contractions in strips of rat detrusor and human detrusor. When added at the time of peak potassium chloride-induced increase in muscle tone, the drug lowered the tone gradually and concentration-dependently. Diltiazem also depressed carbachol-induced contractions. In patients with disturbances of micturition due to detrusor hyperactivity, oral diltiazem (Angizem) treatment for 10 days significantly increased bladder capacity, lowered bladder pressure and maximum detrusor pressure and raised the threshold of the second sensation of micturition. In addition, diltiazem significantly reduced frequency of diurnal and nocturnal micturition and number of episodes of incontinence. Diltiazem appears to be an effective detrusor muscle relaxant and may be useful for the treatment of disturbances of micturition due to detrusor hyperactivity.
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Affiliation(s)
- S Faustini
- Department of Surgery, University of Milan, S. Donato Milanese Hospital, Italy
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