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Siebald B, Groll AH, Salou S, Boldt A, Seiffert S, Sack U, Reemtsma J, Jassoy C, Klusmann JH, Ciesek S, Hoehl S, Lehrnbecher T. Pediatric cancer patients vaccinated against SARS-CoV-2-a clinical and laboratory follow-up. Support Care Cancer 2024; 32:221. [PMID: 38467829 PMCID: PMC10927757 DOI: 10.1007/s00520-024-08422-5] [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: 09/25/2023] [Accepted: 03/05/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Vaccination against SARS-CoV-2 is recommended for cancer patients. However, long-term data on the effectiveness in the pediatric setting are lacking. METHODS Pediatric patients < 18 years on active treatment for cancer and without prior SARS-CoV-2 infection received three doses of an mRNA vaccine. The clinical course and humoral and cellular immunity were evaluated at the end of the follow-up period of ≥ 1 year after the third dose of vaccine. RESULTS SARS-CoV-2 infection occurred in 17 of 19 analyzed patients (median age 16.5 years) during the follow-up period (median 17 months), but no severe symptoms were seen. At ≥ 1 year after the last SARS-CoV-2 antigen exposure, 4 of 17 patients had received the recommended booster vaccine. At the end of the follow-up period, all evaluable 15 patients had anti-SARS-CoV-2 receptor-binding domain IgG antibodies. Twelve of the 15 patients had neutralizing antibody titers ≥ 1:10 against the Delta variant and 12/15 and 13/15 against the BA.1 and BA.5 variants, respectively. Specific T cells against SARS-CoV-2 antigens were seen in 9/13 patients. CONCLUSIONS Most SARS-CoV-2-vaccinated pediatric cancer patients had SARS-CoV-2 infections and limited interest in booster vaccination. At 1 year after the last antigen exposure, which was mostly an infection, humoral immune responses remained strong. TRIAL REGISTRATION German Clinical Trials Register DRKS00025254, May 26, 2021.
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Affiliation(s)
- Benjamin Siebald
- Department of Pediatrics, Division of Hematology, Oncology and Hemostaseology, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Andreas H Groll
- Department of Pediatric Hematology/Oncology, Infectious Disease Research Program, Center for Bone Marrow Transplantation, University Children's Hospital Muenster, Muenster, Germany
| | - Sarah Salou
- Division of Pediatric Hematology and Oncology, Department of Pediatric and Adolescent Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Andreas Boldt
- Medical Faculty, Institute of Clinical Immunology, University of Leipzig, Leipzig, Germany
| | - Sabine Seiffert
- Medical Faculty, Institute of Clinical Immunology, University of Leipzig, Leipzig, Germany
| | - Ulrich Sack
- Medical Faculty, Institute of Clinical Immunology, University of Leipzig, Leipzig, Germany
| | - Judith Reemtsma
- Medical Faculty, Institute of Clinical Immunology, University of Leipzig, Leipzig, Germany
| | - Christian Jassoy
- Institute for Medical Microbiology and Virology, University Hospital and Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Jan-Henning Klusmann
- Department of Pediatrics, Division of Hematology, Oncology and Hemostaseology, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Institute of Medical Virology, University Hospital Frankfurt, Johann Wolfgang Goethe University, Frankfurt Am Main, Germany
| | - Sebastian Hoehl
- Institute of Medical Virology, University Hospital Frankfurt, Johann Wolfgang Goethe University, Frankfurt Am Main, Germany
| | - Thomas Lehrnbecher
- Department of Pediatrics, Division of Hematology, Oncology and Hemostaseology, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
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Metzdorf K, Jacobsen H, Kim Y, Teixeira Alves LG, Kulkarni U, Eschke K, Chaudhry MZ, Hoffmann M, Bertoglio F, Ruschig M, Hust M, Cokarić Brdovčak M, Materljan J, Šustić M, Krmpotić A, Jonjić S, Widera M, Ciesek S, Pöhlmann S, Landthaler M, Čičin-Šain L. A single-dose MCMV-based vaccine elicits long-lasting immune protection in mice against distinct SARS-CoV-2 variants. bioRxiv 2024:2022.11.25.517953. [PMID: 36482969 PMCID: PMC9727759 DOI: 10.1101/2022.11.25.517953] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Current vaccines against COVID-19 elicit immune responses that are overall strong but wane rapidly. As a consequence, the necessary booster shots have led to vaccine fatigue. Hence, vaccines that would provide lasting protection against COVID-19 are needed, but are still unavailable. Cytomegaloviruses (CMV) elicit lasting and uniquely strong immune responses. Used as vaccine vectors, they may be attractive tools that obviate the need for boosters. Therefore, we tested the murine CMV (MCMV) as a vaccine vector against COVID-19 in relevant preclinical models of immunization and challenge. We have previously developed a recombinant murine CMV (MCMV) vaccine vector expressing the spike protein of the ancestral SARS-CoV-2 (MCMVS). In this study, we show that the MCMVS elicits a robust and lasting protection in young and aged mice. Notably, S-specific humoral and cellular immunity was not only maintained but even increased over a period of at least 6 months. During that time, antibody avidity continuously increased and expanded in breadth, resulting in neutralization of genetically distant variants, like Omicron BA.1. A single dose of MCMVS conferred rapid virus clearance upon challenge. Moreover, MCMVS vaccination controlled two immune-evading variants of concern (VoCs), the Beta (B.1.135) and the Omicron (BA.1) variants. Thus, CMV vectors provide unique advantages over other vaccine technologies, eliciting broadly reactive and long-lasting immune responses against COVID-19.
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Affiliation(s)
- Kristin Metzdorf
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Henning Jacobsen
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Yeonsu Kim
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Luiz Gustavo Teixeira Alves
- Berlin Institute for Medical Systems Biology (BIMSB), Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Upasana Kulkarni
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Kathrin Eschke
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - M. Zeeshan Chaudhry
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Markus Hoffmann
- Infection Biology Unit, German Primate Center – Leibniz Institute for Primate Research, Göttingen, Germany
- Faculty of Biology and Psychology, Georg-August-University Göttingen, Göttingen, Germany
| | - Federico Bertoglio
- Department of Medical Biotechnology, Institute for Biochemistry, Biotechnology and Bioinformatics, Technische Universität Braunschweig, Braunschweig, Germany
| | - Maximilian Ruschig
- Department of Medical Biotechnology, Institute for Biochemistry, Biotechnology and Bioinformatics, Technische Universität Braunschweig, Braunschweig, Germany
| | - Michael Hust
- Department of Medical Biotechnology, Institute for Biochemistry, Biotechnology and Bioinformatics, Technische Universität Braunschweig, Braunschweig, Germany
| | | | - Jelena Materljan
- Center for Proteomics, University of Rijeka, Faculty of Medicine, Rijeka, Croatia
- Department of Histology and Embryology, University of Rijeka, Faculty of Medicine, Rijeka, Croatia
| | - Marko Šustić
- Center for Proteomics, University of Rijeka, Faculty of Medicine, Rijeka, Croatia
| | - Astrid Krmpotić
- Department of Histology and Embryology, University of Rijeka, Faculty of Medicine, Rijeka, Croatia
| | - Stipan Jonjić
- Center for Proteomics, University of Rijeka, Faculty of Medicine, Rijeka, Croatia
| | - Marek Widera
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- German Centre for Infection Research (DZIF), External partner site Frankfurt, Germany
| | - Stefan Pöhlmann
- Infection Biology Unit, German Primate Center – Leibniz Institute for Primate Research, Göttingen, Germany
- Faculty of Biology and Psychology, Georg-August-University Göttingen, Göttingen, Germany
| | - Markus Landthaler
- Berlin Institute for Medical Systems Biology (BIMSB), Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- Institute for Biology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Luka Čičin-Šain
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Centre for Individualized Infection Medicine (CiiM), a joint venture of HZI and MHH, Hannover, Germany
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3
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Cinatl J, Bechtel M, Reus P, Ott M, Rothweiler F, Michaelis M, Ciesek S, Bojkova D. Trifluridine for treatment of mpox infection in drug combinations in ophthalmic cell models. J Med Virol 2024; 96:e29354. [PMID: 38180134 DOI: 10.1002/jmv.29354] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/23/2023] [Accepted: 12/15/2023] [Indexed: 01/06/2024]
Abstract
The Mpox virus can cause severe disease in the susceptible population with dermatologic and systemic manifestations. Furthermore, ophthalmic manifestations of mpox infection are well documented. Topical trifluridine (TFT) eye drops have been used for therapy of ophthalmic mpox infection in patients, however, its efficacy against mpox virus infection in this scenario has not been previously shown. In the present study, we have established ophthalmic cell models suitable for the infection with mpox virus. We show, that TFT is effective against a broad range of mpox isolates in conjunctival epithelial cells and keratocytes. Further, TFT remained effective against a tecovirimat-resistant virus strain. In the context of drug combinations, a nearly additive effect was observed for TFT combinations with brincidofovir and tecovirimat in conjunctival epithelial cells, while a slight antagonism was observed for both combinations in keratocytes. Altogether, our findings demonstrate TFT as a promising drug for treatment of ophthalmic mpox infection able to overcome tecovirimat resistance. However, conflicting results regarding the effect of drug combinations with approved compounds warrant close monitoring of such use in patients.
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Affiliation(s)
- Jindrich Cinatl
- Institute of Medical Virology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany
- Dr. Petra Joh-Forschungshaus, Frankfurt am Main, Germany
| | - Marco Bechtel
- Institute of Medical Virology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany
| | - Philipp Reus
- Institute of Medical Virology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany
- Discovery Research ScreeningPort, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Hamburg, Germany
| | - Melanie Ott
- Dr. Petra Joh-Forschungshaus, Frankfurt am Main, Germany
| | | | - Martin Michaelis
- Dr. Petra Joh-Forschungshaus, Frankfurt am Main, Germany
- School of Biosciences, University of Kent, Canterbury, UK
| | - Sandra Ciesek
- Institute of Medical Virology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany
- German Center for Infection Research, DZIF, External Partner Site, Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
| | - Denisa Bojkova
- Institute of Medical Virology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany
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4
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Enssle JC, Campe J, Moter A, Voit I, Gessner A, Yu W, Wolf S, Steffen B, Serve H, Bremm M, Huenecke S, Lohoff M, Vehreschild M, Rabenau HF, Widera M, Ciesek S, Oellerich T, Imkeller K, Rieger MA, von Metzler I, Ullrich E. Cytokine-responsive T- and NK-cells portray SARS-CoV-2 vaccine-responders and infection in multiple myeloma patients. Leukemia 2024; 38:168-180. [PMID: 38049509 PMCID: PMC10776400 DOI: 10.1038/s41375-023-02070-0] [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: 07/19/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 12/06/2023]
Abstract
Patients with multiple myeloma (MM) routinely receive mRNA-based vaccines to reduce COVID-19-related mortality. However, whether disease- and therapy-related alterations in immune cells and cytokine-responsiveness contribute to the observed heterogeneous vaccination responses is unclear. Thus, we analyzed peripheral blood mononuclear cells from patients with MM during and after SARS-CoV-2 vaccination and breakthrough infection (BTI) using combined whole-transcriptome and surface proteome single-cell profiling with functional serological and T-cell validation in 58 MM patients. Our results demonstrate that vaccine-responders showed a significant overrepresentation of cytotoxic CD4+ T- and mature CD38+ NK-cells expressing FAS+/TIM3+ with a robust cytokine-responsiveness, such as type-I-interferon-, IL-12- and TNF-α-mediated signaling. Patients with MM experiencing BTI developed strong serological and cellular responses and exhibited similar cytokine-responsive immune cell patterns as vaccine-responders. This study can expand our understanding of molecular and cellular patterns associated with immunization responses and may benefit the design of improved vaccination strategies in immunocompromised patients.
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Affiliation(s)
- Julius C Enssle
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Julia Campe
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- Goethe University Frankfurt, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany
| | - Alina Moter
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- Goethe University Frankfurt, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany
| | - Isabel Voit
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- Goethe University Frankfurt, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany
| | - Alec Gessner
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Weijia Yu
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Sebastian Wolf
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Björn Steffen
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
| | - Hubert Serve
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Melanie Bremm
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany
| | - Sabine Huenecke
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany
| | - Michael Lohoff
- Institute of Medical Microbiology and Hospital Hygiene, Philipps University, Marburg, Germany
| | - Maria Vehreschild
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Infectious Diseases, Frankfurt am Main, Germany
| | - Holger F Rabenau
- Goethe University Frankfurt, University Hospital, Institute for Medical Virology, Frankfurt am Main, Germany
| | - Marek Widera
- Goethe University Frankfurt, University Hospital, Institute for Medical Virology, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Goethe University Frankfurt, University Hospital, Institute for Medical Virology, Frankfurt am Main, Germany
- German Centre for Infection Research, external partner site, Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
| | - Thomas Oellerich
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Katharina Imkeller
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- Goethe University Frankfurt, University Hospital, Edinger Institute (Neurological Institute), Frankfurt am Main, Germany
- Goethe University Frankfurt, University Hospital, MSNZ Group of Computational Immunology, Frankfurt am Main, Germany
- University Cancer Center (UCT), Frankfurt am Main, Germany
| | - Michael A Rieger
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
- Cardio-Pulmonary Institute, Frankfurt am Main, Germany
| | - Ivana von Metzler
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Evelyn Ullrich
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany.
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany.
- Goethe University Frankfurt, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany.
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany.
- University Cancer Center (UCT), Frankfurt am Main, Germany.
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5
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Wilhelm A, Schoth J, Meinert-Berning C, Bastian D, Blum H, Elsinga G, Graf A, Heijnen L, Ho J, Kluge M, Krebs S, Stange C, Uchaikina A, Dolny R, Wurzbacher C, Drewes JE, Medema G, Tiehm A, Ciesek S, Teichgräber B, Wintgens T, Weber FA, Widera M. Interlaboratory comparison using inactivated SARS-CoV-2 variants as a feasible tool for quality control in COVID-19 wastewater monitoring. Sci Total Environ 2023; 903:166540. [PMID: 37634730 DOI: 10.1016/j.scitotenv.2023.166540] [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] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/11/2023] [Accepted: 08/22/2023] [Indexed: 08/29/2023]
Abstract
Wastewater-based SARS-CoV-2 epidemiology (WBE) has proven as an excellent tool to monitor pandemic dynamics supporting individual testing strategies. WBE can also be used as an early warning system for monitoring the emergence of novel pathogens or viral variants. However, for a timely transmission of results, sophisticated sample logistics and analytics performed in decentralized laboratories close to the sampling sites are required. Since multiple decentralized laboratories commonly use custom in-house workflows for sample purification and PCR-analysis, comparative quality control of the analytical procedures is essential to report reliable and comparable results. In this study, we performed an interlaboratory comparison at laboratories specialized for PCR and high-throughput-sequencing (HTS)-based WBE analysis. Frozen reserve samples from low COVID-19 incidence periods were spiked with different inactivated authentic SARS-CoV-2 variants in graduated concentrations and ratios. Samples were sent to the participating laboratories for analysis using laboratory specific methods and the reported viral genome copy numbers and the detection of viral variants were compared with the expected values. All PCR-laboratories reported SARS-CoV-2 genome copy equivalents (GCE) for all spiked samples with a mean intra- and inter-laboratory variability of 19 % and 104 %, respectively, largely reproducing the spike-in scheme. PCR-based genotyping was, in dependence of the underlying PCR-assay performance, able to predict the relative amount of variant specific substitutions even in samples with low spike-in amount. The identification of variants by HTS, however, required >100 copies/ml wastewater and had limited predictive value when analyzing at a genome coverage below 60 %. This interlaboratory test demonstrates that despite highly heterogeneous isolation and analysis procedures, overall SARS-CoV-2 GCE and mutations were determined accurately. Hence, decentralized SARS-CoV-2 wastewater monitoring is feasible to generate comparable analysis results. However, since not all assays detected the correct variant, prior evaluation of PCR and sequencing workflows as well as sustained quality control such as interlaboratory comparisons are mandatory for correct variant detection.
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Affiliation(s)
- Alexander Wilhelm
- Goethe University Frankfurt, University Hospital, Institute for Medical Virology, Paul-Ehrlich-Str. 40, D-60596 Frankfurt, Germany
| | - Jens Schoth
- Emschergenossenschaft/Lippeverband, Kronprinzenstraße 24, D-45128 Essen, Germany
| | | | - Daniel Bastian
- FiW e.V., Research Institute for Water Management and Climate Future at RWTH Aachen University, Kackertstraße 15-17, D-52056 Aachen, Germany
| | - Helmut Blum
- Laboratory for Functional Genome Analysis, Gene Center, LMU München, Feodor-Lynen-Straße 25, D-81377 Munich, Germany
| | - Goffe Elsinga
- KWR Water Research Institute, Groningenhaven 7, 3433 PE Nieuwegein, the Netherlands
| | - Alexander Graf
- Laboratory for Functional Genome Analysis, Gene Center, LMU München, Feodor-Lynen-Straße 25, D-81377 Munich, Germany
| | - Leo Heijnen
- KWR Water Research Institute, Groningenhaven 7, 3433 PE Nieuwegein, the Netherlands
| | - Johannes Ho
- TZW: DVGW-Technologiezentrum Wasser, Karlsruher Str. 84, 76139 Karlsruhe, Germany
| | - Mariana Kluge
- Chair of Urban Water Systems Engineering, Technical University of Munich, Am Coulombwall 3, D-85748 Garching, Germany
| | - Stefan Krebs
- Laboratory for Functional Genome Analysis, Gene Center, LMU München, Feodor-Lynen-Straße 25, D-81377 Munich, Germany
| | - Claudia Stange
- TZW: DVGW-Technologiezentrum Wasser, Karlsruher Str. 84, 76139 Karlsruhe, Germany
| | - Anna Uchaikina
- Chair of Urban Water Systems Engineering, Technical University of Munich, Am Coulombwall 3, D-85748 Garching, Germany
| | - Regina Dolny
- Institute of Environmental Engineering, RWTH Aachen University, Mies-van-der-Rohe-Strasse 1, D-52074 Aachen, Germany
| | - Christian Wurzbacher
- Chair of Urban Water Systems Engineering, Technical University of Munich, Am Coulombwall 3, D-85748 Garching, Germany
| | - Jörg E Drewes
- Chair of Urban Water Systems Engineering, Technical University of Munich, Am Coulombwall 3, D-85748 Garching, Germany
| | - Gertjan Medema
- KWR Water Research Institute, Groningenhaven 7, 3433 PE Nieuwegein, the Netherlands
| | - Andreas Tiehm
- TZW: DVGW-Technologiezentrum Wasser, Karlsruher Str. 84, 76139 Karlsruhe, Germany
| | - Sandra Ciesek
- Goethe University Frankfurt, University Hospital, Institute for Medical Virology, Paul-Ehrlich-Str. 40, D-60596 Frankfurt, Germany; German Center for Infection Research (DZIF), 38124 Braunschweig, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Theodor-Stern-Kai 7, D 60595 Frankfurt am Main, Germany
| | - Burkhard Teichgräber
- Emschergenossenschaft/Lippeverband, Kronprinzenstraße 24, D-45128 Essen, Germany
| | - Thomas Wintgens
- Institute of Environmental Engineering, RWTH Aachen University, Mies-van-der-Rohe-Strasse 1, D-52074 Aachen, Germany
| | - Frank-Andreas Weber
- FiW e.V., Research Institute for Water Management and Climate Future at RWTH Aachen University, Kackertstraße 15-17, D-52056 Aachen, Germany
| | - Marek Widera
- Goethe University Frankfurt, University Hospital, Institute for Medical Virology, Paul-Ehrlich-Str. 40, D-60596 Frankfurt, Germany.
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6
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Reus P, Guthmann H, Uhlig N, Agbaria M, Issmail L, Eberlein V, Nordling-David MM, Jbara-Agbaria D, Ciesek S, Bojkova D, Cinatl J, Burger-Kentischer A, Rupp S, Zaliani A, Grunwald T, Gribbon P, Kannt A, Golomb G. Drug repurposing for the treatment of COVID-19: Targeting nafamostat to the lungs by a liposomal delivery system. J Control Release 2023; 364:654-671. [PMID: 37939853 DOI: 10.1016/j.jconrel.2023.10.050] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023]
Abstract
Despite tremendous global efforts since the beginning of the COVID-19 pandemic, still only a limited number of prophylactic and therapeutic options are available. Although vaccination is the most effective measure in preventing morbidity and mortality, there is a need for safe and effective post-infection treatment medication. In this study, we explored a pipeline of 21 potential candidates, examined in the Calu-3 cell line for their antiviral efficacy, for drug repurposing. Ralimetinib and nafamostat, clinically used drugs, have emerged as attractive candidates. Due to the inherent limitations of the selected drugs, we formulated targeted liposomes suitable for both systemic and intranasal administration. Non-targeted and targeted nafamostat liposomes (LipNaf) decorated with an Apolipoprotein B peptide (ApoB-P) as a specific lung-targeting ligand were successfully developed. The developed liposomal formulations of nafamostat were found to possess favorable physicochemical properties including nano size (119-147 nm), long-term stability of the normally rapidly degrading compound in aqueous solution, negligible leakage from the liposomes upon storage, and a neutral surface charge with low polydispersity index (PDI). Both nafamostat and ralimetinib liposomes showed good cellular uptake and lack of cytotoxicity, and non-targeted LipNaf demonstrated enhanced accumulation in the lungs following intranasal (IN) administration in non-infected mice. LipNaf retained its anti-SARS-CoV 2 activity in Calu 3 cells with only a modest decrease, exhibiting complete inhibition at concentrations >100 nM. IN, but not intraperitoneal (IP) treatment with targeted LipNaf resulted in a trend to reduced viral load in the lungs of K18-hACE2 mice compared to targeted empty Lip. Nevertheless, upon removal of outlier data, a statistically significant 1.9-fold reduction in viral load was achieved. This observation further highlights the importance of a targeted delivery into the respiratory tract. In summary, we were able to demonstrate a proof-of-concept of drug repurposing by liposomal formulations with anti-SARS-CoV-2 activity. The biodistribution and bioactivity studies with LipNaf suggest an IN or inhalation route of administration for optimal therapeutic efficacy.
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Affiliation(s)
- Philipp Reus
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Discovery Research ScreeningPort, Schnackenburgallee 114, 22525 Hamburg, Germany; Goethe University Frankfurt, University Hospital, Institute for Medical Virology, Paul-Ehrlich-Straße 40, 60596 Frankfurt am Main, Germany
| | - Hadar Guthmann
- Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112001, Israel; The Center for Nanoscience and Nanotechnology, The Hebrew University of Jerusalem, Jerusalem 9190401, Israel
| | - Nadja Uhlig
- Fraunhofer Institute for Cell Therapy und Immunology IZI, Perlickstrasse 1, 04103 Leipzig, Germany
| | - Majd Agbaria
- Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112001, Israel
| | - Leila Issmail
- Fraunhofer Institute for Cell Therapy und Immunology IZI, Perlickstrasse 1, 04103 Leipzig, Germany
| | - Valentina Eberlein
- Fraunhofer Institute for Cell Therapy und Immunology IZI, Perlickstrasse 1, 04103 Leipzig, Germany
| | - Mirjam M Nordling-David
- Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112001, Israel
| | - Doaa Jbara-Agbaria
- Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112001, Israel
| | - Sandra Ciesek
- Goethe University Frankfurt, University Hospital, Institute for Medical Virology, Paul-Ehrlich-Straße 40, 60596 Frankfurt am Main, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Denisa Bojkova
- Goethe University Frankfurt, University Hospital, Institute for Medical Virology, Paul-Ehrlich-Straße 40, 60596 Frankfurt am Main, Germany
| | - Jindrich Cinatl
- Goethe University Frankfurt, University Hospital, Institute for Medical Virology, Paul-Ehrlich-Straße 40, 60596 Frankfurt am Main, Germany
| | - Anke Burger-Kentischer
- Fraunhofer Institute for Interfacial Engineering and Biotechnology IGB, Nobelstraße 12, 70569 Stuttgart, Germany
| | - Steffen Rupp
- Fraunhofer Institute for Interfacial Engineering and Biotechnology IGB, Nobelstraße 12, 70569 Stuttgart, Germany
| | - Andrea Zaliani
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Discovery Research ScreeningPort, Schnackenburgallee 114, 22525 Hamburg, Germany
| | - Thomas Grunwald
- Fraunhofer Institute for Cell Therapy und Immunology IZI, Perlickstrasse 1, 04103 Leipzig, Germany
| | - Philip Gribbon
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Discovery Research ScreeningPort, Schnackenburgallee 114, 22525 Hamburg, Germany
| | - Aimo Kannt
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany; Fraunhofer Innovation Center TheraNova, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany; Institute for Clinical Pharmacology, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany.
| | - Gershon Golomb
- Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112001, Israel; The Center for Nanoscience and Nanotechnology, The Hebrew University of Jerusalem, Jerusalem 9190401, Israel
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7
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Katsaouni N, Llavona P, Khodamoradi Y, Otto AK, Körber S, Geisen C, Seidl C, Vehreschild MJGT, Ciesek S, Ackermann J, Koch I, Schulz MH, Krause DS. Dataset of single nucleotide polymorphisms of immune-associated genes in patients with SARS-CoV-2 infection. PLoS One 2023; 18:e0287725. [PMID: 37971979 PMCID: PMC10653545 DOI: 10.1371/journal.pone.0287725] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 06/09/2023] [Indexed: 11/19/2023] Open
Abstract
The SARS-CoV-2 pandemic has affected nations globally leading to illness, death, and economic downturn. Why disease severity, ranging from no symptoms to the requirement for extracorporeal membrane oxygenation, varies between patients is still incompletely understood. Consequently, we aimed at understanding the impact of genetic factors on disease severity in infection with SARS-CoV-2. Here, we provide data on demographics, ABO blood group, human leukocyte antigen (HLA) type, as well as next-generation sequencing data of genes in the natural killer cell receptor family, the renin-angiotensin-aldosterone and kallikrein-kinin systems and others in 159 patients with SARS-CoV-2 infection, stratified into seven categories of disease severity. We provide single-nucleotide polymorphism (SNP) data on the patients and a protein structural analysis as a case study on a SNP in the SIGLEC7 gene, which was significantly associated with the clinical score. Our data represent a resource for correlation analyses involving genetic factors and disease severity and may help predict outcomes in infections with future SARS-CoV-2 variants and aid vaccine adaptation.
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Affiliation(s)
- Nikoletta Katsaouni
- Computational Epigenomics & Systems Cardiology, Institute of Cardiovascular Regeneration, Goethe University and University Clinic, Frankfurt am Main, Germany
- German Center for Cardiovascular Research (DZHK), Partner site Rhein Main, Frankfurt am Main, Germany
- Cardio-Pulmonary Institute, Goethe University Hospital, Frankfurt am Main, Germany
| | - Pablo Llavona
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt am Main, Germany
| | - Yascha Khodamoradi
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Ann-Kathrin Otto
- Molecular Bioinformatics, Institute of Computer Science, Goethe University Frankfurt am Main, Germany
| | - Stephanie Körber
- German Red Cross Blood Donor Service Baden-Württemberg Hessen, Frankfurt am Main, Germany
| | - Christof Geisen
- German Red Cross Blood Donor Service Baden-Württemberg Hessen, Frankfurt am Main, Germany
| | - Christian Seidl
- German Red Cross Blood Donor Service Baden-Württemberg Hessen, Frankfurt am Main, Germany
| | - Maria J. G. T. Vehreschild
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University, Frankfurt, Germany
- German Centre for Infection Research, External Partner Site, Frankfurt, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, Frankfurt, Germany
| | - Jörg Ackermann
- Molecular Bioinformatics, Institute of Computer Science, Goethe University Frankfurt am Main, Germany
| | - Ina Koch
- Molecular Bioinformatics, Institute of Computer Science, Goethe University Frankfurt am Main, Germany
| | - Marcel H. Schulz
- Computational Epigenomics & Systems Cardiology, Institute of Cardiovascular Regeneration, Goethe University and University Clinic, Frankfurt am Main, Germany
- German Center for Cardiovascular Research (DZHK), Partner site Rhein Main, Frankfurt am Main, Germany
- Cardio-Pulmonary Institute, Goethe University Hospital, Frankfurt am Main, Germany
| | - Daniela S. Krause
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt am Main, Germany
- German Red Cross Blood Donor Service Baden-Württemberg Hessen, Frankfurt am Main, Germany
- Institute of Biochemistry II and Institute of General Pharmacology and Toxicology, Goethe-University, Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), Frankfurt, Germany
- Frankfurt Cancer Institute, Frankfurt am Main, Germany
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8
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Muik A, Lui BG, Quandt J, Diao H, Fu Y, Bacher M, Gordon J, Toker A, Grosser J, Ozhelvaci O, Grikscheit K, Hoehl S, Kohmer N, Lustig Y, Regev-Yochay G, Ciesek S, Beguir K, Poran A, Vogler I, Türeci Ö, Sahin U. Progressive loss of conserved spike protein neutralizing antibody sites in Omicron sublineages is balanced by preserved T cell immunity. Cell Rep 2023; 42:112888. [PMID: 37527039 DOI: 10.1016/j.celrep.2023.112888] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 03/27/2023] [Accepted: 07/13/2023] [Indexed: 08/03/2023] Open
Abstract
Evolution of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant has led to the emergence of sublineages with different patterns of neutralizing antibody evasion. We report that Omicron BA.4/BA.5 breakthrough infection of individuals immunized with SARS-CoV-2 wild-type-strain-based mRNA vaccines results in a boost of Omicron BA.4.6, BF.7, BQ.1.1, and BA.2.75 neutralization but does not efficiently boost BA.2.75.2, XBB, or XBB.1.5 neutralization. In silico analyses showed that the Omicron spike glycoprotein lost most neutralizing B cell epitopes, especially in sublineages BA.2.75.2, XBB, and XBB.1.5. In contrast, T cell epitopes are conserved across variants including XBB.1.5. T cell responses of mRNA-vaccinated, SARS-CoV-2-naive individuals against the wild-type strain, Omicron BA.1, and BA.4/BA.5 were comparable, suggesting that T cell immunity against recent sublineages including XBB.1.5 may remain largely unaffected. While some Omicron sublineages effectively evade B cell immunity, spike-protein-specific T cell immunity, due to the nature of polymorphic cell-mediated immune responses, may continue to contribute to prevention/limitation of severe COVID-19 manifestation.
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Affiliation(s)
| | | | | | - Huitian Diao
- BioNTech US, 40 Erie Street, Cambridge, MA 02139, USA
| | - Yunguan Fu
- InstaDeep, Ltd., 5 Merchant Square, London W2 1AY, UK
| | - Maren Bacher
- BioNTech, An der Goldgrube 12, 55131 Mainz, Germany
| | | | - Aras Toker
- BioNTech, An der Goldgrube 12, 55131 Mainz, Germany
| | | | | | - Katharina Grikscheit
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Sebastian Hoehl
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Yaniv Lustig
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel; Central Virology Laboratory, Public Health Services, Ministry of Health, Tel-Hashomer, Ramat Gan, Israel
| | - Gili Regev-Yochay
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel; SPRI-Sheba Pandemic Preparedness Research Institute, Sheba Medical Center Tel Hashomer, Ramat Gan, Israel
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany; DZIF - German Centre for Infection Research, External Partner Site, 60596 Frankfurt am Main, Germany
| | - Karim Beguir
- InstaDeep, Ltd., 5 Merchant Square, London W2 1AY, UK
| | - Asaf Poran
- BioNTech US, 40 Erie Street, Cambridge, MA 02139, USA
| | | | - Özlem Türeci
- BioNTech, An der Goldgrube 12, 55131 Mainz, Germany; HI-TRON - Helmholtz Institute for Translational Oncology Mainz by DKFZ, Obere Zahlbacherstr. 63, 55131 Mainz, Germany
| | - Ugur Sahin
- BioNTech, An der Goldgrube 12, 55131 Mainz, Germany; TRON gGmbH - Translational Oncology at the University Medical Center of the Johannes Gutenberg University, Freiligrathstraße 12, 55131 Mainz, Germany.
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9
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Ovcar E, Patyna S, Kohmer N, Heckel-Kratz E, Ciesek S, Rabenau HF, Hauser IA, de Groot K. Riding the Omicron BA.5 Wave: Improved Humoral Response after Vaccination with Bivalent Omicron BA.4-5-Adapted mRNA SARS-CoV-2 Vaccine in Chronic Hemodialysis Patients. Vaccines (Basel) 2023; 11:1428. [PMID: 37766105 PMCID: PMC10537021 DOI: 10.3390/vaccines11091428] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Hemodialysis patients faced an excess morbidity and mortality during the COVID-19 pandemic. We evaluated the effect of second-generation mRNA vaccines against Omicron BA.4 and BA.5 variants of SARS-CoV-2 on humoral immunity. The study population comprised 66 adult hemodialysis patients who have encountered four SARS-CoV-2 antigen contacts through vaccination or infection. We assessed their humoral response using an anti-SARS-CoV-2 spike receptor binding domain IgG antibody assay (S-RBD-ab), measuring neutralizing antibodies against ancestral strain of SARS-CoV-2, Delta, and Omicron in a surrogate virus neutralization test (SVNT), and specifically against BA.5 in a plaque reduction neutralization test (PRNT) before and four weeks after vaccination with Comirnaty Original/Omicron BA.4-5. During the following six months, SARS-CoV-2 infections and symptom severity were documented. The bivalent mRNA vaccine led to a 7.6-fold increase in S-RBD-ab levels and an augmented inhibition of the Omicron variant in SVNT by 35% (median). Seroconversion in the Omicron BA.5-specific PRNT was attained by in 78.4% of previously negative patients (29/37). Levels of S-RBD-ab correlated with inhibition in the Omicron-specific SVNT and neutralization titers in the BA.5-PRNT. Eleven SARS-CoV-2 infections occurred in the six-month follow-up, none of which took a life-threatening course. The bivalent mRNA vaccine improved the SARS-CoV-2 virus variant-specific humoral immunity in chronic hemodialysis patients. Measurement of S-RBD-ab can be used in hemodialysis patients to estimate their humoral immunity status against Omicron BA.5.
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Affiliation(s)
- Eugen Ovcar
- Department of Internal Medicine 4, Nephrology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
- KfH Kuratorium for Dialysis and Transplantation, 63069 Offenbach am Main, Germany
- Department of Internal Medicine III, Internal Medicine, Nephrology, Rheumatology, Sana Klinikum, 63069 Offenbach am Main, Germany
| | - Sammy Patyna
- Department of Internal Medicine 4, Nephrology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | | | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
- German Center for Infection Research, External Partner Site, 60596 Frankfurt am Main, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, 60596 Frankfurt am Main, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Ingeborg A Hauser
- Department of Internal Medicine 4, Nephrology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Kirsten de Groot
- KfH Kuratorium for Dialysis and Transplantation, 63069 Offenbach am Main, Germany
- Department of Internal Medicine III, Internal Medicine, Nephrology, Rheumatology, Sana Klinikum, 63069 Offenbach am Main, Germany
- University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
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10
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Koehm M, Klippstein M, Dauth S, Hallmann K, Kohmer N, Burkhardt H, Ciesek S, Geisslinger G, Rabenau HF, Behrens F. Impact of different classes of immune-modulating treatments on B cell-related and T cell-related immune response before and after COVID-19 booster vaccination in patients with immune-mediated diseases and primary immunodeficiency: a cohort study. RMD Open 2023; 9:e003094. [PMID: 37652553 PMCID: PMC10476126 DOI: 10.1136/rmdopen-2023-003094] [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: 02/21/2023] [Accepted: 06/23/2023] [Indexed: 09/02/2023] Open
Abstract
OBJECTIVES To evaluate the potential of immunosuppressed patients to mount B-cell and T-cell responses to COVID-19 booster vaccination (third vaccination). METHODS Patients with primary immunodeficiency (PID), immune-mediated inflammatory diseases (IMIDs) on CD20-depleting treatment with rituximab (RTX), or IMIDs treated with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) or biological disease-modifying antirheumatic drug (bDMARDs) were included and assessed before (baseline visit (BL)) and 2, 4 and 8 weeks after COVID-19 booster vaccination. Serum B-cell responses were assessed by antibody levels against SARS-CoV-2 spike protein (anti-spike IgG antibody (S-AB)) and a surrogate virus neutralisation test (sVNT). T-cell responses were assessed by an interferon gamma release assay (IGRA). RESULTS Fifty patients with PID (n=6), treated with RTX therapy (n=13), or treated with csDMARDs/bDMARDs (n=31) were included. At BL, anti-S-AB titres in PID and csDMARD/bDMARD-treated patients were low (although significantly higher than RTX patients); measures of B-cell-mediated response increased significantly after booster vaccination. In the RTX cohort, low BL anti-S-AB and sVNT values did not improve after booster vaccination, but patients had significantly elevated IGRA responses post booster vaccination compared with the other groups. csDMARD/bDMARD-treated patients showed the highest BL values in all three assays with greater increases in all parameters after booster vaccination compared with patients with PID. CONCLUSION Patients with IMID on therapeutic B-cell depletion have low anti-S-AB and sVNT values before and after booster vaccination but show significantly higher levels of IGRA compared with other immunosuppressed patients, suggesting an underlying mechanism attempting to compensate compromised humoral immunity by upregulating T-cell responsiveness. PID appears to have a stronger impact on antiviral immune response than csDMARD/bDMARD treatment.
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Affiliation(s)
- Michaela Koehm
- Department of Rheumatology, Goethe University, Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD, Frankfurt am Main, Germany
| | - Maximilian Klippstein
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD, Frankfurt am Main, Germany
| | - Stephanie Dauth
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD, Frankfurt am Main, Germany
| | - Konstantin Hallmann
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD, Frankfurt am Main, Germany
| | - Niko Kohmer
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Harald Burkhardt
- Department of Rheumatology, Goethe University, Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
- Virology, German Centre for Infection Research, Frankfurt am Main, Germany
| | - Gerd Geisslinger
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD, Frankfurt am Main, Germany
- Pharmazentrum Frankfurt/ZAFES, Institute of Clinical Pharmacology, Goethe University, Frankfurt am Main, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Frank Behrens
- Department of Rheumatology, Goethe University, Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Fraunhofer Cluster of Excellence Immune-mediated Diseases CIMD, Frankfurt am Main, Germany
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11
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Bormann M, Brochhagen L, Alt M, Otte M, Thümmler L, van de Sand L, Kraiselburd I, Thomas A, Gosch J, Braß P, Ciesek S, Widera M, Dolff S, Dittmer U, Witzke O, Meyer F, Lindemann M, Schönfeld A, Rohn H, Krawczyk A. Immune responses in COVID-19 patients during breakthrough infection with SARS-CoV-2 variants Delta, Omicron-BA.1 and Omicron-BA.5. Front Immunol 2023; 14:1150667. [PMID: 37520539 PMCID: PMC10372796 DOI: 10.3389/fimmu.2023.1150667] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Background Breakthrough infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants are increasingly observed in vaccinated individuals. Immune responses towards SARS-CoV-2 variants, particularly Omicron-BA.5, are poorly understood. We investigated the humoral and cellular immune responses of hospitalized COVID-19 patients during Delta and Omicron infection waves. Methods The corresponding SARS-CoV-2 variant of the respective patients were identified by whole genome sequencing. Humoral immune responses were analyzed by ELISA and a cell culture-based neutralization assay against SARS-CoV-2 D614G isolate (wildtype), Alpha, Delta (AY.43) and Omicron (BA.1 and BA.5). Cellular immunity was evaluated with an IFN-γ ELISpot assay. Results On a cellular level, patients showed a minor IFN-γ response after stimulating PBMCs with mutated regions of SARS-CoV-2 variants. Neutralizing antibody titers against Omicron-BA.1 and especially BA.5 were strongly reduced. Double-vaccinated patients with Delta breakthrough infection showed a significantly increased neutralizing antibody response against Delta compared to double-vaccinated uninfected controls (median complete neutralization titer (NT100) 640 versus 80, p<0.05). Omicron-BA.1 infection increased neutralization titers against BA.1 in double-vaccinated patients (median NT100 of 160 in patients versus 20 in controls, p=0.07) and patients that received booster vaccination (median NT100 of 50 in patients versus 20 in controls, p=0.68). For boosted patients with BA.5 breakthrough infection, we found no enhancing effect on humoral immunity against SARS-CoV-2 variants. Conclusion Neutralizing antibody titers against Omicron-BA.1 and especially BA.5 were strongly reduced in SARS-CoV-2 breakthrough infections. Delta and Omicron-BA.1 but not Omicron-BA.5 infections boosted the humoral immunity in double-vaccinated patients and patients with booster vaccination. Despite BA.5 breakthrough infection, those patients may still be vulnerable for reinfections with BA.5 or other newly emerging variants of concern.
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Affiliation(s)
- Maren Bormann
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Leonie Brochhagen
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Mira Alt
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Mona Otte
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Laura Thümmler
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lukas van de Sand
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ivana Kraiselburd
- Institute for Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany
| | - Alexander Thomas
- Institute for Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany
| | - Jule Gosch
- Institute for Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany
| | - Peer Braß
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
- Institute of Pharmaceutical Biology, Goethe University Frankfurt, Frankfurt am Main, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, Frankfurt am Main, Germany
| | - Marek Widera
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Sebastian Dolff
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ulf Dittmer
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Folker Meyer
- Institute for Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Andreas Schönfeld
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Hana Rohn
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Adalbert Krawczyk
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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12
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Wedemeyer H, Aleman S, Brunetto MR, Blank A, Andreone P, Bogomolov P, Chulanov V, Mamonova N, Geyvandova N, Morozov V, Sagalova O, Stepanova T, Berger A, Manuilov D, Suri V, An Q, Da B, Flaherty J, Osinusi A, Liu Y, Merle U, Schulze Zur Wiesch J, Zeuzem S, Ciesek S, Cornberg M, Lampertico P. A Phase 3, Randomized Trial of Bulevirtide in Chronic Hepatitis D. N Engl J Med 2023; 389:22-32. [PMID: 37345876 DOI: 10.1056/nejmoa2213429] [Citation(s) in RCA: 40] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
BACKGROUND Coinfection with hepatitis D virus (HDV) accelerates the progression of liver disease associated with chronic hepatitis B. Bulevirtide inhibits the entry of HDV into hepatocytes. METHODS In this ongoing phase 3 trial, patients with chronic hepatitis D, with or without compensated cirrhosis, were randomly assigned, in a 1:1:1 ratio, to receive bulevirtide subcutaneously at 2 mg per day (2-mg group) or 10 mg per day (10-mg group) for 144 weeks or to receive no treatment for 48 weeks followed by bulevirtide subcutaneously at 10 mg per day for 96 weeks (control group). Patients will complete 96 weeks of additional follow-up after the end of treatment. The primary end point was a combined response at week 48 of an undetectable HDV RNA level, or a level that decreased by at least 2 log10 IU per milliliter from baseline, and normalization of the alanine aminotransferase (ALT) level. The key secondary end point was an undetectable HDV RNA level at week 48, in a comparison between the 2-mg group and the 10-mg group. RESULTS A total of 49 patients were assigned to the 2-mg group, 50 to the 10-mg group, and 51 to the control group. A primary end-point response occurred in 45% of patients in the 2-mg group, 48% in the 10-mg group, and 2% in the control group (P<0.001 for the comparison of each dose group with the control group). The HDV RNA level at week 48 was undetectable in 12% of patients in the 2-mg group and in 20% in the 10-mg group (P = 0.41). The ALT level normalized in 12% of patients in the control group, 51% in the 2-mg group (difference from control, 39 percentage points [95% confidence interval {CI}, 20 to 56]), and 56% in the 10-mg group (difference from control, 44 percentage points [95% CI, 26 to 60]). Loss of hepatitis B virus surface antigen (HBsAg) or an HBsAg level that decreased by at least 1 log10 IU per milliliter did not occur in the bulevirtide groups by week 48. Headache, pruritus, fatigue, eosinophilia, injection-site reactions, upper abdominal pain, arthralgia, and asthenia were more common in the 2-mg and 10-mg groups combined than in the control group. No treatment-related serious adverse events occurred. Dose-dependent increases in bile acid levels were noted in the 2-mg and 10-mg groups. CONCLUSIONS After 48 weeks of bulevirtide treatment, HDV RNA and ALT levels were reduced in patients with chronic hepatitis D. (Funded by Gilead Sciences; MYR 301 ClinicalTrials.gov number, NCT03852719.).
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Affiliation(s)
- Heiner Wedemeyer
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Soo Aleman
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Maurizia Rossana Brunetto
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Antje Blank
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Pietro Andreone
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Pavel Bogomolov
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Vladimir Chulanov
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Nina Mamonova
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Natalia Geyvandova
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Viacheslav Morozov
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Olga Sagalova
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Tatyana Stepanova
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Annemarie Berger
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Dmitry Manuilov
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Vithika Suri
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Qi An
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Ben Da
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - John Flaherty
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Anu Osinusi
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Yang Liu
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Uta Merle
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Julian Schulze Zur Wiesch
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Stefan Zeuzem
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Sandra Ciesek
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Markus Cornberg
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
| | - Pietro Lampertico
- From Medizinische Hochschule Hannover, Excellence Cluster RESIST, and D-SOLVE Consortium (H.W., M.C.), Hannover, German Center for Infection Research (DZIF) Partner Site Hannover-Braunschweig, Braunschweig (H.W., M.C.), Clinical Pharmacology and Pharmacoepidemiology and DZIF Partner Site Heidelberg (A. Blank) and the Department of Internal Medicine IV (U.M.), Heidelberg University Hospital, Heidelberg, the Institute of Medical Virology (A. Berger, S.C.), the Department of Internal Medicine, University Hospital Frankfurt (S.Z.), DZIF (S.C.), and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP (S.C.), Frankfurt, and Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik, and DZIF, Hamburg-Lübeck-Borstel-Riems, Hamburg (J.S.W.) - all in Germany; the Department of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm (S.A.); the Department of Clinical and Experimental Medicine, University of Pisa, and the Hepatology Unit, Pisa University Hospital, Pisa (M.R.B.), the Division of Internal Medicine, University of Modena and Reggio Emilia, Modena (P.A.), and the Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, CRC "A. M. and A. Migliavacca" Center for Liver Disease, and the Department of Pathophysiology and Transplantation, University of Milan, Milan (P.L.) - all in Italy; M.F. Vladimirsky Moscow Regional Research and Clinical Institute (P.B.), National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health (V.C.), Sechenov University (V.C.), and the Clinic of Modern Medicine (T.S.), Moscow, the National Medical Research Center of Physiopulmonology and Infectious Diseases, Yekaterinburg (N.M.), Stavropol Regional Clinical Hospital, Stavropol (N.G.), Hepatolog, Samara (V.M.), and Southern Ural State Medical University, Chelyabinsk (O.S.) - all in Russia; and Gilead Sciences, Foster City, CA (D.M., V.S., Q.A., B.D., J.F., A.O., Y.L.)
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Pather S, Madhi SA, Cowling BJ, Moss P, Kamil JP, Ciesek S, Muik A, Türeci Ö. Corrigendum: SARS-CoV-2 Omicron variants: burden of disease, impact on vaccine effectiveness and need for variant-adapted vaccines. Front Immunol 2023; 14:1232965. [PMID: 37377964 PMCID: PMC10292686 DOI: 10.3389/fimmu.2023.1232965] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fimmu.2023.1130539.].
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Affiliation(s)
| | - Shabir A. Madhi
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Benjamin J. Cowling
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
| | - Jeremy P. Kamil
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, United States
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
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Schierwagen R, Gu W, Brieger A, Brüne B, Ciesek S, Đikić I, Dimmeler S, Geisslinger G, Greten FR, Herrmann E, Hildt E, Kempf VAJ, Klein S, Koch I, Mühl H, Müller V, Peiffer KH, Kestner RI, Piiper A, Rohde G, Scholich K, Schulz MH, Storf H, Toptan T, Vasa-Nicotera M, Vehreschild MJGT, Weigert A, Wild PJ, Zeuzem S, Engelmann C, Schaefer L, Welsch C, Trebicka J. Pathogenetic mechanisms and therapeutic approaches of acute-to-chronic liver failure. Am J Physiol Cell Physiol 2023. [PMID: 37273239 DOI: 10.1152/ajpcell.00101.2023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Liver cirrhosis is the end stage of all chronic liver diseases and contributes significantly to overall mortality of 2% globally. The age-standardized mortality from liver cirrhosis in Europe is between 10 and 20% and can be explained not only by the development of liver cancer but also by the acute deterioration in the patient's overall condition. The development of complications including accumulation of fluid in the abdomen (ascites), bleeding in the gastrointestinal tract (variceal bleeding), bacterial infections or a decrease in brain function (hepatic encephalopathy) defines an acute decompensation that requires therapy, and often leads to acute-on-chronic liver failure (ACLF) by different precipitating events. However, due to its complexity and organ-spanning nature, the pathogenesis of ACLF is poorly understood, and the common underlying mechanisms leading to the development of organ dysfunction or failure in ACLF are still elusive. Apart from general intensive care interventions, there are no specific therapy options for ACLF. Liver transplantation is often not possible in these patients due to contraindications and a lack of prioritization. In this review, we describe the framework of the ACLF-I project consortium funded by the Hessian Ministry of Higher Education, Research and the Arts (HMWK) based on existing findings and will provide answers to these open questions.
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Affiliation(s)
- Robert Schierwagen
- Department of Internal Medicine B, University of Münster, Münster, Germany
- Department of Internal Medicine I, Goethe University Frankfurt, Frankfurt, Germany
| | - Wenyi Gu
- Department of Internal Medicine B, University of Münster, Münster, Germany
- Department of Internal Medicine I, Goethe University Frankfurt, Frankfurt, Germany
| | - Angela Brieger
- Department of Internal Medicine I, Goethe University Frankfurt, Frankfurt, Germany
| | - Bernhard Brüne
- Institute of Biochemistry I, Faculty of Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, Faculty of Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Ivan Đikić
- Institute of Biochemistry II, Goethe University Frankfurt, Frankfurt, Hessen, Germany
| | - Stafanie Dimmeler
- Institute for Cardiovascular Regeneration, Centre of Molecular Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Gerd Geisslinger
- Fraunhofer Institute for Translational Medicine and Pharmacology, Frankfurt, Germany
- Institute for Cardiovascular Regeneration, Goethe University Frankfurt, Frankfurt, Germany
| | - Florian R Greten
- Institute for Tumor Biology and Experimental Therapy, Frankfurt, Germany
| | - Eva Herrmann
- Institute of Biostatistics and Mathematical Modeling, Goethe University Frankfurt, Frankfurt Main, Germany
| | | | - Volkhard A J Kempf
- Institute for Medical Microbiology and Infection Control, Goethe University Frankfurt, Frankfurt, Germany
| | - Sabine Klein
- Department of Internal Medicine B, University of Münster, Münster, Germany
- Department of Internal Medicine I, Goethe University Frankfurt, Frankfurt, Germany
| | - Ina Koch
- Institute of Computer Science, Department of Molecular Bioinformatics, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Heiko Mühl
- Institute of General Pharmacology and Toxicology, Goethe University Frankfurt, Frankfurt, Germany
| | - Volker Müller
- nstitute of Molecular Biosciences, Department of Molecular Microbiology and Bioenergetics, Goethe University Frankfurt, Frankfurt, Germany
| | - Kai-Henrik Peiffer
- Department of Internal Medicine B, University of Münster, Münster, Germany
- Department of Internal Medicine I, Goethe University Frankfurt, Frankfurt, Germany
| | | | - Albrecht Piiper
- Department of Internal Medicine I, Goethe University Frankfurt, Frankfurt, Germany
| | - Gernot Rohde
- Department of Respiratory Medicine and Allergology, Goethe University Frankfurt, Frankfurt, Germany
| | - Klaus Scholich
- Fraunhofer Institute for Translational Medicine and Pharmacology, Frankfurt, Germany
- Institute of Clinical Pharmacology, Goethe University Frankfurt, Frankfurt, Germany
| | - Marcel H Schulz
- Institute for Cardiovascular Regeneration, Goethe University Frankfurt, Frankfurt, Germany
| | - Holger Storf
- Institute of Medical Informatics, Goethe University Frankfurt, Frankfurt, Germany
| | - Tuna Toptan
- Institute for Medical Virology, Faculty of Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | | | | | - Andreas Weigert
- Institute of Biochemistry I, Faculty of Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Peter J Wild
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, Frankfurt, Germany
| | - Stefan Zeuzem
- Department of Internal Medicine I, Goethe University Frankfurt, Frankfurt, Germany
| | - Cornelius Engelmann
- Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Liliana Schaefer
- nstitute of General Pharmacology and Toxicology,, Goethe University Frankfurt, Germany
| | - Christoph Welsch
- Department of Internal Medicine I, Goethe University Frankfurt, Frankfurt, Germany
| | - Jonel Trebicka
- Department of Internal Medicine B, University of Münster, Münster, Germany
- Department of Internal Medicine I, Goethe University Frankfurt, Frankfurt, Germany
- European Foundation for the Study of Chronic Liver Failure - EF Clif, Barcelona, Spain
- Institute for Bioengineering of Catalonia, Barcelona, Spain
- Department of Medical Gastroenterology and Hepatology, University of Southern Denmark, Odense, Denmark
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15
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Kelch MA, Vera-Guapi A, Beder T, Oswald M, Hiemisch A, Beil N, Wajda P, Ciesek S, Erfle H, Toptan T, Koenig R. Machine learning on large scale perturbation screens for SARS-CoV-2 host factors identifies β-catenin/CBP inhibitor PRI-724 as a potent antiviral. Front Microbiol 2023; 14:1193320. [PMID: 37342561 PMCID: PMC10277617 DOI: 10.3389/fmicb.2023.1193320] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/16/2023] [Indexed: 06/23/2023] Open
Abstract
Expanding antiviral treatment options against SARS-CoV-2 remains crucial as the virus evolves under selection pressure which already led to the emergence of several drug resistant strains. Broad spectrum host-directed antivirals (HDA) are promising therapeutic options, however the robust identification of relevant host factors by CRISPR/Cas9 or RNA interference screens remains challenging due to low consistency in the resulting hits. To address this issue, we employed machine learning, based on experimental data from several knockout screens and a drug screen. We trained classifiers using genes essential for virus life cycle obtained from the knockout screens. The machines based their predictions on features describing cellular localization, protein domains, annotated gene sets from Gene Ontology, gene and protein sequences, and experimental data from proteomics, phospho-proteomics, protein interaction and transcriptomic profiles of SARS-CoV-2 infected cells. The models reached a remarkable performance suggesting patterns of intrinsic data consistency. The predicted HDF were enriched in sets of genes particularly encoding development, morphogenesis, and neural processes. Focusing on development and morphogenesis-associated gene sets, we found β-catenin to be central and selected PRI-724, a canonical β-catenin/CBP disruptor, as a potential HDA. PRI-724 limited infection with SARS-CoV-2 variants, SARS-CoV-1, MERS-CoV and IAV in different cell line models. We detected a concentration-dependent reduction in cytopathic effects, viral RNA replication, and infectious virus production in SARS-CoV-2 and SARS-CoV-1-infected cells. Independent of virus infection, PRI-724 treatment caused cell cycle deregulation which substantiates its potential as a broad spectrum antiviral. Our proposed machine learning concept supports focusing and accelerating the discovery of host dependency factors and identification of potential host-directed antivirals.
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Affiliation(s)
- Maximilian A. Kelch
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | | | - Thomas Beder
- Medical Department II, Hematology and Oncology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Marcus Oswald
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
| | - Alicia Hiemisch
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
| | - Nina Beil
- Advanced Biological Screening Facility (ABSF), High-Content Analysis of the Cell (HiCell), BioQuant, Heidelberg University, Heidelberg, Germany
| | - Piotr Wajda
- Advanced Biological Screening Facility (ABSF), High-Content Analysis of the Cell (HiCell), BioQuant, Heidelberg University, Heidelberg, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
- German Centre for Infection Research (DZIF), External Partner Site Frankfurt, Frankfurt, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt, Germany
| | - Holger Erfle
- Advanced Biological Screening Facility (ABSF), High-Content Analysis of the Cell (HiCell), BioQuant, Heidelberg University, Heidelberg, Germany
| | - Tuna Toptan
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Rainer Koenig
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
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16
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Marcinkevics R, Silva PN, Hankele AK, Dörnte C, Kadelka S, Csik K, Godbersen S, Goga A, Hasenöhrl L, Hirschi P, Kabakci H, LaPierre MP, Mayrhofer J, Title AC, Shu X, Baiioud N, Bernal S, Dassisti L, Saenz-de-Juano MD, Schmidhauser M, Silvestrelli G, Ulbrich SZ, Ulbrich TJ, Wyss T, Stekhoven DJ, Al-Quaddoomi FS, Yu S, Binder M, Schultheiβ C, Zindel C, Kolling C, Goldhahn J, Seighalani BK, Zjablovskaja P, Hardung F, Schuster M, Richter A, Huang YJ, Lauer G, Baurmann H, Low JS, Vaqueirinho D, Jovic S, Piccoli L, Ciesek S, Vogt JE, Sallusto F, Stoffel M, Ulbrich SE. Machine learning analysis of humoral and cellular responses to SARS-CoV-2 infection in young adults. Front Immunol 2023; 14:1158905. [PMID: 37313411 PMCID: PMC10258347 DOI: 10.3389/fimmu.2023.1158905] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 05/09/2023] [Indexed: 06/15/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces B and T cell responses, contributing to virus neutralization. In a cohort of 2,911 young adults, we identified 65 individuals who had an asymptomatic or mildly symptomatic SARS-CoV-2 infection and characterized their humoral and T cell responses to the Spike (S), Nucleocapsid (N) and Membrane (M) proteins. We found that previous infection induced CD4 T cells that vigorously responded to pools of peptides derived from the S and N proteins. By using statistical and machine learning models, we observed that the T cell response highly correlated with a compound titer of antibodies against the Receptor Binding Domain (RBD), S and N. However, while serum antibodies decayed over time, the cellular phenotype of these individuals remained stable over four months. Our computational analysis demonstrates that in young adults, asymptomatic and paucisymptomatic SARS-CoV-2 infections can induce robust and long-lasting CD4 T cell responses that exhibit slower decays than antibody titers. These observations imply that next-generation COVID-19 vaccines should be designed to induce stronger cellular responses to sustain the generation of potent neutralizing antibodies.
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Affiliation(s)
| | | | | | - Charlyn Dörnte
- Miltenyi Biotec B.V. & Co. KG, Bergisch Gladbach, Germany
| | - Sarah Kadelka
- Institute of Integrative Biology, ETH Zurich, Zurich, Switzerland
| | - Katharina Csik
- Institute of Molecular Health Sciences, ETH Zurich, Zurich, Switzerland
| | - Svenja Godbersen
- Institute of Molecular Health Sciences, ETH Zurich, Zurich, Switzerland
| | - Algera Goga
- Institute of Molecular Health Sciences, ETH Zurich, Zurich, Switzerland
| | - Lynn Hasenöhrl
- Institute of Molecular Health Sciences, ETH Zurich, Zurich, Switzerland
| | - Pascale Hirschi
- Institute of Molecular Health Sciences, ETH Zurich, Zurich, Switzerland
| | - Hasan Kabakci
- Institute of Molecular Health Sciences, ETH Zurich, Zurich, Switzerland
| | - Mary P. LaPierre
- Institute of Molecular Health Sciences, ETH Zurich, Zurich, Switzerland
| | - Johanna Mayrhofer
- Institute of Molecular Health Sciences, ETH Zurich, Zurich, Switzerland
| | | | - Xuan Shu
- Institute of Molecular Health Sciences, ETH Zurich, Zurich, Switzerland
| | - Nouell Baiioud
- Animal Physiology, Institute of Agricultural Sciences, ETH Zurich, Zurich, Switzerland
| | - Sandra Bernal
- Animal Physiology, Institute of Agricultural Sciences, ETH Zurich, Zurich, Switzerland
| | - Laura Dassisti
- Animal Physiology, Institute of Agricultural Sciences, ETH Zurich, Zurich, Switzerland
| | | | - Meret Schmidhauser
- Animal Physiology, Institute of Agricultural Sciences, ETH Zurich, Zurich, Switzerland
| | - Giulia Silvestrelli
- Animal Physiology, Institute of Agricultural Sciences, ETH Zurich, Zurich, Switzerland
| | - Simon Z. Ulbrich
- Animal Physiology, Institute of Agricultural Sciences, ETH Zurich, Zurich, Switzerland
| | - Thea J. Ulbrich
- Animal Physiology, Institute of Agricultural Sciences, ETH Zurich, Zurich, Switzerland
| | - Tamara Wyss
- Animal Physiology, Institute of Agricultural Sciences, ETH Zurich, Zurich, Switzerland
| | - Daniel J. Stekhoven
- NEXUS Personalized Health Technologies, Zurich & SIB Swiss Institute of Bioinformatics, ETH Zurich, Lausanne, Switzerland
| | - Faisal S. Al-Quaddoomi
- NEXUS Personalized Health Technologies, Zurich & SIB Swiss Institute of Bioinformatics, ETH Zurich, Lausanne, Switzerland
| | - Shuqing Yu
- NEXUS Personalized Health Technologies, Zurich & SIB Swiss Institute of Bioinformatics, ETH Zurich, Lausanne, Switzerland
| | - Mascha Binder
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Christoph Schultheiβ
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Claudia Zindel
- Department of Health Science, Translational Medicine, ETH Zurich, Zurich, Switzerland
| | - Christoph Kolling
- Department of Health Science, Translational Medicine, ETH Zurich, Zurich, Switzerland
| | - Jörg Goldhahn
- Department of Health Science, Translational Medicine, ETH Zurich, Zurich, Switzerland
| | | | | | - Frank Hardung
- Miltenyi Biotec B.V. & Co. KG, Bergisch Gladbach, Germany
| | - Marc Schuster
- Miltenyi Biotec B.V. & Co. KG, Bergisch Gladbach, Germany
| | - Anne Richter
- Miltenyi Biotec B.V. & Co. KG, Bergisch Gladbach, Germany
| | - Yi-Ju Huang
- Miltenyi Biotec B.V. & Co. KG, Bergisch Gladbach, Germany
| | - Gereon Lauer
- Miltenyi Biotec B.V. & Co. KG, Bergisch Gladbach, Germany
| | | | - Jun Siong Low
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Bellinzona, Switzerland
| | - Daniela Vaqueirinho
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Bellinzona, Switzerland
| | - Sandra Jovic
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Bellinzona, Switzerland
| | - Luca Piccoli
- Humabs BioMed SA, a Subsidiary of Vir Biotechnology, Bellinzona, Switzerland
| | - Sandra Ciesek
- Institute of Medical Virology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Julia E. Vogt
- Department of Computer Science, ETH Zurich, Zurich, Switzerland
| | - Federica Sallusto
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Bellinzona, Switzerland
- Medical Immunology, Institute of Microbiology, ETH Zurich, Zurich, Switzerland
| | - Markus Stoffel
- Institute of Molecular Health Sciences, ETH Zurich, Zurich, Switzerland
- University Hospital Zurich, Zurich, Switzerland
| | - Susanne E. Ulbrich
- Animal Physiology, Institute of Agricultural Sciences, ETH Zurich, Zurich, Switzerland
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17
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Roesmann F, Jakobsche I, Pallas C, Wilhelm A, Raffel J, Kohmer N, Toptan T, Berger A, Goetsch U, Ciesek S, Widera M. Comparison of the Ct-values for genomic and subgenomic SARS-CoV-2 RNA reveals limited predictive value for the presence of replication competent virus. J Clin Virol 2023; 165:105499. [PMID: 37327554 DOI: 10.1016/j.jcv.2023.105499] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 02/16/2023] [Revised: 05/23/2023] [Accepted: 05/28/2023] [Indexed: 06/18/2023]
Abstract
SARS-CoV-2 is the causative agent of the acute respiratory disease COVID-19. In addition to the full length positive-sensed, single-stranded genomic RNA (gRNA), viral subgenomic RNAs (sgRNAs) that are required for expression of the 3' region of the genome are synthesized in virus-infected cells. However, whether these sgRNA-species might be used as a measure of active virus replication and to predict infectivity is still under debate. The commonly used methods to monitor and quantitate SARS-CoV-2 infections are based on RT-qPCR analysis and the detection of gRNA. The infectivity of a sample obtained from nasopharyngeal or throat swabs is associated with the viral load and inversely correlates with Ct-values, however, a cut-off value predicting the infectivity highly depends on the performance of the assay. Furthermore, gRNA derived Ct-values result from nucleic acid detection and do not necessarily correspond to active replicating virus. We established a multiplex RT-qPCR assay on the cobas 6800 omni utility channel concomitantly detecting SARS-CoV-2 gRNAOrf1a/b, sgRNAE,7a,N, and human RNaseP-mRNA used as human input control. We compared the target specific Ct-values with the viral culture frequency and performed ROC curve analysis to determine the assay sensitivity and specificity. We found no advantage in the prediction of viral culture when using sgRNA detection compared to gRNA only, since Ct-values for gRNA and sgRNA were highly correlated and gRNA offered a slightly more reliable predictive value. Single Ct-values alone only provide a very limited prediction for the presence of replication competent virus. Hence, careful consideration of the medical history including symptom onset has to be considered for risk stratification.
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Affiliation(s)
- Fabian Roesmann
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Sandhofstr. 2-4, House 75, Room 1.207, Frankfurt am Main 60528, Germany
| | - Irene Jakobsche
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Sandhofstr. 2-4, House 75, Room 1.207, Frankfurt am Main 60528, Germany
| | - Christiane Pallas
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Sandhofstr. 2-4, House 75, Room 1.207, Frankfurt am Main 60528, Germany
| | - Alexander Wilhelm
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Sandhofstr. 2-4, House 75, Room 1.207, Frankfurt am Main 60528, Germany
| | - Johanna Raffel
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Sandhofstr. 2-4, House 75, Room 1.207, Frankfurt am Main 60528, Germany
| | - Niko Kohmer
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Sandhofstr. 2-4, House 75, Room 1.207, Frankfurt am Main 60528, Germany
| | - Tuna Toptan
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Sandhofstr. 2-4, House 75, Room 1.207, Frankfurt am Main 60528, Germany
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Sandhofstr. 2-4, House 75, Room 1.207, Frankfurt am Main 60528, Germany
| | - Udo Goetsch
- Health Protection Authority, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Sandhofstr. 2-4, House 75, Room 1.207, Frankfurt am Main 60528, Germany; German Center for Infection Research, DZIF, Braunschweig, Germany; Branch Translational Medicine and Pharmacology, Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Frankfurt am Main, Germany
| | - Marek Widera
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Sandhofstr. 2-4, House 75, Room 1.207, Frankfurt am Main 60528, Germany.
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18
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Pather S, Madhi SA, Cowling BJ, Moss P, Kamil JP, Ciesek S, Muik A, Türeci Ö. SARS-CoV-2 Omicron variants: burden of disease, impact on vaccine effectiveness and need for variant-adapted vaccines. Front Immunol 2023; 14:1130539. [PMID: 37287979 PMCID: PMC10242031 DOI: 10.3389/fimmu.2023.1130539] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/05/2023] [Indexed: 06/09/2023] Open
Abstract
The highly transmissible Omicron (B.1.1.529) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first detected in late 2021. Initial Omicron waves were primarily made up of sub-lineages BA.1 and/or BA.2, BA.4, and BA.5 subsequently became dominant in mid-2022, and several descendants of these sub-lineages have since emerged. Omicron infections have generally caused less severe disease on average than those caused by earlier variants of concern in healthy adult populations, at least, in part, due to increased population immunity. Nevertheless, healthcare systems in many countries, particularly those with low population immunity, have been overwhelmed by unprecedented surges in disease prevalence during Omicron waves. Pediatric admissions were also higher during Omicron waves compared with waves of previous variants of concern. All Omicron sub-lineages exhibit partial escape from wild-type (Wuhan-Hu 1) spike-based vaccine-elicited neutralizing antibodies, with sub-lineages with more enhanced immuno-evasive properties emerging over time. Evaluating vaccine effectiveness (VE) against Omicron sub-lineages has become challenging against a complex background of varying vaccine coverage, vaccine platforms, prior infection rates, and hybrid immunity. Original messenger RNA vaccine booster doses substantially improved VE against BA.1 or BA.2 symptomatic disease. However, protection against symptomatic disease waned, with reductions detected from 2 months after booster administration. While original vaccine-elicited CD8+ and CD4+ T-cell responses cross-recognize Omicron sub-lineages, thereby retaining protection against severe outcomes, variant-adapted vaccines are required to expand the breadth of B-cell responses and improve durability of protection. Variant-adapted vaccines were rolled out in late 2022 to increase overall protection against symptomatic and severe infections caused by Omicron sub-lineages and antigenically aligned variants with enhanced immune escape mechanisms.
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Affiliation(s)
| | - Shabir A. Madhi
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Benjamin J. Cowling
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
| | - Jeremy P. Kamil
- Department of Microbiology and Immunology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, United States
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
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19
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Salzberger B, Mellmann A, Bludau A, Ciesek S, Corman V, Dilthey A, Donker T, Eckmanns T, Egelkamp R, Gatermann SG, Grundmann H, Häcker G, Kaase M, Lange B, Mielke M, Pletz MW, Semmler T, Thürmer A, Wieler LH, Wolff T, Widmer AF, Scheithauer S. An appeal for strengthening genomic pathogen surveillance to improve pandemic preparedness and infection prevention: the German perspective. Infection 2023:10.1007/s15010-023-02040-9. [PMID: 37129842 PMCID: PMC10152431 DOI: 10.1007/s15010-023-02040-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/13/2023] [Indexed: 05/03/2023]
Abstract
The SARS-CoV-2 pandemic has highlighted the importance of viable infection surveillance and the relevant infrastructure. From a German perspective, an integral part of this infrastructure, genomic pathogen sequencing, was at best fragmentary and stretched to its limits due to the lack or inefficient use of equipment, human resources, data management and coordination. The experience in other countries has shown that the rate of sequenced positive samples and linkage of genomic and epidemiological data (person, place, time) represent important factors for a successful application of genomic pathogen surveillance. Planning, establishing and consistently supporting adequate structures for genomic pathogen surveillance will be crucial to identify and combat future pandemics as well as other challenges in infectious diseases such as multi-drug resistant bacteria and healthcare-associated infections. Therefore, the authors propose a multifaceted and coordinated process for the definition of procedural, legal and technical standards for comprehensive genomic pathogen surveillance in Germany, covering the areas of genomic sequencing, data collection and data linkage, as well as target pathogens. A comparative analysis of the structures established in Germany and in other countries is applied. This proposal aims to better tackle epi- and pandemics to come and take action from the "lessons learned" from the SARS-CoV-2 pandemic.
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Affiliation(s)
- Bernd Salzberger
- Department for Infection Control and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - Alexander Mellmann
- Institute for Hygiene, University Hospital Münster, Robert-Koch-Straße 41, 48149, Münster, Germany.
| | - Anna Bludau
- Department for Infection Control and Infectious Diseases, University Medical Center (UMG), Georg-August University Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Sandra Ciesek
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
| | - Victor Corman
- Institute of Virology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Alexander Dilthey
- Institute of Medical Microbiology and Hospital Hygiene, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Tjibbe Donker
- Institute for Infection Prevention and Hospital Epidemiology, University Medical Center Freiburg, Freiburg, Germany
| | | | - Richard Egelkamp
- Next Generation Sequencing, Public Health Agency of Lower Saxony, Hanover, Germany
| | - Sören G Gatermann
- Department of Medical Microbiology, Ruhr University Bochum, Bochum, Germany
| | - Hajo Grundmann
- Institute for Infection Prevention and Hospital Epidemiology, University Medical Center Freiburg, Freiburg, Germany
| | - Georg Häcker
- Faculty of Medicine, Institute of Medical Microbiology and Hygiene, Medical Centre University of Freiburg, Freiburg, Germany
| | - Martin Kaase
- Department for Infection Control and Infectious Diseases, University Medical Center (UMG), Georg-August University Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Berit Lange
- Department of Epidemiology, Helmholtz Centre for Infection Research, Brunswick, Germany
| | | | - Mathias W Pletz
- Institute of Infectious Diseases and Infection Control, University Hospital, Jena, Germany
| | | | | | | | | | - Andreas F Widmer
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Simone Scheithauer
- Department for Infection Control and Infectious Diseases, University Medical Center (UMG), Georg-August University Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
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20
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Graf C, Wagener I, Grikscheit K, Hoehl S, Berger A, Wetzstein N, Dietz J, Dultz G, Michael F, Filmann N, Herrmann E, Tinnemann P, Goetsch U, Ciesek S. Is Olfactory Testing a Useful Diagnostic Tool to Identify SARS-CoV-2 Infections Early? A Cross-Sectional and Longitudinal Analysis. J Clin Med 2023; 12:jcm12093162. [PMID: 37176604 PMCID: PMC10179328 DOI: 10.3390/jcm12093162] [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: 01/19/2023] [Revised: 03/16/2023] [Accepted: 03/23/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Genesis and the prognostic value of olfactory dysfunction (OD) in COVID-19 remain partially described. The objective of our study was to characterize OD during SARS-CoV-2 infection and to examine whether testing of OD may be a useful tool in clinical practice in order to early identify patients with SARS-CoV-2 infection. METHODS Olfactory function assessment was objectively carried out using the u-Smell-it® test. In a cross-sectional study part, we evaluated this test in a control cohort of SARS-CoV-2 negative tested patients, who attended the University Hospital Frankfurt between May 2021 and March 2022. In a second longitudinal study part, sensitivity and specificity of OD was evaluated as a diagnostic marker of a SARS-CoV-2 infection in Frankfurt am Main, Germany in SARS-CoV-2 infected patients and their close contacts. RESULTS Among 494 SARS-CoV-2 negative tested patients, OD was detected in 45.7% and was found to be significantly associated with the male gender (p < 0.001), higher age (p < 0.001), cardiovascular and pulmonary comorbidities (p < 0.001; p = 0.03). Among 90 COVID-19 positive patients, OD was found in 65.6% and was significantly associated with male gender and positive smoking status (p = 0.04 each). Prevalence and severity of OD were significantly increased in infections with the Delta variant (B.1.617.2) compared to those with the Omicron variant (BA.1.1.529). Diagnostic sensitivity and specificity of OD for diagnosis of SARS-CoV-2 infection were 69% and 64%, respectively. CONCLUSION OD is common in COVID-19 negative and positive tested patients with significantly different prevalence rates observed between different variants. Diagnostic accuracy of OD is not high enough to implement olfactory testing as a tool in diagnostic routine to early identify patients with a SARS-CoV-2 infection.
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Affiliation(s)
- Christiana Graf
- Institute of Medical Virology, University Hospital Frankfurt, 60306 Frankfurt am Main, Germany
- Department of Internal Medicine I, University Hospital Frankfurt, 60306 Frankfurt am Main, Germany
| | - Inken Wagener
- Institute of Medical Virology, University Hospital Frankfurt, 60306 Frankfurt am Main, Germany
| | - Katharina Grikscheit
- Institute of Medical Virology, University Hospital Frankfurt, 60306 Frankfurt am Main, Germany
| | - Sebastian Hoehl
- Institute of Medical Virology, University Hospital Frankfurt, 60306 Frankfurt am Main, Germany
| | - Annemarie Berger
- Institute of Medical Virology, University Hospital Frankfurt, 60306 Frankfurt am Main, Germany
| | - Nils Wetzstein
- Department of Internal Medicine II, Infectious Diseases, University Hospital Frankfurt, 60306 Frankfurt am Main, Germany
| | - Julia Dietz
- Department of Internal Medicine I, University Hospital Frankfurt, 60306 Frankfurt am Main, Germany
| | - Georg Dultz
- Department of Internal Medicine I, University Hospital Frankfurt, 60306 Frankfurt am Main, Germany
| | - Florian Michael
- Department of Internal Medicine I, University Hospital Frankfurt, 60306 Frankfurt am Main, Germany
| | - Natalie Filmann
- Institute of Biostatistics and Mathematical Modeling, Goethe University, 60323 Frankfurt am Main, Germany
| | - Eva Herrmann
- Institute of Biostatistics and Mathematical Modeling, Goethe University, 60323 Frankfurt am Main, Germany
| | - Peter Tinnemann
- Public Health Department of the City of Frankfurt am Main, 60306 Frankfurt am Main, Germany
| | - Udo Goetsch
- Public Health Department of the City of Frankfurt am Main, 60306 Frankfurt am Main, Germany
| | - Sandra Ciesek
- Institute of Medical Virology, University Hospital Frankfurt, 60306 Frankfurt am Main, Germany
- German Centre for Infection Research, Deutsches Zentrum für Infektionsforschung, External Partner Site Frankfurt, 60306 Frankfurt am Main, Germany
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21
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Kohmer N, Rabenau HF, Rilling V, Ciesek S, Enders M, Eggers M. Polio type 2 and 3 eradication: Relevance to the immunity status of individuals living in Germany, 2005-2020. J Clin Virol 2023; 164:105471. [PMID: 37130476 DOI: 10.1016/j.jcv.2023.105471] [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: 12/30/2022] [Revised: 03/28/2023] [Accepted: 04/24/2023] [Indexed: 05/04/2023]
Abstract
Since October 2019, poliovirus type 3 (PV3) has been certified as globally eradicated, and further laboratory use of PV3 will be restricted according to the WHO Polio Eradication Initiative and containment measures. To examine a possible gap in PV3 immunity and a lack of immunity against poliovirus type 2 (PV2), which was already declared as eradicated in 2015, neutralising antibodies against polioviruses (PV) of individuals living in Germany (n = 91,530 samples; mainly outpatients (≈90%) who received immune status testing) were investigated from 2005 to 2020 (age distribution: <18 years 15.8%, 18-64 years 71.2% and ≥65 years 9.5% for 2005-2015; <18 years 19.6%, 18-64 years 67% and ≥65 years 11.5% for 2016-2020). The results showed that the proportion of sera exclusively lacking antibodies against PV3 was 10.6% in 2005-2015 and 9.6% in 2016-2020 and against PV2 2.8% in 2005-2015. As there is decreased protection against PV3 and to detect potential antigenically (immune escape) variant PVs not covered by used vaccines, we recommend continued testing of PV1 and PV3.
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Affiliation(s)
- Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, 60596, Frankfurt, Germany.
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, 60596, Frankfurt, Germany
| | - Veronika Rilling
- Laboratory Prof. Gisela Enders MVZ GbR, 70193, Stuttgart, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, 60596, Frankfurt, Germany; German Centre for Infection Research, External Partner Site, 60323, Frankfurt, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), 60596, Frankfurt, Germany
| | - Martin Enders
- Laboratory Prof. Gisela Enders MVZ GbR, 70193, Stuttgart, Germany
| | - Maren Eggers
- Laboratory Prof. Gisela Enders MVZ GbR, 70193, Stuttgart, Germany
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22
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Offergeld R, Preußel K, Zeiler T, Aurich K, Baumann-Baretti BI, Ciesek S, Corman VM, Dienst V, Drosten C, Görg S, Greinacher A, Grossegesse M, Haller S, Heuft HG, Hofmann N, Horn PA, Houareau C, Gülec I, Jiménez Klingberg CL, Juhl D, Lindemann M, Martin S, Neuhauser HK, Nitsche A, Ohme J, Peine S, Sachs UJ, Schaade L, Schäfer R, Scheiblauer H, Schlaud M, Schmidt M, Umhau M, Vollmer T, Wagner FF, Wieler LH, Wilking H, Ziemann M, Zimmermann M, der Heiden MA. Monitoring the SARS-CoV-2 Pandemic: Prevalence of Antibodies in a Large, Repetitive Cross-Sectional Study of Blood Donors in Germany—Results from the SeBluCo Study 2020–2022. Pathogens 2023; 12:pathogens12040551. [PMID: 37111436 PMCID: PMC10144823 DOI: 10.3390/pathogens12040551] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/17/2023] [Accepted: 03/27/2023] [Indexed: 04/05/2023] Open
Abstract
SARS-CoV-2 serosurveillance is important to adapt infection control measures and estimate the degree of underreporting. Blood donor samples can be used as a proxy for the healthy adult population. In a repeated cross-sectional study from April 2020 to April 2021, September 2021, and April/May 2022, 13 blood establishments collected 134,510 anonymised specimens from blood donors in 28 study regions across Germany. These were tested for antibodies against the SARS-CoV-2 spike protein and nucleocapsid, including neutralising capacity. Seroprevalence was adjusted for test performance and sampling and weighted for demographic differences between the sample and the general population. Seroprevalence estimates were compared to notified COVID-19 cases. The overall adjusted SARS-CoV-2 seroprevalence remained below 2% until December 2020 and increased to 18.1% in April 2021, 89.4% in September 2021, and to 100% in April/May 2022. Neutralising capacity was found in 74% of all positive specimens until April 2021 and in 98% in April/May 2022. Our serosurveillance allowed for repeated estimations of underreporting from the early stage of the pandemic onwards. Underreporting ranged between factors 5.1 and 1.1 in the first two waves of the pandemic and remained well below 2 afterwards, indicating an adequate test strategy and notification system in Germany.
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Affiliation(s)
- Ruth Offergeld
- Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Karina Preußel
- Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Thomas Zeiler
- German Red Cross Blood Service West, 58097 Hagen, Germany
| | - Konstanze Aurich
- Institute for Immunology and Transfusion Medicine, University Medicine Greifswald, Sauerbruchstrasse, 17475 Greifswald, Germany
| | | | - Sandra Ciesek
- Institute for Medical Virology, German Centre for Infection Research, External Partner Site Frankfurt, University Hospital, Goethe University Frankfurt am Main, 39120 Frankfurt am Main, Germany
| | - Victor M. Corman
- Institute of Virology, German National Reference Laboratory for Coronavirus, Charité—University Medicine Berlin, 10117 Berlin, Germany
| | | | - Christian Drosten
- Institute of Virology, German National Reference Laboratory for Coronavirus, Charité—University Medicine Berlin, 10117 Berlin, Germany
| | - Siegfried Görg
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Andreas Greinacher
- Institute for Immunology and Transfusion Medicine, University Medicine Greifswald, Sauerbruchstrasse, 17475 Greifswald, Germany
| | | | | | - Hans-Gert Heuft
- Institute of Transfusion Medicine and Immunohaematology/Blood Bank, University Hospital Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany
| | | | - Peter A. Horn
- Institute for Transfusion Medicine, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
| | | | - Ilay Gülec
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Transfusion Service Baden-Württemberg—Hessen, Sandhofstraße 1, 60528 Frankfurt am Main, Germany
| | | | - David Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Silke Martin
- Bavarian Red Cross Blood Service, Herzog-Heinrich-Str. 2, 80336 München, Germany
| | | | | | - Julia Ohme
- German Red Cross Blood Service NSTOB, Eldagsener Straße 38, 31832 Springe, Germany
| | - Sven Peine
- Institute of Transfusion Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Ulrich J. Sachs
- Center for Transfusion Medicine and Haemotherapy, University Hospital Giessen and Marburg, Langhansstr. 7, 35392 Giessen, Germany
| | - Lars Schaade
- Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Richard Schäfer
- Institute for Transfusion Medicine and Gene Therapy, Faculty of Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | | | - Martin Schlaud
- Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Michael Schmidt
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Transfusion Service Baden-Württemberg—Hessen, Sandhofstraße 1, 60528 Frankfurt am Main, Germany
| | - Markus Umhau
- Institute for Transfusion Medicine and Gene Therapy, Faculty of Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Tanja Vollmer
- Heart and Diabetes Centre NRW, Institute for Laboratory and Transfusion Medicine, Ruhr-University Bochum, 32545 Bad Oeynhausen, Germany
| | - Franz F. Wagner
- German Red Cross Blood Service NSTOB, Eldagsener Straße 38, 31832 Springe, Germany
| | | | | | - Malte Ziemann
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Ratzeburger Allee 160, 23538 Lübeck, Germany
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23
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Bojkova D, Bechtel M, Rothenburger T, Kandler JD, Hayes L, Olmer R, Martin U, Jonigk D, Ciesek S, Wass MN, Michaelis M, Cinatl J. Omicron-induced interferon signalling prevents influenza A H1N1 and H5N1 virus infection. J Med Virol 2023; 95:e28686. [PMID: 36938992 DOI: 10.1002/jmv.28686] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 09/26/2022] [Revised: 03/01/2023] [Accepted: 03/16/2023] [Indexed: 03/21/2023]
Abstract
Recent findings in permanent cell lines suggested that SARS-CoV-2 Omicron BA.1 induces a stronger interferon response than Delta. Here, we show that BA.1 and BA.5 but not Delta induce an antiviral state in air-liquid interface (ALI) cultures of primary human bronchial epithelial (HBE) cells and primary human monocytes. Both Omicron subvariants caused the production of biologically active type I (α/β) and III (λ) interferons and protected cells from super-infection with influenza A viruses. Notably, abortive Omicron infection of monocytes was sufficient to protect monocytes from influenza A virus infection. Interestingly, while influenza-like illnesses surged during the Delta wave in England, their spread rapidly declined upon the emergence of Omicron. Mechanistically, Omicron-induced interferon signalling was mediated via double-stranded RNA recognition by MDA5, as MDA5 knock-out prevented it. The JAK/STAT inhibitor baricitinib inhibited the Omicron-mediated antiviral response, suggesting it is caused by MDA5-mediated interferon production, which activates interferon receptors that then trigger JAK/STAT signalling. In conclusion, our study 1) demonstrates that only Omicron but not Delta induces a substantial interferon response in physiologically relevant models, 2) shows that Omicron infection protects cells from influenza A virus super-infection, and 3) indicates that BA.1 and BA.5 induce comparable antiviral states. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Denisa Bojkova
- Institute for Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Marco Bechtel
- Institute for Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Tamara Rothenburger
- Institute for Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Joshua D Kandler
- Institute for Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Lauren Hayes
- School of Biosciences, University of Kent, Canterbury, CT2 7NJ, UK
| | - Ruth Olmer
- Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), Department of Cardiothoracic, Transplantation and Vascular Surgery (HTTG), REBIRTH-Research Center for Translational Regenerative Medicine, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Ulrich Martin
- Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), Department of Cardiothoracic, Transplantation and Vascular Surgery (HTTG), REBIRTH-Research Center for Translational Regenerative Medicine, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Danny Jonigk
- Institute of Pathology, Hannover Medical School (MHH), Carl-Neuberg-Straße, 1 30625, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), The German Center for Lung Research (Deutsches Zentrum für Lungenforschung, DZL), Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany.,German Center for Infection Research, DZIF, External partner site, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.,Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine und Pharmacology, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Mark N Wass
- School of Biosciences, University of Kent, Canterbury, CT2 7NJ, UK
| | - Martin Michaelis
- School of Biosciences, University of Kent, Canterbury, CT2 7NJ, UK
| | - Jindrich Cinatl
- Institute for Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany.,Dr. Petra Joh-Forschungshaus, Komturstr. 3A, 60528, Frankfurt am Main, Germany
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24
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Bojkova D, Zöller N, Tietgen M, Steinhorst K, Bechtel M, Rothenburger T, Kandler JD, Schneider J, Corman VM, Ciesek S, Rabenau HF, Wass MN, Kippenberger S, Göttig S, Michaelis M, Cinatl J. Repurposing of the antibiotic nitroxoline for the treatment of mpox. J Med Virol 2023; 95:e28652. [PMID: 36897017 DOI: 10.1002/jmv.28652] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023]
Abstract
The antiviral drugs tecovirimat, brincidofovir, and cidofovir are considered for mpox (monkeypox) treatment despite a lack of clinical evidence. Moreover, their use is affected by toxic side-effects (brincidofovir, cidofovir), limited availability (tecovirimat), and potentially by resistance formation. Hence, additional, readily available drugs are needed. Here, therapeutic concentrations of nitroxoline, a hydroxyquinoline antibiotic with a favourable safety profile in humans, inhibited the replication of 12 mpox virus isolates from the current outbreak in primary cultures of human keratinocytes and fibroblasts and a skin explant model by interference with host cell signalling. Tecovirimat, but not nitroxoline, treatment resulted in rapid resistance development. Nitroxoline remained effective against the tecovirimat-resistant strain and increased the anti-mpox virus activity of tecovirimat and brincidofovir. Moreover, nitroxoline inhibited bacterial and viral pathogens that are often co-transmitted with mpox. In conclusion, nitroxoline is a repurposing candidate for the treatment of mpox due to both antiviral and antimicrobial activity. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Denisa Bojkova
- Institute of Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Nadja Zöller
- Department of Dermatology, Venereology and Allergology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Manuela Tietgen
- Institute for Medical Microbiology and Infection Control, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Katja Steinhorst
- Department of Dermatology, Venereology and Allergology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Marco Bechtel
- Institute of Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Tamara Rothenburger
- Institute of Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Joshua D Kandler
- Institute of Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Julia Schneider
- Institute of Virology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,German Center for Infection Research (DZIF), Berlin, Germany
| | - Victor M Corman
- Institute of Virology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,German Center for Infection Research (DZIF), Berlin, Germany
| | - Sandra Ciesek
- Institute of Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany.,German Center for Infection Research, DZIF, External partner site, Frankfurt am Main, Germany.,Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
| | - Holger F Rabenau
- Institute of Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Mark N Wass
- School of Biosciences, University of Kent, Canterbury, UK
| | - Stefan Kippenberger
- Department of Dermatology, Venereology and Allergology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Stephan Göttig
- Institute for Medical Microbiology and Infection Control, University Hospital, Goethe University, Frankfurt am Main, Germany
| | | | - Jindrich Cinatl
- Institute of Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany.,Dr. Petra Joh-Forschungshaus, Frankfurt am Main, Germany
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25
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Doijen J, Temmerman K, Van den Eynde C, Diels A, Van den Broeck N, Van Gool M, Heo I, Jaensch S, Zwaagstra M, Diosa Toro M, Chiu W, De Jonghe S, Leyssen P, Bojkova D, Ciesek S, Cinatl J, Verschueren L, Buyck C, Van Kuppeveld F, Neyts J, Van Loock M, Van Damme E. Identification of Z-Tyr-Ala-CHN 2, a Cathepsin L Inhibitor with Broad-Spectrum Cell-Specific Activity against Coronaviruses, including SARS-CoV-2. Microorganisms 2023; 11:717. [PMID: 36985290 PMCID: PMC10055926 DOI: 10.3390/microorganisms11030717] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/17/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
The ongoing COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is partly under control by vaccination. However, highly potent and safe antiviral drugs for SARS-CoV-2 are still needed to avoid development of severe COVID-19. We report the discovery of a small molecule, Z-Tyr-Ala-CHN2, which was identified in a cell-based antiviral screen. The molecule exerts sub-micromolar antiviral activity against SARS-CoV-2, SARS-CoV-1, and human coronavirus 229E. Time-of-addition studies reveal that Z-Tyr-Ala-CHN2 acts at the early phase of the infection cycle, which is in line with the observation that the molecule inhibits cathepsin L. This results in antiviral activity against SARS-CoV-2 in VeroE6, A549-hACE2, and HeLa-hACE2 cells, but not in Caco-2 cells or primary human nasal epithelial cells since the latter two cell types also permit entry via transmembrane protease serine subtype 2 (TMPRSS2). Given their cell-specific activity, cathepsin L inhibitors still need to prove their value in the clinic; nevertheless, the activity profile of Z-Tyr-Ala-CHN2 makes it an interesting tool compound for studying the biology of coronavirus entry and replication.
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Affiliation(s)
- Jordi Doijen
- Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340 Beerse, Belgium
| | - Koen Temmerman
- Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340 Beerse, Belgium
| | | | - Annick Diels
- Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340 Beerse, Belgium
| | | | | | - Inha Heo
- Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340 Beerse, Belgium
| | - Steffen Jaensch
- Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340 Beerse, Belgium
| | - Marleen Zwaagstra
- Faculty of Veterinary Medicine, Yalelaan 1, Virology Division, Department of Biomolecular Health Sciences, Infectious Diseases and Immunology, Utrecht University, 3584 Utrecht, The Netherlands
| | - Mayra Diosa Toro
- Faculty of Veterinary Medicine, Yalelaan 1, Virology Division, Department of Biomolecular Health Sciences, Infectious Diseases and Immunology, Utrecht University, 3584 Utrecht, The Netherlands
| | - Winston Chiu
- Laboratory of Virology and Chemotherapy, Herestraat 49, Rega Institute for Medical Research, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Steven De Jonghe
- Laboratory of Virology and Chemotherapy, Herestraat 49, Rega Institute for Medical Research, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Pieter Leyssen
- Laboratory of Virology and Chemotherapy, Herestraat 49, Rega Institute for Medical Research, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Denisa Bojkova
- Institute for Medical Virology, University Hospital, Paul-Ehrlich-Str. 40, Frankfurt University, 60596 Frankfurt am Main, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Paul-Ehrlich-Str. 40, Frankfurt University, 60596 Frankfurt am Main, Germany
| | - Jindrich Cinatl
- Institute for Medical Virology, University Hospital, Paul-Ehrlich-Str. 40, Frankfurt University, 60596 Frankfurt am Main, Germany
| | - Lore Verschueren
- Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340 Beerse, Belgium
| | - Christophe Buyck
- Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340 Beerse, Belgium
| | - Frank Van Kuppeveld
- Faculty of Veterinary Medicine, Yalelaan 1, Virology Division, Department of Biomolecular Health Sciences, Infectious Diseases and Immunology, Utrecht University, 3584 Utrecht, The Netherlands
| | - Johan Neyts
- Laboratory of Virology and Chemotherapy, Herestraat 49, Rega Institute for Medical Research, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Marnix Van Loock
- Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340 Beerse, Belgium
| | - Ellen Van Damme
- Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340 Beerse, Belgium
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26
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Metzler M, Tharyan RG, Klann K, Grikscheit K, Bojkova D, Cinatl J, Tascher G, Ciesek S, Münch C. SARS-CoV-2 variants show different host cell proteome profiles with delayed immune response activation in Omicron-infected cells. Mol Cell Proteomics 2023; 22:100537. [PMID: 37001587 PMCID: PMC10060015 DOI: 10.1016/j.mcpro.2023.100537] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 02/21/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023] Open
Abstract
The ancestral SARS-CoV-2 strain that initiated the Covid-19 pandemic at the end of 2019 has rapidly mutated into multiple variants of concern with variable pathogenicity and increasing immune escape strategies. However, differences in host cellular antiviral responses upon infection with SARS-CoV-2 variants remains elusive. Leveraging whole cell proteomics, we determined host signalling pathways that are differentially modulated upon infection with the clinical isolates of the ancestral SARS-CoV-2 B.1 and the variants of concern Delta and Omicron BA.1. Our findings illustrate alterations in the global host proteome landscape upon infection with SARS-CoV-2 variants and the resulting host immune responses. Additionally, viral proteome kinetics reveal declining levels of viral protein expression during Omicron BA.1 infection when compared to ancestral B.1 and Delta variants, consistent with its reduced replication rates. Moreover, molecular assays reveal deferral activation of specific host antiviral signalling upon Omicron BA.1 and BA.2 infections. Our study provides an overview of host proteome profile of multiple SARS-CoV-2 variants and brings forth a better understanding of the instigation of key immune signalling pathways causative for the differential pathogenicity of SARS-CoV-2 variants.
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Affiliation(s)
- Melinda Metzler
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Rebecca George Tharyan
- Institute of Biochemistry II, Faculty of Medicine, Goethe University, Frankfurt, Germany
| | - Kevin Klann
- Institute of Biochemistry II, Faculty of Medicine, Goethe University, Frankfurt, Germany
| | - Katharina Grikscheit
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Denisa Bojkova
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Jindrich Cinatl
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Georg Tascher
- Institute of Biochemistry II, Faculty of Medicine, Goethe University, Frankfurt, Germany
| | - Sandra Ciesek
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Frankfurt, Germany; German Center for Infection Research, DZIF, External Partner Site, Frankfurt, Germany
| | - Christian Münch
- Institute of Biochemistry II, Faculty of Medicine, Goethe University, Frankfurt, Germany; Frankfurt Cancer Institute, Goethe University, Frankfurt, Germany; Cardio-Pulmonary Institute, Goethe University, Frankfurt, Germany.
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Kohmer N, Stein S, Schenk B, Grikscheit K, Metzler M, Rabenau HF, Widera M, Herrmann E, Wicker S, Ciesek S. Heterologous prime-boost immunization with ChAdOx1-S and BNT162b2: reactogenicity and immunogenicity in a prospective cohort study. Int J Infect Dis 2023; 128:166-175. [PMID: 36587839 PMCID: PMC9800011 DOI: 10.1016/j.ijid.2022.12.034] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/21/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES Regarding reactogenicity and immunogenicity, heterologous COVID-19 vaccination regimens are considered as an alternative to conventional immunization schemes. METHODS Individuals receiving either heterologous (ChAdOx1-S [AstraZeneca, Cambridge, UK]/BNT162b2 [Pfizer-BioNTech, Mainz, Germany]; n = 306) or homologous (messenger RNA [mRNA]-1273 [Moderna, Cambridge, Massachusetts, USA]; n = 139) vaccination were asked to participate when receiving their second dose. Reactogenicity was assessed after 1 month, immunogenicity after 1, 3, and/or 6 months, including a third dose, through SARS-CoV-2 antispike immunoglobulin G, surrogate virus neutralization test, and a plaque reduction neutralization test against the Delta (B.1.167.2) and Omicron (B.1.1.529; BA.1) variants of concern. RESULTS The overall reactogenicity was lower after heterologous vaccination. In both cohorts, SARS-CoV-2 antispike immunoglobulin G concentrations waned over time with the heterologous vaccination demonstrating higher neutralizing activity than homologous mRNA vaccination after 3 months to low neutralizing levels in the Delta plaque reduction neutralization test after 6 months. At this point, 3.2% of the heterologous and 11.4% of the homologous cohort yielded low neutralizing activity against Omicron. After a third dose of an mRNA vaccine, ≥99% of vaccinees demonstrated positive neutralizing activity against Delta. Depending on the vaccination scheme and against Omicron, 60% to 87.5% of vaccinees demonstrated positive neutralizing activity. CONCLUSION ChAdOx1-S/BNT162b2 vaccination demonstrated an acceptable reactogenicity and immunogenicity profile. A third dose of an mRNA vaccine is necessary to maintain neutralizing activity against SARS-CoV-2. However, variants of concern-adapted versions of the vaccines would be desirable.
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Affiliation(s)
- Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany.
| | - Shivana Stein
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Barbara Schenk
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Katharina Grikscheit
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Melinda Metzler
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Marek Widera
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Eva Herrmann
- Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, Frankfurt, Germany
| | - Sabine Wicker
- Occupational Health Service, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany; German Centre for Infection Research, External Partner Site, Frankfurt, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology, Frankfurt, Germany.
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28
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Scheithauer S, Dilthey A, Bludau A, Ciesek S, Corman V, Donker T, Eckmanns T, Egelkamp R, Grundmann H, Häcker G, Kaase M, Lange B, Mellmann A, Mielke M, Pletz M, Salzberger B, Thürmer A, Widmer A, Wieler LH, Wolff T, Gatermann S, Semmler T. [Establishment of genomic pathogen surveillance to strengthen pandemic preparedness and infection prevention in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:443-449. [PMID: 36811648 PMCID: PMC9945818 DOI: 10.1007/s00103-023-03680-w] [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] [Indexed: 02/24/2023]
Abstract
The SARS-CoV‑2 pandemic has shown a deficit of essential epidemiological infrastructure, especially with regard to genomic pathogen surveillance in Germany. In order to prepare for future pandemics, the authors consider it urgently necessary to remedy this existing deficit by establishing an efficient infrastructure for genomic pathogen surveillance. Such a network can build on structures, processes, and interactions that have already been initiated regionally and further optimize them. It will be able to respond to current and future challenges with a high degree of adaptability.The aim of this paper is to address the urgency and to outline proposed measures for establishing an efficient, adaptable, and responsive genomic pathogen surveillance network, taking into account external framework conditions and internal standards. The proposed measures are based on global and country-specific best practices and strategy papers. Specific next steps to achieve an integrated genomic pathogen surveillance include linking epidemiological data with pathogen genomic data; sharing and coordinating existing resources; making surveillance data available to relevant decision-makers, the public health service, and the scientific community; and engaging all stakeholders. The establishment of a genomic pathogen surveillance network is essential for the continuous, stable, active surveillance of the infection situation in Germany, both during pandemic phases and beyond.
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Affiliation(s)
- Simone Scheithauer
- Institut für Krankenhaushygiene und Infektiologie, Universitätsmedizin Göttingen (UMG), Georg-August Universität Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.
| | - Alexander Dilthey
- Medizinische Mikrobiologie und Krankenhaushygiene, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - Anna Bludau
- Institut für Krankenhaushygiene und Infektiologie, Universitätsmedizin Göttingen (UMG), Georg-August Universität Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland
| | - Sandra Ciesek
- Institut für Medizinische Virologie, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland
| | - Victor Corman
- Institut für Virologie, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - Tjibbe Donker
- Institut für Infektionsprävention und Krankenhaushygiene, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | | | - Richard Egelkamp
- Next Generation Sequencing, Niedersächsisches Landesgesundheitsamt, Hannover, Deutschland
| | - Hajo Grundmann
- Institut für Infektionsprävention und Krankenhaushygiene, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - Georg Häcker
- Institut für Medizinische Mikrobiologie und Hygiene, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - Martin Kaase
- Institut für Krankenhaushygiene und Infektiologie, Universitätsmedizin Göttingen (UMG), Georg-August Universität Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland
| | - Berit Lange
- Abteilung Epidemiologie, Helmholtz-Zentrum für Infektionsforschung, Braunschweig, Deutschland
| | - Alexander Mellmann
- Institut für Hygiene, Universitätsklinikum Münster, Münster, Deutschland
| | | | - Mathias Pletz
- Institut für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Jena, Deutschland
| | - Bernd Salzberger
- Infektiologie, Abteilung für Krankenhaushygiene und Infektiologie, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | | | - Andreas Widmer
- Abteilung für Infektiologie und Spitalhygiene, Universitätsspital Basel, Basel, Schweiz
| | | | | | - Sören Gatermann
- Institut für Hygiene und Mikrobiologie, Ruhr-Universität Bochum, Bochum, Deutschland
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29
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Plenzig S, Kettner M, Berger A, Ciesek S, Verhoff MA, Rabenau HF. Respiratory viruses in medicolegal autopsies during the winter season 2021/2022: observations after reduction of coronavirus disease-19 (COVID-19) pandemic restrictions. Int J Legal Med 2023; 137:897-902. [PMID: 36807752 PMCID: PMC9937855 DOI: 10.1007/s00414-023-02974-7] [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: 08/19/2022] [Accepted: 02/08/2023] [Indexed: 02/20/2023]
Abstract
In the context of the coronavirus disease (COVID-19) pandemic, measures were taken to protect the population from infection. These were almost completely lifted in several countries in the spring of 2022. To obtain an overview of the spectrum of respiratory viruses encountered in autoptical routine case work, and their infectivity, all autopsy cases at the Institute of Legal Medicine in Frankfurt/M. with flu-like symptoms (among others) were examined for at least 16 different viruses via multiplex PCR and cell culture. Out of 24 cases, 10 were virus-positive in PCR: specifically, 8 cases with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 1 with respiratory syncytial virus (RSV), and 1 with SARS-CoV-2 and the human coronavirus OC43 (HCoV-OC43), as a double infection. The RSV infection and one of the SARS-CoV-2 infections were only detected due to the autopsy. Two SARS-CoV-2 cases (postmortem interval of 8 and 10 days, respectively) showed infectious virus in cell culture; the 6 other cases did not show infectious virus. In the RSV case, virus isolation by cell culture was unsuccessful (Ct value of 23.15 for PCR on cryoconserved lung tissue). HCoV-OC43 was measured as non-infectious in cell culture, with a Ct value of 29.57. The detection of RSV and HCoV-OC43 infections may shed light on the relevance of respiratory viruses other than SARS-CoV-2 in postmortem settings; however, further, more extensive studies are needed for a robust assessment of the hazard potential due to infectious postmortem fluids and tissues in medicolegal autopsy settings.
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Affiliation(s)
- S. Plenzig
- Institute of Legal Medicine, University Hospital Frankfurt, Goethe University, Kennedyallee 104, 60596 Frankfurt am Main, Germany
| | - M. Kettner
- Institute of Legal Medicine, University Hospital Frankfurt, Goethe University, Kennedyallee 104, 60596 Frankfurt am Main, Germany
| | - A. Berger
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Paul-Ehrlich-Straße 40, 60596 Frankfurt am Main, Germany
| | - S. Ciesek
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Paul-Ehrlich-Straße 40, 60596 Frankfurt am Main, Germany ,German Centre for Infection Research, External Partner Site 60323, Frankfurt, Germany ,Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, 60596 Frankfurt, Germany
| | - M. A. Verhoff
- Institute of Legal Medicine, University Hospital Frankfurt, Goethe University, Kennedyallee 104, 60596 Frankfurt am Main, Germany
| | - H. F. Rabenau
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Paul-Ehrlich-Straße 40, 60596 Frankfurt am Main, Germany
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30
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Bojkova D, Bechtel M, Rothenburger T, Steinhorst K, Zöller N, Kippenberger S, Schneider J, Corman VM, Uri H, Wass MN, Knecht G, Khaykin P, Wolf T, Ciesek S, Rabenau HF, Michaelis M, Cinatl J. Drug Sensitivity of Currently Circulating Mpox Viruses. N Engl J Med 2023; 388:279-281. [PMID: 36577096 DOI: 10.1056/nejmc2212136] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | - Hannah Uri
- University of Kent, Canterbury, United Kingdom
| | - Mark N Wass
- University of Kent, Canterbury, United Kingdom
| | | | | | - Timo Wolf
- University Hospital, Frankfurt am Main, Germany
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31
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Muik A, Lui BG, Bacher M, Wallisch AK, Toker A, Couto CIC, Güler A, Mampilli V, Schmitt GJ, Mottl J, Ziegenhals T, Fesser S, Reinholz J, Wernig F, Schraut KG, Hefesha H, Cai H, Yang Q, Walzer KC, Grosser J, Strauss S, Finlayson A, Krüger K, Ozhelvaci O, Grikscheit K, Kohmer N, Ciesek S, Swanson KA, Vogel AB, Türeci Ö, Sahin U. Exposure to BA.4/5 S protein drives neutralization of Omicron BA.1, BA.2, BA.2.12.1, and BA.4/5 in vaccine-experienced humans and mice. Sci Immunol 2022; 7:eade9888. [PMID: 36378074 PMCID: PMC9765452 DOI: 10.1126/sciimmunol.ade9888] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The SARS-CoV-2 Omicron variant and its sublineages show pronounced viral escape from neutralizing antibodies elicited by vaccination or prior SARS-CoV-2 variant infection owing to over 30-amino acid alterations within the spike (S) glycoprotein. Breakthrough infection of vaccinated individuals with Omicron sublineages BA.1 and BA.2 is associated with distinct patterns of cross-neutralizing activity against SARS-CoV-2 variants of concern (VOCs). In continuation of our previous work, we characterized the effect of Omicron BA.4/BA.5 S glycoprotein exposure on the neutralizing antibody response upon breakthrough infection in vaccinated individuals and upon variant-adapted booster vaccination in mice. We found that immune sera from triple mRNA-vaccinated individuals with subsequent breakthrough infection during the Omicron BA.4/BA.5 wave showed cross-neutralizing activity against previous Omicron variants BA.1, BA.2, BA.2.12.1, and BA.4/BA.5 itself. Administration of a prototypic BA.4/BA.5-adapted mRNA booster vaccine to mice after SARS-CoV-2 wild-type strain-based primary immunization is associated with broader cross-neutralizing activity than a BA.1-adapted booster. Whereas the Omicron BA.1-adapted mRNA vaccine in a bivalent format (wild-type + BA.1) broadens cross-neutralizing activity relative to the BA.1 monovalent booster, cross-neutralization of BA.2 and descendants is more effective in mice boosted with a bivalent wild-type + BA.4/BA.5 vaccine. In naïve mice, primary immunization with the bivalent wild-type + Omicron BA.4/BA.5 vaccine induces strong cross-neutralizing activity against Omicron VOCs and previous variants. These findings suggest that, when administered as boosters, mono- and bivalent Omicron BA.4/BA.5-adapted vaccines enhance neutralization breadth and that the bivalent version also has the potential to confer protection to individuals with no preexisting immunity against SARS-CoV-2.
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Affiliation(s)
| | | | - Maren Bacher
- BioNTech, An der Goldgrube 12, 55131 Mainz, Germany
| | | | - Aras Toker
- BioNTech, An der Goldgrube 12, 55131 Mainz, Germany
| | | | | | | | | | | | | | | | | | | | | | | | - Hui Cai
- Pfizer, 401 N. Middletown Rd., Pearl River, NY 10960, USA
| | - Qi Yang
- Pfizer, 401 N. Middletown Rd., Pearl River, NY 10960, USA
| | | | | | | | | | | | | | - Katharina Grikscheit
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany.,DZIF – German Centre for Infection Research, External Partner Site, 60596 Frankfurt am Main, Germany
| | | | | | - Özlem Türeci
- BioNTech, An der Goldgrube 12, 55131 Mainz, Germany.,HI-TRON – Helmholtz Institute for Translational Oncology Mainz by DKFZ, Obere Zahlbacherstr. 63, 55131 Mainz, Germany
| | - Ugur Sahin
- BioNTech, An der Goldgrube 12, 55131 Mainz, Germany.,TRON gGmbH – Translational Oncology at the University Medical Center of the Johannes Gutenberg University, Freiligrathstraße 12, 55131 Mainz, Germany.,Corresponding author.
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32
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Wilhelm A, Schoth J, Meinert-Berning C, Agrawal S, Bastian D, Orschler L, Ciesek S, Teichgräber B, Wintgens T, Lackner S, Weber FA, Widera M. Wastewater surveillance allows early detection of SARS-CoV-2 omicron in North Rhine-Westphalia, Germany. Sci Total Environ 2022; 846:157375. [PMID: 35850355 PMCID: PMC9287496 DOI: 10.1016/j.scitotenv.2022.157375] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/08/2022] [Accepted: 07/10/2022] [Indexed: 05/25/2023]
Abstract
Wastewater-based epidemiology (WBE) has demonstrated its importance to support SARS-CoV-2 epidemiology complementing individual testing strategies. Due to their immune-evasive potential and the resulting significance for public health, close monitoring of SARS-CoV-2 variants of concern (VoC) is required to evaluate the regulation of early local countermeasures. In this study, we demonstrate a rapid workflow for wastewater-based early detection and monitoring of the newly emerging SARS-CoV-2 VoCs Omicron in the end of 2021 at the municipal wastewater treatment plant (WWTP) Emschermuendung (KLEM) in the Federal State of North-Rhine-Westphalia (NRW, Germany). Initially, available primers detecting Omicron-related mutations were rapidly validated in a central laboratory. Subsequently, RT-qPCR analysis of purified SARS-CoV-2 RNA was performed in a decentral PCR laboratory in close proximity to KLEM. This decentralized approach enabled the early detection of K417N present in Omicron in samples collected on 8th December 2021 and the detection of further mutations (N501Y, Δ69/70) in subsequent biweekly sampling campaigns. The presence of Omicron in wastewater was confirmed by next generation sequencing (NGS) in a central laboratory with samples obtained on 14th December 2021. Moreover, the relative increase of the mutant fraction of Omicron was quantitatively monitored over time by dPCR in a central PCR laboratory starting on 12th December 2021 confirming Omicron as the dominant variant by the end of 2021. In conclusions, WBE plays a crucial role in surveillance of SARS-CoV-2 variants and is suitable as an early warning system to identify variant emergence. In particular, the successive workflow using RT-qPCR, RT-dPCR and NGS demonstrates the strength of WBE as a versatile tool to monitor variant spreading.
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Affiliation(s)
- Alexander Wilhelm
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, Paul-Ehrlich-Str. 40, D-60596 Frankfurt, Germany
| | - Jens Schoth
- Emschergenossenschaft/Lippeverband, Kronprinzenstraße 24, D-45128 Essen, Germany
| | | | - Shelesh Agrawal
- Department of Civil and Environmental Engineering Sciences, Institute IWAR, Water and Environmental Biotechnology, Technical University of Darmstadt, D-64287 Darmstadt, Germany
| | - Daniel Bastian
- FiW e.V., Research Institute for Water Management and Climate Future at RWTH Aachen University, Kackertstraße 15- 17, D-52056 Aachen, Germany
| | - Laura Orschler
- Department of Civil and Environmental Engineering Sciences, Institute IWAR, Water and Environmental Biotechnology, Technical University of Darmstadt, D-64287 Darmstadt, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, Paul-Ehrlich-Str. 40, D-60596 Frankfurt, Germany; German Center for Infection Research (DZIF), 38124 Braunschweig, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Theodor Stern Kai 7, D-60595 Frankfurt am Main, Germany
| | - Burkhard Teichgräber
- Emschergenossenschaft/Lippeverband, Kronprinzenstraße 24, D-45128 Essen, Germany
| | - Thomas Wintgens
- FiW e.V., Research Institute for Water Management and Climate Future at RWTH Aachen University, Kackertstraße 15- 17, D-52056 Aachen, Germany; Institute of Environmental Engineering, RWTH Aachen University, Mies-van-der-Rohe-Strasse 1, D-52074, Aachen, Germany
| | - Susanne Lackner
- Department of Civil and Environmental Engineering Sciences, Institute IWAR, Water and Environmental Biotechnology, Technical University of Darmstadt, D-64287 Darmstadt, Germany
| | - Frank-Andreas Weber
- FiW e.V., Research Institute for Water Management and Climate Future at RWTH Aachen University, Kackertstraße 15- 17, D-52056 Aachen, Germany
| | - Marek Widera
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, Paul-Ehrlich-Str. 40, D-60596 Frankfurt, Germany.
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33
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Niemeyer D, Stenzel S, Veith T, Schroeder S, Friedmann K, Weege F, Trimpert J, Heinze J, Richter A, Jansen J, Emanuel J, Kazmierski J, Pott F, Jeworowski LM, Olmer R, Jaboreck MC, Tenner B, Papies J, Walper F, Schmidt ML, Heinemann N, Möncke-Buchner E, Baumgardt M, Hoffmann K, Widera M, Thao TTN, Balázs A, Schulze J, Mache C, Jones TC, Morkel M, Ciesek S, Hanitsch LG, Mall MA, Hocke AC, Thiel V, Osterrieder K, Wolff T, Martin U, Corman VM, Müller MA, Goffinet C, Drosten C. SARS-CoV-2 variant Alpha has a spike-dependent replication advantage over the ancestral B.1 strain in human cells with low ACE2 expression. PLoS Biol 2022; 20:e3001871. [PMID: 36383605 PMCID: PMC9710838 DOI: 10.1371/journal.pbio.3001871] [Citation(s) in RCA: 8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 11/30/2022] [Accepted: 10/06/2022] [Indexed: 11/17/2022] Open
Abstract
Epidemiological data demonstrate that Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) Alpha and Delta are more transmissible, infectious, and pathogenic than previous variants. Phenotypic properties of VOC remain understudied. Here, we provide an extensive functional study of VOC Alpha replication and cell entry phenotypes assisted by reverse genetics, mutational mapping of spike in lentiviral pseudotypes, viral and cellular gene expression studies, and infectivity stability assays in an enhanced range of cell and epithelial culture models. In almost all models, VOC Alpha spread less or equally efficiently as ancestral (B.1) SARS-CoV-2. B.1. and VOC Alpha shared similar susceptibility to serum neutralization. Despite increased relative abundance of specific sgRNAs in the context of VOC Alpha infection, immune gene expression in infected cells did not differ between VOC Alpha and B.1. However, inferior spreading and entry efficiencies of VOC Alpha corresponded to lower abundance of proteolytically cleaved spike products presumably linked to the T716I mutation. In addition, we identified a bronchial cell line, NCI-H1299, which supported 24-fold increased growth of VOC Alpha and is to our knowledge the only cell line to recapitulate the fitness advantage of VOC Alpha compared to B.1. Interestingly, also VOC Delta showed a strong (595-fold) fitness advantage over B.1 in these cells. Comparative analysis of chimeric viruses expressing VOC Alpha spike in the backbone of B.1, and vice versa, showed that the specific replication phenotype of VOC Alpha in NCI-H1299 cells is largely determined by its spike protein. Despite undetectable ACE2 protein expression in NCI-H1299 cells, CRISPR/Cas9 knock-out and antibody-mediated blocking experiments revealed that multicycle spread of B.1 and VOC Alpha required ACE2 expression. Interestingly, entry of VOC Alpha, as opposed to B.1 virions, was largely unaffected by treatment with exogenous trypsin or saliva prior to infection, suggesting enhanced resistance of VOC Alpha spike to premature proteolytic cleavage in the extracellular environment of the human respiratory tract. This property may result in delayed degradation of VOC Alpha particle infectivity in conditions typical of mucosal fluids of the upper respiratory tract that may be recapitulated in NCI-H1299 cells closer than in highly ACE2-expressing cell lines and models. Our study highlights the importance of cell model evaluation and comparison for in-depth characterization of virus variant-specific phenotypes and uncovers a fine-tuned interrelationship between VOC Alpha- and host cell-specific determinants that may underlie the increased and prolonged virus shedding detected in patients infected with VOC Alpha.
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Affiliation(s)
- Daniela Niemeyer
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
- German Center for Infection Research, associated partner Charité, Berlin, Germany
| | - Saskia Stenzel
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Talitha Veith
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
- German Center for Infection Research, associated partner Charité, Berlin, Germany
| | - Simon Schroeder
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
| | - Kirstin Friedmann
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
| | - Friderike Weege
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
| | - Jakob Trimpert
- Institut für Virologie, Freie Universität Berlin, Berlin, Germany
| | - Julian Heinze
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
- German Center for Infection Research, associated partner Charité, Berlin, Germany
| | - Anja Richter
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
| | - Jenny Jansen
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Jackson Emanuel
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
| | - Julia Kazmierski
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Fabian Pott
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Lara M. Jeworowski
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
| | - Ruth Olmer
- Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), Department of Cardiothoracic, Transplantation and Vascular Surgery, REBIRTH — Center for Translational Regenerative Medicine, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany
| | - Mark-Christian Jaboreck
- Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), Department of Cardiothoracic, Transplantation and Vascular Surgery, REBIRTH — Center for Translational Regenerative Medicine, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany
| | - Beate Tenner
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
| | - Jan Papies
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
| | - Felix Walper
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
| | - Marie L. Schmidt
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
| | - Nicolas Heinemann
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
| | - Elisabeth Möncke-Buchner
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
| | - Morris Baumgardt
- Department of Infectious Diseases and Respiratory Medicine, Charité — Universitätsmedizin Berlin, Berlin, Germany
| | - Karen Hoffmann
- Department of Infectious Diseases and Respiratory Medicine, Charité — Universitätsmedizin Berlin, Berlin, Germany
| | - Marek Widera
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | | | - Anita Balázs
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jessica Schulze
- Unit 17 “Influenza and other Respiratory Viruses", Robert Koch Institute, Berlin, Germany
| | - Christin Mache
- Unit 17 “Influenza and other Respiratory Viruses", Robert Koch Institute, Berlin, Germany
| | - Terry C. Jones
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
| | - Markus Morkel
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin, Berlin, Germany
- BIH Bioportal Single Cells, Berlin Institute of Health at Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
- German Center for Infection Research, DZIF, Braunschweig, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, Frankfurt am Main, Germany
| | - Leif G. Hanitsch
- Institute of Medical Immunology, Charité — Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Marcus A. Mall
- Institut für Virologie, Freie Universität Berlin, Berlin, Germany
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
- German Centre for Lung Research (DZL), associated partner Charité, Berlin, Germany
| | - Andreas C. Hocke
- Department of Infectious Diseases and Respiratory Medicine, Charité — Universitätsmedizin Berlin, Berlin, Germany
| | - Volker Thiel
- Institute of Virology and Immunology, Bern, Switzerland
| | - Klaus Osterrieder
- Berlin Institute of Health, Berlin, Germany
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong
| | - Thorsten Wolff
- Unit 17 “Influenza and other Respiratory Viruses", Robert Koch Institute, Berlin, Germany
| | - Ulrich Martin
- Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), Department of Cardiothoracic, Transplantation and Vascular Surgery, REBIRTH — Center for Translational Regenerative Medicine, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany
| | - Victor M. Corman
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
- German Center for Infection Research, associated partner Charité, Berlin, Germany
- Labor Berlin – Charité Vivantes GmbH, Berlin, Germany
| | - Marcel A. Müller
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
- German Center for Infection Research, associated partner Charité, Berlin, Germany
| | - Christine Goffinet
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Christian Drosten
- Institute of Virology, Campus Charité Mitte, Charité — Universitätsmedizin Berlin, Berlin, Germany
- German Center for Infection Research, associated partner Charité, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
- Labor Berlin – Charité Vivantes GmbH, Berlin, Germany
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34
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Barut GT, Halwe NJ, Taddeo A, Kelly JN, Schön J, Ebert N, Ulrich L, Devisme C, Steiner S, Trüeb BS, Hoffmann B, Veiga IB, Leborgne NGF, Moreira EA, Breithaupt A, Wylezich C, Höper D, Wernike K, Godel A, Thomann L, Flück V, Stalder H, Brügger M, Esteves BIO, Zumkehr B, Beilleau G, Kratzel A, Schmied K, Ochsenbein S, Lang RM, Wider M, Machahua C, Dorn P, Marti TM, Funke-Chambour M, Rauch A, Widera M, Ciesek S, Dijkman R, Hoffmann D, Alves MP, Benarafa C, Beer M, Thiel V. The spike gene is a major determinant for the SARS-CoV-2 Omicron-BA.1 phenotype. Nat Commun 2022; 13:5929. [PMID: 36207334 PMCID: PMC9543931 DOI: 10.1038/s41467-022-33632-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/26/2022] [Indexed: 11/09/2022] Open
Abstract
Variant of concern (VOC) Omicron-BA.1 has achieved global predominance in early 2022. Therefore, surveillance and comprehensive characterization of Omicron-BA.1 in advanced primary cell culture systems and animal models are urgently needed. Here, we characterize Omicron-BA.1 and recombinant Omicron-BA.1 spike gene mutants in comparison with VOC Delta in well-differentiated primary human nasal and bronchial epithelial cells in vitro, followed by in vivo fitness characterization in hamsters, ferrets and hACE2-expressing mice, and immunized hACE2-mice. We demonstrate a spike-mediated enhancement of early replication of Omicron-BA.1 in nasal epithelial cultures, but limited replication in bronchial epithelial cultures. In hamsters, Delta shows dominance over Omicron-BA.1, and in ferrets Omicron-BA.1 infection is abortive. In hACE2-knock-in mice, Delta and a Delta spike clone also show dominance over Omicron-BA.1 and an Omicron-BA.1 spike clone, respectively. Interestingly, in naïve K18-hACE2 mice, we observe Delta spike-mediated increased replication and pathogenicity and Omicron-BA.1 spike-mediated reduced replication and pathogenicity, suggesting that the spike gene is a major determinant of replication and pathogenicity. Finally, the Omicron-BA.1 spike clone is less well-controlled by mRNA-vaccination in K18-hACE2-mice and becomes more competitive compared to the progenitor and Delta spike clones, suggesting that spike gene-mediated immune evasion is another important factor that led to Omicron-BA.1 dominance.
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Affiliation(s)
- G Tuba Barut
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Nico Joel Halwe
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Greifswald, Germany
| | - Adriano Taddeo
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Jenna N Kelly
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland.,Multidisciplinary Center for Infectious Diseases, University of Bern, Bern, Switzerland.,European Virus Bioinformatics Center, Jena, Germany
| | - Jacob Schön
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Greifswald, Germany
| | - Nadine Ebert
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Lorenz Ulrich
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Greifswald, Germany
| | - Christelle Devisme
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Silvio Steiner
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Bettina Salome Trüeb
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Bernd Hoffmann
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Greifswald, Germany
| | - Inês Berenguer Veiga
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Nathan Georges François Leborgne
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Etori Aguiar Moreira
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Angele Breithaupt
- Department of Experimental Animal Facilities and Biorisk Management, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Greifswald, Germany
| | - Claudia Wylezich
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Greifswald, Germany
| | - Dirk Höper
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Greifswald, Germany
| | - Kerstin Wernike
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Greifswald, Germany
| | - Aurélie Godel
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Lisa Thomann
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Vera Flück
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Hanspeter Stalder
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Melanie Brügger
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Blandina I Oliveira Esteves
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Beatrice Zumkehr
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Guillaume Beilleau
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland.,Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Annika Kratzel
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Kimberly Schmied
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Sarah Ochsenbein
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Reto M Lang
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland.,Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Manon Wider
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Carlos Machahua
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department for Pulmonary Medicine, BioMedical Research, University of Bern, Bern, Switzerland
| | - Patrick Dorn
- Division of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department for BioMedical Research, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thomas M Marti
- Division of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department for BioMedical Research, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Manuela Funke-Chambour
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department for Pulmonary Medicine, BioMedical Research, University of Bern, Bern, Switzerland
| | - Andri Rauch
- Multidisciplinary Center for Infectious Diseases, University of Bern, Bern, Switzerland.,Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marek Widera
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Ronald Dijkman
- Multidisciplinary Center for Infectious Diseases, University of Bern, Bern, Switzerland.,European Virus Bioinformatics Center, Jena, Germany.,Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Donata Hoffmann
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Greifswald, Germany
| | - Marco P Alves
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland. .,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland. .,Multidisciplinary Center for Infectious Diseases, University of Bern, Bern, Switzerland.
| | - Charaf Benarafa
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland. .,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland. .,Multidisciplinary Center for Infectious Diseases, University of Bern, Bern, Switzerland.
| | - Martin Beer
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Greifswald, Germany. .,European Virus Bioinformatics Center, Jena, Germany.
| | - Volker Thiel
- Institute of Virology and Immunology, Bern and Mittelhäusern, Bern, Switzerland. .,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland. .,Multidisciplinary Center for Infectious Diseases, University of Bern, Bern, Switzerland. .,European Virus Bioinformatics Center, Jena, Germany.
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35
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Muik A, Lui BG, Bacher M, Wallisch AK, Toker A, Finlayson A, Krüger K, Ozhelvaci O, Grikscheit K, Hoehl S, Ciesek S, Türeci Ö, Sahin U. Omicron BA.2 breakthrough infection enhances cross-neutralization of BA.2.12.1 and BA.4/BA.5. Sci Immunol 2022; 7:eade2283. [PMID: 36125366 PMCID: PMC9529054 DOI: 10.1126/sciimmunol.ade2283] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BNT162b2-vaccinated individuals after Omicron BA.1 breakthrough infection have strong serum neutralizing activity against Omicron BA.1, BA.2, and previous SARS-CoV-2 variants of concern (VOCs), yet less against the highly contagious Omicron sublineages BA.4 and BA.5 that have displaced previous variants. As the latter sublineages are derived from Omicron BA.2, we characterized serum neutralizing activity of COVID-19 mRNA vaccine triple-immunized individuals who experienced BA.2 breakthrough infection. We demonstrate that sera of these individuals have broadly neutralizing activity against previous VOCs as well as all tested Omicron sublineages, including BA.2 derived variants BA.2.12.1, BA.4/BA.5. Furthermore, applying antibody depletion we showed that neutralization of BA.2 and BA.4/BA.5 sublineages by BA.2 convalescent sera is driven to a significant extent by antibodies targeting the N-terminal domain (NTD) of the spike glycoprotein. However, neutralization by Omicron BA.1 convalescent sera depends exclusively on antibodies targeting the receptor binding domain (RBD). These findings suggest that exposure to Omicron BA.2, in contrast to BA.1 spike glycoprotein, triggers significant NTD specific recall responses in vaccinated individuals and thereby enhances the neutralization of BA.4/BA.5 sublineages. Given the current epidemiology with a predominance of BA.2 derived sublineages like BA.4/BA.5 and rapidly ongoing evolution, these findings helped to inform development of our Omicron BA.4/BA.5-adapted vaccine.
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Affiliation(s)
| | | | - Maren Bacher
- BioNTech, An der Goldgrube 12, 55131 Mainz, Germany
| | | | - Aras Toker
- BioNTech, An der Goldgrube 12, 55131 Mainz, Germany
| | | | | | | | - Katharina Grikscheit
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Sebastian Hoehl
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany.,DZIF - German Centre for Infection Research, External Partner Site, 60596 Frankfurt am Main, Germany
| | - Özlem Türeci
- BioNTech, An der Goldgrube 12, 55131 Mainz, Germany.,HI-TRON - Helmholtz Institute for Translational Oncology Mainz by DKFZ, Obere Zahlbacherstr. 63, 55131 Mainz, Germany
| | - Ugur Sahin
- BioNTech, An der Goldgrube 12, 55131 Mainz, Germany.,TRON gGmbH - Translational Oncology at the University Medical Center of the Johannes Gutenberg University, Freiligrathstraße 12, 55131 Mainz, Germany
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36
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Ovcar E, Patyna S, Kohmer N, Heckel-Kratz E, Ciesek S, Rabenau HF, Hauser IA, de Groot K. Increasing but insufficient neutralizing activity against Omicron-BA.1 after a second booster dose of mRNA-1273 vaccine in chronic hemodialysis patients. Clin Kidney J 2022; 15:2346-2348. [PMID: 36381372 PMCID: PMC9664578 DOI: 10.1093/ckj/sfac211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Indexed: 12/01/2022] Open
Affiliation(s)
- Eugen Ovcar
- KfH Nierenzentrum Offenbach , Offenbach/Main, Germany
- Department of Internal Medicine III , Internal Medicine, Nephrology, Rheumatology, Sana Klinikum, Offenbach/Main, Germany
| | - Sammy Patyna
- Department of Internal Medicine III, Division of Nephrology, University Hospital Frankfurt, Goethe University Frankfurt , Frankfurt , Germany
| | - Niko Kohmer
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt , Frankfurt , Germany
| | | | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt , Frankfurt , Germany
- German Centre for Infection Research , External partner site Frankfurt, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology (IME) , Branch Translational Medicine and Pharmacology, Frankfurt , Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt , Frankfurt , Germany
| | - Ingeborg A Hauser
- Department of Internal Medicine III, Division of Nephrology, University Hospital Frankfurt, Goethe University Frankfurt , Frankfurt , Germany
| | - Kirsten de Groot
- KfH Nierenzentrum Offenbach , Offenbach/Main, Germany
- Department of Internal Medicine III , Internal Medicine, Nephrology, Rheumatology, Sana Klinikum, Offenbach/Main, Germany
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37
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Veleanu A, Kelch MA, Ye C, Flohr M, Wilhelm A, Widera M, Martinez-Sobrido L, Ciesek S, Toptan T. Molecular Analyses of Clinical Isolates and Recombinant SARS-CoV-2 Carrying B.1 and B.1.617.2 Spike Mutations Suggest a Potential Role of Non-Spike Mutations in Infection Kinetics. Viruses 2022; 14:v14092017. [PMID: 36146823 PMCID: PMC9506066 DOI: 10.3390/v14092017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 08/10/2022] [Revised: 09/09/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
Some of the emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants are less susceptible to neutralization with post-vaccine sera and monoclonal antibodies targeting the viral spike glycoprotein. This raises concerns of disease control, transmissibility, and severity. Numerous substitutions have been identified to increase viral fitness within the nucleocapsid and nonstructural proteins, in addition to spike mutations. Therefore, we sought to generate infectious viruses carrying only the variant-specific spike mutations in an identical backbone to evaluate the impact of spike and non-spike mutations in the virus life cycle. We used en passant mutagenesis to generate recombinant viruses carrying spike mutations of B.1 and B.1.617.2 variants using SARS-CoV-2- bacterial artificial chromosome (BAC). Neutralization assays using clinical sera yielded comparable results between recombinant viruses and corresponding clinical isolates. Non-spike mutations for both variants neither seemed to effect neutralization efficiencies with monoclonal antibodies nor the response to treatment with inhibitors. However, live-cell imaging and microscopy revealed differences, such as persisting syncytia and pronounced cytopathic effect formation, as well as their progression between BAC-derived viruses and clinical isolates in human lung epithelial cell lines and primary bronchial epithelial cells. Complementary RNA analyses further suggested a potential role of non-spike mutations in infection kinetics.
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Affiliation(s)
- Andrei Veleanu
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, D-60596 Frankfurt am Main, Germany
| | - Maximilian A. Kelch
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, D-60596 Frankfurt am Main, Germany
| | - Chengjin Ye
- Texas Biomedical Research Institute, San Antonio, TX 78227-5302, USA
| | - Melanie Flohr
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, D-60596 Frankfurt am Main, Germany
| | - Alexander Wilhelm
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, D-60596 Frankfurt am Main, Germany
| | - Marek Widera
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, D-60596 Frankfurt am Main, Germany
| | | | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, D-60596 Frankfurt am Main, Germany
- German Centre for Infection Research (DZIF), Partner Site Frankfurt am Main, D-60596 Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Theodor Stern Kai 7, D-60595 Frankfurt am Main, Germany
| | - Tuna Toptan
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, D-60596 Frankfurt am Main, Germany
- Correspondence: ; Tel.: +49-69-6301-4536
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38
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Hoehl S, Toptan T, F. Rabenau H, Ciesek S. The Relapse Phenomenon in Mild COVID Treated With Nirmatrelvir/Ritonavir in an Immunocompetent Patient. Dtsch Arztebl Int 2022; 119:619-620. [PMID: 36507731 PMCID: PMC9756324 DOI: 10.3238/arztebl.m2022.0267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 05/25/2022] [Accepted: 06/30/2022] [Indexed: 01/05/2023]
Affiliation(s)
- Sebastian Hoehl
- Institut für Medizinische Virologie, Universitätsklinikum Frankfurt
| | - Tuna Toptan
- Institut für Medizinische Virologie, Universitätsklinikum Frankfurt
| | | | - Sandra Ciesek
- Institut für Medizinische Virologie, Universitätsklinikum Frankfurt
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39
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Hoehl S, Kohmer N, Eckermann L, Gottschalk R, Ciesek S. Reply to Fabbris et al. A Viable Alternative. Comment on "Kohmer et al. Self-Collected Samples to Detect SARS-CoV-2: Direct Comparison of Saliva, Tongue Swab, Nasal Swab, Chewed Cotton Pads and Gargle Lavage. J. Clin. Med. 2021, 10, 5751". J Clin Med 2022; 11:jcm11164920. [PMID: 36013159 PMCID: PMC9410057 DOI: 10.3390/jcm11164920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 12/02/2022] Open
Affiliation(s)
- Sebastian Hoehl
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany
- Correspondence: ; Tel.: +49-69-6301-0
| | - Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany
| | - Lisa Eckermann
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany
| | - Rene Gottschalk
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany
- Health Protection Authority, City of Frankfurt, 60313 Frankfurt, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt, 60596 Frankfurt, Germany
- German Centre for Infection Research, External Partner Site, 60323 Frankfurt, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, 60596 Frankfurt, Germany
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40
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Burm R, Maravelia P, Ahlen G, Ciesek S, Caro Perez N, Pasetto A, Urban S, Van Houtte F, Verhoye L, Wedemeyer H, Johansson M, Frelin L, Sällberg M, Meuleman P. Novel prime-boost immune-based therapy inhibiting both hepatitis B and D virus infections. Gut 2022; 72:1186-1195. [PMID: 35977815 PMCID: PMC10176361 DOI: 10.1136/gutjnl-2022-327216] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 07/29/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Chronic HBV/HDV infections are a major cause of liver cancer. Current treatments can only rarely eliminate HBV and HDV. Our previously developed preS1-HDAg immunotherapy could induce neutralising antibodies to HBV in vivo and raise HBV/HDV-specific T-cells. Here, we further investigate if a heterologous prime-boost strategy can circumvent T-cell tolerance and preclude HDV superinfection in vivo. DESIGN A DNA prime-protein boost strategy was evaluated for immunogenicity in mice and rabbits. Its ability to circumvent T-cell tolerance was assessed in immunocompetent hepatitis B surface antigen (HBsAg)-transgenic mice. Neutralisation of HBV and HDV was evaluated both in vitro and in immunodeficient human-liver chimeric mice upon adoptive transfer. RESULTS The prime-boost strategy elicits robust HBV/HDV-specific T-cells and preS1-antibodies that can effectively prevent HBV and HDV (co-)infection in vitro and in vivo. In a mouse model representing the chronic HBsAg carrier state, active immunisation primes high levels of preS1-antibodies and HDAg-specific T-cells. Moreover, transfer of vaccine-induced antibodies completely protects HBV-infected human-liver chimeric mice from HDV superinfection. CONCLUSION The herein described preS1-HDAg immunotherapy is shown to be immunogenic and vaccine-induced antibodies are highly effective at preventing HBV and HDV (super)infection both in vitro and in vivo. Our vaccine can complement current and future therapies for the control of chronic HBV and HDV infection.
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Affiliation(s)
- Rani Burm
- Laboratory of Liver Infectious Diseases (LLID), Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Panagiota Maravelia
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gustaf Ahlen
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University, Frankfurt am Main, Germany.,Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany.,German Center for Infection Research, DZIF, External partner site, Frankfurt am Main, Germany
| | - Noelia Caro Perez
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Pasetto
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Stephan Urban
- Department of Infectious Diseases, Molecular Virology, University Hospital Heidelberg, Heidelberg, Germany
| | - Freya Van Houtte
- Laboratory of Liver Infectious Diseases (LLID), Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Lieven Verhoye
- Laboratory of Liver Infectious Diseases (LLID), Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Heiner Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Magnus Johansson
- School of Medical Sciences, Inflammatory Response and Infection Susceptibility Centre (iRiSC), Faculty of Medicine and Health, Örebro University, Orebro, Sweden
| | - Lars Frelin
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Matti Sällberg
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Philip Meuleman
- Laboratory of Liver Infectious Diseases (LLID), Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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41
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Wilhelm A, Widera M, Grikscheit K, Toptan T, Schenk B, Pallas C, Metzler M, Kohmer N, Hoehl S, Marschalek R, Herrmann E, Helfritz FA, Wolf T, Goetsch U, Ciesek S. Limited neutralisation of the SARS-CoV-2 Omicron subvariants BA.1 and BA.2 by convalescent and vaccine serum and monoclonal antibodies. EBioMedicine 2022; 82:104158. [PMID: 35834885 DOI: 10.1101/2021.12.07.21267432] [Citation(s) in RCA: 157] [Impact Index Per Article: 78.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND In recent months, Omicron variants of SARS-CoV-2 have become dominant in many regions of the world, and case numbers with Omicron subvariants BA.1 and BA.2 continue to increase. Due to numerous mutations in the spike protein, the efficacy of currently available vaccines, which are based on Wuhan-Hu 1 isolate of SARS-CoV-2, is reduced, leading to breakthrough infections. Efficacy of monoclonal antibody therapy is also likely impaired. METHODS In our in vitro study using A549-AT cells constitutively expressing ACE2 and TMPRSS2, we determined and compared the neutralizing capacity of vaccine-elicited sera, convalescent sera and monoclonal antibodies against authentic SARS-CoV-2 Omicron BA.1 and BA.2 compared with Delta. FINDINGS Almost no neutralisation of Omicron BA.1 and BA.2 was observed using sera from individuals vaccinated with two doses 6 months earlier, regardless of the type of vaccine taken. Shortly after the booster dose, most sera from triple BNT162b2-vaccinated individuals were able to neutralise both Omicron variants. In line with waning antibody levels three months after the booster, only weak residual neutralisation was observed for BA.1 (26%, n = 34, 0 median NT50) and BA.2 (44%, n = 34, 0 median NT50). In addition, BA.1 but not BA.2 was resistant to the neutralising monoclonal antibodies casirivimab/imdevimab, while BA.2 exhibited almost a complete evasion from the neutralisation induced by sotrovimab. INTERPRETATION Both SARS-CoV-2 Omicron subvariants BA.1 and BA.2 escape antibody-mediated neutralisation elicited by vaccination, previous infection with SARS-CoV-2, and monoclonal antibodies. Waning immunity renders the majority of tested sera obtained three months after booster vaccination negative in BA.1 and BA.2 neutralisation. Omicron subvariant specific resistance to the monoclonal antibodies casirivimab/imdevimab and sotrovimab emphasizes the importance of genotype-surveillance and guided application. FUNDING This study was supported in part by the Goethe-Corona-Fund of the Goethe University Frankfurt (M.W.) and the Federal Ministry of Education and Research (COVIDready; grant 02WRS1621C (M.W.).
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Affiliation(s)
- Alexander Wilhelm
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Marek Widera
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany.
| | - Katharina Grikscheit
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Tuna Toptan
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Barbara Schenk
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Christiane Pallas
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Melinda Metzler
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Niko Kohmer
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Sebastian Hoehl
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Rolf Marschalek
- Institute of Pharmaceutical Biology, Goethe University, Frankfurt am Main, Germany
| | - Eva Herrmann
- Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, 60596 Frankfurt, Germany
| | - Fabian A Helfritz
- Bürgerhospital Frankfurt, Nibelungenallee 37-41, 60318 Frankfurt am Main, Germany
| | - Timo Wolf
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Udo Goetsch
- Health Protection Authority of the City of Frankfurt am Main, 60313 Frankfurt am Main, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany; German Centre for Infection Research (DZIF), partner site Frankfurt, Germany; Fraunhofer Institute for Molecular Biology and Applied Ecology, Branch Translational Medicine and Pharmacology, 60596 Frankfurt am Main, Germany.
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42
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Lehrnbecher T, Sack U, Speckmann C, Groll AH, Boldt A, Siebald B, Hettmer S, Demmerath EM, Schenk B, Ciesek S, Klusmann JH, Jassoy C, Hoehl S. Longitudinal Immune Response to 3 Doses of Messenger RNA Vaccine Against Coronavirus Disease 2019 (COVID-19) in Pediatric Patients Receiving Chemotherapy for Cancer. Clin Infect Dis 2022; 76:e510-e513. [PMID: 35901198 PMCID: PMC9384602 DOI: 10.1093/cid/ciac570] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/28/2022] [Accepted: 07/07/2022] [Indexed: 01/09/2023] Open
Abstract
Our study in 21 pediatric cancer patients demonstrates that 3 doses of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA vaccine (BioNTech/Pfizer) elicited both humoral and cellular immunity in most patients during chemotherapy. Immunity was stronger in children with solid tumors and during maintenance therapy compared to those with hematological malignancies or during intensive chemotherapy. Clinical Trials Registration.ȃGerman Registry for Clinical Trials (DRKS00025254).
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Affiliation(s)
- Thomas Lehrnbecher
- Correspondence: T. Lehrnbecher, Division of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, D-60590 Frankfurt, Germany ()
| | | | - Carsten Speckmann
- Division of Pediatric Hematology and Oncology, Department of Pediatric and Adolescent Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Andreas H Groll
- Infectious Disease Research Program, Center for Bone Marrow Transplantation, Department of Pediatric Hematology/Oncology, University Children’s Hospital, Muenster, Muenster, Germany
| | - Andreas Boldt
- Institute of Clinical Immunology, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Benjamin Siebald
- Division of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, University Hospital, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Simone Hettmer
- Division of Pediatric Hematology and Oncology, Department of Pediatric and Adolescent Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Eva Maria Demmerath
- Division of Pediatric Hematology and Oncology, Department of Pediatric and Adolescent Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Barbara Schenk
- Institute of Medical Virology, University Hospital Frankfurt, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Institute of Medical Virology, University Hospital Frankfurt, Johann Wolfgang Goethe University, Frankfurt am Main, Germany,Fraunhofer Institute for Translational Medicine and Pharmacology, Frankfurt am Main, Germany,German Center for Infection Research, External Partner Site Frankfurt, Braunschweig, Germany
| | - Jan Henning Klusmann
- Division of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, University Hospital, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
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43
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Grikscheit K, Rabenau HF, Ghodratian Z, Widera M, Wilhelm A, Toptan Grabmair T, Hoehl S, Layer E, Helfritz F, Ciesek S. Characterization of the Antibody and Interferon-Gamma Release Response after a Second COVID-19 Booster Vaccination. Vaccines (Basel) 2022; 10:vaccines10071163. [PMID: 35891326 PMCID: PMC9323888 DOI: 10.3390/vaccines10071163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/28/2022] [Accepted: 07/14/2022] [Indexed: 11/26/2022] Open
Abstract
The emergence of SARS-CoV-2 Omicron subvariants prompted countries to call for accelerated booster vaccinations to limit disease and transmission. Here, we characterized correlates of protection over time after the second booster or after Omicron BA.1 infection comparing variants of concern (VOCs). Sera from subjects before and two and seven weeks after the second booster or after Omicron infection were examined for the level of Spike receptor-binding-domain (RBD)-specific antibodies. Furthermore, neutralizing antibodies (nABs) were characterized in in vitro neutralization assays comparing the variants of concern Alpha, Beta, Delta, and Omicron BA.1 and BA.2 against the ancestral strain B.1. Here, the second booster resulted in an increase in anti-RBD-IgG-antibodies, remaining nearly constant over time, accompanied by an increase in nABs against B.1 and the VOCs Alpha, Beta, Delta, and Omicron BA.1 and BA.2. However, compared to B.1, the neutralizing capacity against the Omicron subvariants remained low and was limited after the second booster vaccination. This indicates that antibody-mediated protection against infection with this VOC is unlikely, as evidenced by the fact that three individuals of our study cohort became infected with Omicron BA.1 after the second booster. T cell activation was measured by interferon-gamma release assays in a subgroup of subjects and was increased in all subjects tested after the second booster vaccination, correlating with the amount of Spike-specific antibodies. In subjects with Omicron BA.1 breakthrough infection, a significant increase in nABs to all VOCs studied was observed independently of booster vaccinations. Taken together, our data indicate that a second booster or Omicron BA.1 infection mediate a substantial increase in anti-Spike IgG antibodies; however, infection with Omicron BA.1 induced a stronger increase in neutralizing antibodies against the different VOCs
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Affiliation(s)
- Katharina Grikscheit
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt, Germany; (K.G.); (H.F.R.); (Z.G.); (M.W.); (A.W.); (T.T.G.); (S.H.)
| | - Holger F. Rabenau
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt, Germany; (K.G.); (H.F.R.); (Z.G.); (M.W.); (A.W.); (T.T.G.); (S.H.)
| | - Zahra Ghodratian
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt, Germany; (K.G.); (H.F.R.); (Z.G.); (M.W.); (A.W.); (T.T.G.); (S.H.)
| | - Marek Widera
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt, Germany; (K.G.); (H.F.R.); (Z.G.); (M.W.); (A.W.); (T.T.G.); (S.H.)
| | - Alexander Wilhelm
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt, Germany; (K.G.); (H.F.R.); (Z.G.); (M.W.); (A.W.); (T.T.G.); (S.H.)
| | - Tuna Toptan Grabmair
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt, Germany; (K.G.); (H.F.R.); (Z.G.); (M.W.); (A.W.); (T.T.G.); (S.H.)
| | - Sebastian Hoehl
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt, Germany; (K.G.); (H.F.R.); (Z.G.); (M.W.); (A.W.); (T.T.G.); (S.H.)
| | - Emily Layer
- Health Protection Authority of the City of Frankfurt am Main, 60313 Frankfurt am Main, Germany;
| | - Fabian Helfritz
- Bürgerhospital Frankfurt, Nibelungenallee 37-41, 60318 Frankfurt am Main, Germany;
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University Frankfurt, 60596 Frankfurt, Germany; (K.G.); (H.F.R.); (Z.G.); (M.W.); (A.W.); (T.T.G.); (S.H.)
- German Centre for Infection Research (DZIF), Partner Site Frankfurt, 60596 Frankfurt, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology, Branch Translational Medicine and Pharmcology, 60596 Frankfurt am Main, Germany
- Correspondence:
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44
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Degenhardt F, Ellinghaus D, Juzenas S, Lerga-Jaso J, Wendorff M, Maya-Miles D, Uellendahl-Werth F, ElAbd H, Rühlemann MC, Arora J, Özer O, Lenning OB, Myhre R, Vadla MS, Wacker EM, Wienbrandt L, Blandino Ortiz A, de Salazar A, Garrido Chercoles A, Palom A, Ruiz A, Garcia-Fernandez AE, Blanco-Grau A, Mantovani A, Zanella A, Holten AR, Mayer A, Bandera A, Cherubini A, Protti A, Aghemo A, Gerussi A, Ramirez A, Braun A, Nebel A, Barreira A, Lleo A, Teles A, Kildal AB, Biondi A, Caballero-Garralda A, Ganna A, Gori A, Glück A, Lind A, Tanck A, Hinney A, Carreras Nolla A, Fracanzani AL, Peschuck A, Cavallero A, Dyrhol-Riise AM, Ruello A, Julià A, Muscatello A, Pesenti A, Voza A, Rando-Segura A, Solier A, Schmidt A, Cortes B, Mateos B, Nafria-Jimenez B, Schaefer B, Jensen B, Bellinghausen C, Maj C, Ferrando C, de la Horra C, Quereda C, Skurk C, Thibeault C, Scollo C, Herr C, Spinner CD, Gassner C, Lange C, Hu C, Paccapelo C, Lehmann C, Angelini C, Cappadona C, Azuure C, Bianco C, Cea C, Sancho C, Hoff DAL, Galimberti D, Prati D, Haschka D, Jiménez D, Pestaña D, Toapanta D, Muñiz-Diaz E, Azzolini E, Sandoval E, Binatti E, Scarpini E, Helbig ET, Casalone E, Urrechaga E, Paraboschi EM, Pontali E, Reverter E, Calderón EJ, Navas E, Solligård E, Contro E, Arana-Arri E, Aziz F, Garcia F, García Sánchez F, Ceriotti F, Martinelli-Boneschi F, Peyvandi F, Kurth F, Blasi F, Malvestiti F, Medrano FJ, Mesonero F, Rodriguez-Frias F, Hanses F, Müller F, Hemmrich-Stanisak G, Bellani G, Grasselli G, Pezzoli G, Costantino G, Albano G, Cardamone G, Bellelli G, Citerio G, Foti G, Lamorte G, Matullo G, Baselli G, Kurihara H, Neb H, My I, Kurth I, Hernández I, Pink I, de Rojas I, Galván-Femenia I, Holter JC, Afset JE, Heyckendorf J, Kässens J, Damås JK, Rybniker J, Altmüller J, Ampuero J, Martín J, Erdmann J, Banales JM, Badia JR, Dopazo J, Schneider J, Bergan J, Barretina J, Walter J, Hernández Quero J, Goikoetxea J, Delgado J, Guerrero JM, Fazaal J, Kraft J, Schröder J, Risnes K, Banasik K, Müller KE, Gaede KI, Garcia-Etxebarria K, Tonby K, Heggelund L, Izquierdo-Sanchez L, Bettini LR, Sumoy L, Sander LE, Lippert LJ, Terranova L, Nkambule L, Knopp L, Gustad LT, Garbarino L, Santoro L, Téllez L, Roade L, Ostadreza M, Intxausti M, Kogevinas M, Riveiro-Barciela M, Berger MM, Schaefer M, Niemi MEK, Gutiérrez-Stampa MA, Carrabba M, Figuera Basso ME, Valsecchi MG, Hernandez-Tejero M, Vehreschild MJGT, Manunta M, Acosta-Herrera M, D'Angiò M, Baldini M, Cazzaniga M, Grimsrud MM, Cornberg M, Nöthen MM, Marquié M, Castoldi M, Cordioli M, Cecconi M, D'Amato M, Augustin M, Tomasi M, Boada M, Dreher M, Seilmaier MJ, Joannidis M, Wittig M, Mazzocco M, Ciccarelli M, Rodríguez-Gandía M, Bocciolone M, Miozzo M, Imaz Ayo N, Blay N, Chueca N, Montano N, Braun N, Ludwig N, Marx N, Martínez N, Cornely OA, Witzke O, Palmieri O, Faverio P, Preatoni P, Bonfanti P, Omodei P, Tentorio P, Castro P, Rodrigues PM, España PP, Hoffmann P, Rosenstiel P, Schommers P, Suwalski P, de Pablo R, Ferrer R, Bals R, Gualtierotti R, Gallego-Durán R, Nieto R, Carpani R, Morilla R, Badalamenti S, Haider S, Ciesek S, May S, Bombace S, Marsal S, Pigazzini S, Klein S, Pelusi S, Wilfling S, Bosari S, Volland S, Brunak S, Raychaudhuri S, Schreiber S, Heilmann-Heimbach S, Aliberti S, Ripke S, Dudman S, Wesse T, Zheng T, Bahmer T, Eggermann T, Illig T, Brenner T, Pumarola T, Feldt T, Folseraas T, Gonzalez Cejudo T, Landmesser U, Protzer U, Hehr U, Rimoldi V, Monzani V, Skogen V, Keitel V, Kopfnagel V, Friaza V, Andrade V, Moreno V, Albrecht W, Peter W, Poller W, Farre X, Yi X, Wang X, Khodamoradi Y, Karadeniz Z, Latiano A, Goerg S, Bacher P, Koehler P, Tran F, Zoller H, Schulte EC, Heidecker B, Ludwig KU, Fernández J, Romero-Gómez M, Albillos A, Invernizzi P, Buti M, Duga S, Bujanda L, Hov JR, Lenz TL, Asselta R, de Cid R, Valenti L, Karlsen TH, Cáceres M, Franke A. Detailed stratified GWAS analysis for severe COVID-19 in four European populations. Hum Mol Genet 2022; 31:3945-3966. [PMID: 35848942 PMCID: PMC9703941 DOI: 10.1093/hmg/ddac158] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/11/2022] [Accepted: 07/26/2022] [Indexed: 12/11/2022] Open
Abstract
Given the highly variable clinical phenotype of Coronavirus disease 2019 (COVID-19), a deeper analysis of the host genetic contribution to severe COVID-19 is important to improve our understanding of underlying disease mechanisms. Here, we describe an extended genome-wide association meta-analysis of a well-characterized cohort of 3255 COVID-19 patients with respiratory failure and 12 488 population controls from Italy, Spain, Norway and Germany/Austria, including stratified analyses based on age, sex and disease severity, as well as targeted analyses of chromosome Y haplotypes, the human leukocyte antigen region and the SARS-CoV-2 peptidome. By inversion imputation, we traced a reported association at 17q21.31 to a ~0.9-Mb inversion polymorphism that creates two highly differentiated haplotypes and characterized the potential effects of the inversion in detail. Our data, together with the 5th release of summary statistics from the COVID-19 Host Genetics Initiative including non-Caucasian individuals, also identified a new locus at 19q13.33, including NAPSA, a gene which is expressed primarily in alveolar cells responsible for gas exchange in the lung.
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Affiliation(s)
- Frauke Degenhardt
- To whom correspondence should be addressed. (Frauke Degenhardt) and (Andre Franke)
| | | | | | | | | | | | | | - Hesham ElAbd
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - Malte C Rühlemann
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany,Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany
| | - Jatin Arora
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA,Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA,Division of Genetics, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA,Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA,Center for Data Sciences, Brigham and Women’s Hospital, Boston, MA, USA
| | - Onur Özer
- Research Group for Evolutionary Immunogenomics, Max Planck Institute for Evolutionary Biology, Plön, Germany,Research Unit for Evolutionary Immunogenomics, Department of Biology, University of Hamburg, Hamburg, Germany
| | - Ole Bernt Lenning
- Research Department, Stavanger University Hospital, Stavanger, Norway,Randaberg Municipality, Stavanger, Norway
| | - Ronny Myhre
- Division of Health Data and Digitalization, Department of Genetics and Bioinformatics (HDGB), Norwegian Institute of Public Health, Oslo, Norway
| | - May Sissel Vadla
- Randaberg Municipality, Stavanger, Norway,Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Eike M Wacker
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - Lars Wienbrandt
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - Aaron Blandino Ortiz
- Department of Intensive Care, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain
| | - Adolfo de Salazar
- Ibs.Granada Instituto de Investigación Biosanitaria, Granada, Spain,Microbiology Unit. Hospital Universitario Clinico San Cecilio, Granada, Spain
| | - Adolfo Garrido Chercoles
- Clinical Biochemistry Department, Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, San Sebastian, Spain
| | - Adriana Palom
- Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Barcelona, Spain,Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Agustín Ruiz
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | | | - Albert Blanco-Grau
- Department of Biochemistry, University Hospital Vall d’Hebron, Barcelona, Spain
| | - Alberto Mantovani
- IRCCS Humanitas Research Hospital, Milan, Italy,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alberto Zanella
- University of Milan, Milan, Italy,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Aleksander Rygh Holten
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Alena Mayer
- Charite Universitätsmedizin Berlin, Berlin, Germany
| | - Alessandra Bandera
- University of Milan, Milan, Italy,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Alessandro Protti
- IRCCS Humanitas Research Hospital, Milan, Italy,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alessio Aghemo
- IRCCS Humanitas Research Hospital, Milan, Italy,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alessio Gerussi
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy,Division of Gastroenterology, School of Medicine and Surgery, Center for Autoimmune Liver Diseases, University of Milano-Bicocca, Milan, Italy
| | - Alfredo Ramirez
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany,Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Medical Faculty, Bonn, Germany,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany,Department of Psychiatry, Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, San Antonio, TX, USA
| | - Alice Braun
- Charite Universitätsmedizin Berlin, Berlin, Germany
| | - Almut Nebel
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - Ana Barreira
- Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Ana Lleo
- IRCCS Humanitas Research Hospital, Milan, Italy,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Ana Teles
- Research Group for Evolutionary Immunogenomics, Max Planck Institute for Evolutionary Biology, Plön, Germany,Research Unit for Evolutionary Immunogenomics, Department of Biology, University of Hamburg, Hamburg, Germany
| | - Anders Benjamin Kildal
- Department of Anesthesiology and Intensive Care, University Hospital of North Norway, Tromsø, Norway
| | - Andrea Biondi
- Pediatric Departement, Centro Tettamanti-European Reference Network (ERN) PaedCan, EuroBloodNet, MetabERN-University of Milano-Bicocca-Fondazione MBBM/Ospedale, San Gerardo, Italy
| | | | - Andrea Ganna
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Andrea Gori
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy,Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| | - Andreas Glück
- Klinik für Innere Medizin I, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Andreas Lind
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Anja Tanck
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - Anke Hinney
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anna Carreras Nolla
- Genomes for Life-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Anna Ludovica Fracanzani
- University of Milan, Milan, Italy,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Peschuck
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | | | - Anne Ma Dyrhol-Riise
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Infectious diseases, Oslo University Hospital, Oslo, Norway
| | | | - Antonio Julià
- Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Barcelona, Spain
| | | | - Antonio Pesenti
- University of Milan, Milan, Italy,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonio Voza
- IRCCS Humanitas Research Hospital, Milan, Italy,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Ariadna Rando-Segura
- Microbiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain,Universitat Autònoma de Barcelona, Bellatera, Spain
| | - Aurora Solier
- Department of Respiratory Diseases, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain,Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), University of Alcalá, Madrid, Spain
| | - Axel Schmidt
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Beatriz Cortes
- Genomes for Life-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Beatriz Mateos
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,Department of Gastroenterology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain
| | - Beatriz Nafria-Jimenez
- Clinical Biochemistry Department, Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, San Sebastian, Spain
| | - Benedikt Schaefer
- Department of Medicine I, Gastroenterology, Hepatology and Endocrinology, Medical University of Innsbruck, Innsbruck, Austria,Christian Doppler Laboratory of Iron and Phosphate Biology at the Department of Medicine I, Medical University of Innsbruck, Innsbruck, Austria
| | - Björn Jensen
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Medical Faculty Heinrich Heine University, Duesseldorf, Germany
| | - Carla Bellinghausen
- Department of Respiratory Medicine and Allergology, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Carlo Maj
- Institute of Genomic Statistics and Bioinformatics, University Hospital Bonn, Medical Faculty University of Bonn, Bonn, Germany
| | - Carlos Ferrando
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain,Hospital Clinic, University of Barcelona, and IDIBAPS, Barcelona, Spain
| | - Carmen de la Horra
- Hospital Universitario Virgen del Rocío de Sevilla, Sevilla, Spain,Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain,University of Sevilla, Sevilla, Spain,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain,Consejo Superior de Investigaciones Científicas, Sevilla, Spain
| | - Carmen Quereda
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain
| | | | | | - Chiara Scollo
- Department of Transfusion Medicine and Haematology Laboratory, San Gerardo Hospital, Monza, Italy
| | - Christian Herr
- Department of Internal Medicine V—Pneumology, Allergology and Intensive Care Medicine, University Hospital Saarland, Homburg, Germany
| | - Christoph D Spinner
- Department of Internal Medicine II, School of Medicine, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
| | - Christoph Gassner
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany,Institute of Translational Medicine, Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein
| | - Christoph Lange
- Respiratory Medicine and International Health, University of Lübeck, Lübeck, Germany,Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany,Clinical Tuberculosis Unit, German Center for Infection Research (DZIF), Borstel, Germany
| | - Cinzia Hu
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cinzia Paccapelo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Clara Lehmann
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany,German Center for Infection Research (DZIF), Cologne, Germany
| | | | - Claudio Cappadona
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Clinton Azuure
- Research Group for Evolutionary Immunogenomics, Max Planck Institute for Evolutionary Biology, Plön, Germany,Research Unit for Evolutionary Immunogenomics, Department of Biology, University of Hamburg, Hamburg, Germany
| | | | - Cristiana Bianco
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cristina Cea
- Department of Biochemistry, University Hospital Vall d’Hebron, Barcelona, Spain
| | - Cristina Sancho
- Osakidetza Basque Health Service, Basurto University Hospital, Respiratory Service, Bilbao, Spain
| | - Dag Arne Lihaug Hoff
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway,Department of Medicine, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Daniela Galimberti
- University of Milan, Milan, Italy,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniele Prati
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - David Haschka
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - David Jiménez
- Department of Respiratory Diseases, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain,Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), University of Alcalá, Madrid, Spain
| | - David Pestaña
- Department of Anesthesiology and Critical Care, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain
| | - David Toapanta
- Hospital Clinic, University of Barcelona, and IDIBAPS, Barcelona, Spain
| | - Eduardo Muñiz-Diaz
- Immunohematology Department, Banc de Sang i Teixits, Autonomous University of Barcelona, Barcelona, Spain
| | - Elena Azzolini
- IRCCS Humanitas Research Hospital, Milan, Italy,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Elena Sandoval
- Hospital Clinic, University of Barcelona, and IDIBAPS, Barcelona, Spain
| | - Eleonora Binatti
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy,Division of Gastroenterology, School of Medicine and Surgery, Center for Autoimmune Liver Diseases, University of Milano-Bicocca, Milan, Italy
| | - Elio Scarpini
- University of Milan, Milan, Italy,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Elisabetta Casalone
- Department of Medical Sciences, Università degli Studi di Torino, Turin, Italy
| | - Eloisa Urrechaga
- Osakidetza Basque Health Service, Galdakao Hospital, Respiratory Service, Galdakao, Spain,Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Elvezia Maria Paraboschi
- IRCCS Humanitas Research Hospital, Milan, Italy,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Emanuele Pontali
- Department of Infectious Diseases, E.O. Ospedali Galliera, Genova, Italy
| | - Enric Reverter
- Hospital Clinic, University of Barcelona, and IDIBAPS, Barcelona, Spain
| | - Enrique J Calderón
- Hospital Universitario Virgen del Rocío de Sevilla, Sevilla, Spain,Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain,University of Sevilla, Sevilla, Spain,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain,Consejo Superior de Investigaciones Científicas, Sevilla, Spain
| | - Enrique Navas
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain
| | - Erik Solligård
- Geminicenter for Sepsis Research, Institute of Circulation and Medical Imaging (ISB), NTNU, Trondheim, Norway,Clinic of Anesthesia and Intensive Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ernesto Contro
- Accident and Emergency and Emergency Medicine Unit, San Gerardo Hospital, Monza, Italy
| | | | - Fátima Aziz
- Hospital Clinic, University of Barcelona, and IDIBAPS, Barcelona, Spain
| | - Federico Garcia
- Ibs.Granada Instituto de Investigación Biosanitaria, Granada, Spain,Microbiology Unit. Hospital Universitario Clinico San Cecilio, Granada, Spain,Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Félix García Sánchez
- Histocompatibilidad y Biologia Molecular, Centro de Transfusion de Madrid, Madrid, Spain
| | | | - Filippo Martinelli-Boneschi
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, University of Milan, Milan, Italy,Neurology Unit, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Flora Peyvandi
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
| | - Florian Kurth
- Charite Universitätsmedizin Berlin, Berlin, Germany,Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany,Department of Medicine I, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Francesco Blasi
- Respiratory Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | | | - Francisco J Medrano
- Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain,University of Sevilla, Sevilla, Spain,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain,Consejo Superior de Investigaciones Científicas, Sevilla, Spain,Internal Medicine Department, Virgen del Rocio University Hospital, Sevilla, Spain
| | - Francisco Mesonero
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,Department of Gastroenterology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain
| | - Francisco Rodriguez-Frias
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Barcelona, Spain,Department of Biochemistry, University Hospital Vall d’Hebron, Barcelona, Spain,Microbiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain,Universitat Autònoma de Barcelona, Bellatera, Spain,Biochemistry Department, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Frank Hanses
- Emergency Department, University Hospital Regensburg, Regensburg, Germany,Department for Infectious Diseases and Infection Control, University Hospital Regensburg, Regensburg, Germany
| | - Fredrik Müller
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | | | - Giacomo Bellani
- Department Emergency, Anesthesia and Intensive Care, San Gerardo Hospital, Monza, Italy,School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Giacomo Grasselli
- University of Milan, Milan, Italy,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianni Pezzoli
- Fondazione Grigioni per il Morbo di Parkinson and Parkinson Institute, ASST Gaetano Pini-CTO, Milan, Italy
| | - Giorgio Costantino
- University of Milan, Milan, Italy,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Giulia Cardamone
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Giuseppe Bellelli
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy,Acute Geriatric Unit, San Gerardo Hospital, Monza, Italy
| | - Giuseppe Citerio
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy,Neurointensive Care Unit, San Gerardo Hospital, Monza, Italy
| | - Giuseppe Foti
- Department Emergency, Anesthesia and Intensive Care, San Gerardo Hospital, Monza, Italy,School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Giuseppe Lamorte
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Matullo
- Department of Medical Sciences, Università degli Studi di Torino, Turin, Italy
| | - Guido Baselli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Holger Neb
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Ilaria My
- IRCCS Humanitas Research Hospital, Milan, Italy
| | - Ingo Kurth
- Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Isabel Hernández
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Isabell Pink
- Department of Pneumology, Hannover Medical School, Hannover, Germany
| | - Itziar de Rojas
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Iván Galván-Femenia
- Genomes for Life-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Jan Cato Holter
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Jan Egil Afset
- Osakidetza Basque Health Service, Basurto University Hospital, Respiratory Service, Bilbao, Spain,Department of Medical Microbiology, Clinic of Laboratory Medicine, St. Olavs hospital, Trondheim, Norway
| | - Jan Heyckendorf
- Respiratory Medicine and International Health, University of Lübeck, Lübeck, Germany,Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany,Clinical Tuberculosis Unit, German Center for Infection Research (DZIF), Borstel, Germany
| | - Jan Kässens
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - Jan Kristian Damås
- Department of Infectious Diseases, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway,Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
| | - Jan Rybniker
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany,German Centre for Infection Research (DZIF), Cologne, Germany
| | - Janine Altmüller
- Cologne Center for Genomics (CCG), University of Cologne, Cologne, Germany
| | - Javier Ampuero
- Hospital Universitario Virgen del Rocío de Sevilla, Sevilla, Spain,Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain,University of Sevilla, Sevilla, Spain,Digestive Diseases Unit, Virgen del Rocio University Hospital, Institute of Biomedicine of Seville, University of Seville, Seville, Spain
| | - Javier Martín
- Institute of Parasitology and Biomedicine Lopez-Neyra, CSIC, Granada, Spain
| | - Jeanette Erdmann
- Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany,German Research Center for Cardiovascular Research, Lübeck, Germany,University Heart Center Lübeck, Lübeck, Germany
| | - Jesus M Banales
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,Department of Liver and Gastrointestinal Diseases, Biodonostia Health Research Institute—Donostia University Hospital, University of the Basque Country (UPV/EHU), CIBERehd, Ikerbasque, San Sebastian, Spain,Ikerbasque, Basque Foundation for Science, Bilbao, Spain
| | - Joan Ramon Badia
- Respiratory ICU, Institut Clínic Respiratory, Hospital Clinic, University of Barcelona, and IDIBAPS, Barcelona, Spain
| | - Joaquin Dopazo
- Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain,Bioinformatics Area, Fundación Progreso y Salud, and Institute of Biomedicine of Sevilla (IBIS), Sevilla, Spain
| | - Jochen Schneider
- Department of Internal Medicine V—Pneumology, Allergology and Intensive Care Medicine, University Hospital Saarland, Homburg, Germany
| | - Jonas Bergan
- Department of Research, Ostfold Hospital Trust, Gralum, Norway
| | - Jordi Barretina
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Jörn Walter
- Department of Genetics & Epigenetics, Saarland University, Saarbrücken, Germany
| | - Jose Hernández Quero
- Ibs.Granada Instituto de Investigación Biosanitaria, Granada, Spain,Department of Infectious Diseases, Hospital Universitario Clinico San Cecilio, Granada, Spain
| | - Josune Goikoetxea
- Infectious Diseases Service, Osakidetza, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Juan Delgado
- Hospital Universitario Virgen del Rocío de Sevilla, Sevilla, Spain,Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain,University of Sevilla, Sevilla, Spain,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain,Consejo Superior de Investigaciones Científicas, Sevilla, Spain
| | - Juan M Guerrero
- Hospital Universitario Virgen del Rocío de Sevilla, Sevilla, Spain,Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain,University of Sevilla, Sevilla, Spain
| | - Julia Fazaal
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Julia Kraft
- Charite Universitätsmedizin Berlin, Berlin, Germany
| | - Julia Schröder
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Kari Risnes
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway,Department of Research, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Karina Banasik
- Novo Nordisk Foundation Center for Protein Research, Disease Systems Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Karl Erik Müller
- Medical Department, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Karoline I Gaede
- Research Center Borstel, BioMaterialBank Nord, Borstel, Germany,German Center for Lung Research (DZL), Airway Research Center North (ARCN), Borstel, Germany,Popgen 2.0 Network (P2N), Kiel, Germany
| | - Koldo Garcia-Etxebarria
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,Department of Liver and Gastrointestinal Diseases, Biodonostia Health Research Institute—Donostia University Hospital, University of the Basque Country (UPV/EHU), CIBERehd, Ikerbasque, San Sebastian, Spain
| | - Kristian Tonby
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Infectious diseases, Oslo University Hospital, Oslo, Norway
| | - Lars Heggelund
- Medical Department, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Laura Izquierdo-Sanchez
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,Department of Liver and Gastrointestinal Diseases, Biodonostia Health Research Institute—Donostia University Hospital, University of the Basque Country (UPV/EHU), CIBERehd, Ikerbasque, San Sebastian, Spain,Biodonostia Health Research Institute, Donostia University Hospital, San Sebastian, Spain
| | - Laura Rachele Bettini
- Pediatric Departement, Centro Tettamanti-European Reference Network (ERN) PaedCan, EuroBloodNet, MetabERN-University of Milano-Bicocca-Fondazione MBBM/Ospedale, San Gerardo, Italy
| | - Lauro Sumoy
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | | | | | | | - Lindokuhle Nkambule
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA,Stanley Center for Psychiatric Research & Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Lisa Knopp
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Medical Faculty Heinrich Heine University, Duesseldorf, Germany
| | - Lise Tuset Gustad
- Geminicenter for Sepsis Research, Institute of Circulation and Medical Imaging (ISB), NTNU, Trondheim, Norway,Clinic of Medicine and Rehabilitation, Levanger Hospital, Nord-Trondelag Hospital Trust, Levanger, Norway
| | | | - Luigi Santoro
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luis Téllez
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,Department of Gastroenterology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain
| | - Luisa Roade
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain,Department of Respiratory Diseases, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain
| | | | - Maider Intxausti
- Osakidetza Basque Health Service, Basurto University Hospital, Respiratory Service, Bilbao, Spain
| | - Manolis Kogevinas
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain,ISGlobal, Barcelona, Spain,Universitat Pompeu Fabra (UPF), Barcelona, Spain,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Mar Riveiro-Barciela
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain,Universitat Autònoma de Barcelona, Bellatera, Spain
| | - Marc M Berger
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | | | - Mari E K Niemi
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - María A Gutiérrez-Stampa
- Osakidetza, OSI Donostialdea, Altza Primary Care, Biodonostia Health Research Institute, San Sebastián, Spain
| | - Maria Carrabba
- Internal Medicine Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria E Figuera Basso
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - Maria Grazia Valsecchi
- Center of Bioinformatics, Biostatistics and Bioimaging, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | | | - Maria J G T Vehreschild
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt & Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Maria Manunta
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Mariella D'Angiò
- Pediatric Departement, Centro Tettamanti-European Reference Network (ERN) PaedCan, EuroBloodNet, MetabERN-University of Milano-Bicocca-Fondazione MBBM/Ospedale, San Gerardo, Italy
| | - Marina Baldini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marina Cazzaniga
- Phase 1 Research Centre, ASST Monza, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Marit M Grimsrud
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Surgery, Inflammatory Diseases and Transplantation, Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet and University of Oslo, Oslo, Norway,Division of Surgery, Inflammatory Diseases and Transplantation, Department of Transplantation Medicine, Norwegian PSC Research Center, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Markus Cornberg
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Marta Marquié
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | | | - Mattia Cordioli
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Maurizio Cecconi
- IRCCS Humanitas Research Hospital, Milan, Italy,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Mauro D'Amato
- Ikerbasque, Basque Foundation for Science, Bilbao, Spain,Gastrointestinal Genetics Lab, CIC bioGUNE—BRTA, Derio, Spain,Department of Medicine and Surgery, LUM University, Casamassima, Italy
| | - Max Augustin
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany,German Center for Infection Research (DZIF), Cologne, Germany
| | - Melissa Tomasi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mercè Boada
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Michael Dreher
- Department of Pneumology and Intensive Care Medicine, University Hospital Aachen, Aachen, Germany
| | - Michael J Seilmaier
- Munich Clinic Schwabing, Academic Teaching Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Michael Joannidis
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Michael Wittig
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | | | | | - Miguel Rodríguez-Gandía
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,Department of Gastroenterology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain
| | | | - Monica Miozzo
- University of Milan, Milan, Italy,Internal Medicine Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Natale Imaz Ayo
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Natalia Blay
- Genomes for Life-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Natalia Chueca
- Microbiology Unit. Hospital Universitario Clinico San Cecilio, Granada, Spain
| | - Nicola Montano
- University of Milan, Milan, Italy,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nicole Braun
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany,University Hospital Schleswig-Holstein, Kiel, Germany
| | - Nicole Ludwig
- Department of Human Genetics, Center of Human and Molecular Biology, University Hospital Saarland, Homburg/Saar, Germany
| | - Nikolaus Marx
- Department of Internal Medicine I, RWTH Aachen University Hospital, Aachen, Germany
| | - Nilda Martínez
- Department of Anesthesiology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | | | - Oliver A Cornely
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany,Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany,German Center for Infection Research (DZIF), Cologne, Germany,Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), University of Cologne, Cologne, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Orazio Palmieri
- Gastroenterology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | - Paola Faverio
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy,Pulmonary Unit, San Gerardo Hospital, Monza, Italy
| | | | - Paolo Bonfanti
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy,Infectious Diseases Unit, San Gerardo Hospital, Monza, Italy
| | - Paolo Omodei
- Humanitas Clinical and Research Center, IRCCS, Milan, Italy
| | | | - Pedro Castro
- Hospital Clinic, University of Barcelona, and IDIBAPS, Barcelona, Spain
| | - Pedro M Rodrigues
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,Department of Liver and Gastrointestinal Diseases, Biodonostia Health Research Institute—Donostia University Hospital, University of the Basque Country (UPV/EHU), CIBERehd, Ikerbasque, San Sebastian, Spain,Ikerbasque, Basque Foundation for Science, Bilbao, Spain,Biodonostia Health Research Institute, Donostia University Hospital, San Sebastian, Spain
| | - Pedro Pablo España
- Osakidetza Basque Health Service, Galdakao Hospital, Respiratory Service, Galdakao, Spain
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Philip Rosenstiel
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - Philipp Schommers
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany,German Center for Infection Research (DZIF), Cologne, Germany
| | | | - Raúl de Pablo
- Department of Intensive Care, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain
| | - Ricard Ferrer
- Intensive Care Department, Vall d'Hebron University Hospital, SODIR-VHIR research group, Barcelona, Spain
| | - Robert Bals
- Department of Internal Medicine V—Pneumology, Allergology and Intensive Care Medicine, University Hospital Saarland, Homburg, Germany
| | - Roberta Gualtierotti
- University of Milan, Milan, Italy,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Rocío Gallego-Durán
- Hospital Universitario Virgen del Rocío de Sevilla, Sevilla, Spain,Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
| | - Rosa Nieto
- Department of Respiratory Diseases, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain,Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), University of Alcalá, Madrid, Spain
| | - Rossana Carpani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Rubén Morilla
- Hospital Universitario Virgen del Rocío de Sevilla, Sevilla, Spain,Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain,University of Sevilla, Sevilla, Spain,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain,Consejo Superior de Investigaciones Científicas, Sevilla, Spain
| | | | - Sammra Haider
- Department of Medicine, Møre & Romsdal Hospital Trust, Molde, Norway
| | - Sandra Ciesek
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany,German Centre for Infection Research (DZIF), Frankfurt am Main, Germany
| | - Sandra May
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - Sara Bombace
- IRCCS Humanitas Research Hospital, Milan, Italy,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Sara Marsal
- Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Barcelona, Spain
| | - Sara Pigazzini
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Sebastian Klein
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Serena Pelusi
- University of Milan, Milan, Italy,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sibylle Wilfling
- Department for Infectious Diseases and Infection Control, University Hospital Regensburg, Regensburg, Germany,Zentrum für Humangenetik Regensburg, Regensburg, Germany,Department of Neurology, Bezirksklinikum Regensburg, University of Regensburg, Regensburg, Germany
| | - Silvano Bosari
- University of Milan, Milan, Italy,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sonja Volland
- Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Disease Systems Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Soumya Raychaudhuri
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA,Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA,Division of Genetics, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA,Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA,Center for Data Sciences, Brigham and Women’s Hospital, Boston, MA, USA,Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Stefan Schreiber
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany,Klinik für Innere Medizin I, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Stefano Aliberti
- IRCCS Humanitas Research Hospital, Milan, Italy,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Susanne Dudman
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Tanja Wesse
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - Tenghao Zheng
- School of Biological Sciences, Monash University, Clayton, VIC, Australia
| | | | - Thomas Bahmer
- Klinik für Innere Medizin I, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Thomas Eggermann
- Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Thomas Illig
- Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - Thorsten Brenner
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Tomas Pumarola
- Department of Microbiology, University Hospital Vall d’Hebron, Barcelona, Spain,Autonoma University of Barcelona, Barcelona, Spain
| | - Torsten Feldt
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Medical Faculty Heinrich Heine University, Duesseldorf, Germany
| | - Trine Folseraas
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Surgery, Inflammatory Diseases and Transplantation, Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet and University of Oslo, Oslo, Norway,Division of Surgery, Inflammatory Diseases and Transplantation, Department of Transplantation Medicine, Norwegian PSC Research Center, Oslo University Hospital Rikshospitalet, Oslo, Norway,Division for Cancer Medicine, Surgery and Transplantation, Section for Gastroenterology, Department of Transplantation Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | | | - Ulf Landmesser
- Berlin Institute of Health, Charite Universitätsmedizin Berlin, Berlin Germany
| | - Ulrike Protzer
- Institute of Virology, Technical University Munich/Helmholtz Zentrum München, Munich, Germany,German Center for Infection Research (DZIF), Munich, Germany
| | - Ute Hehr
- Zentrum für Humangenetik Regensburg, Regensburg, Germany
| | - Valeria Rimoldi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Valter Monzani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Vegard Skogen
- Department of Infectious Diseases, University Hospital of North Norway, Tromsø, Norway,Faculty of Health Sciences, UIT The Arctic University of Norway, Norway
| | - Verena Keitel
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Medical Faculty Heinrich Heine University, Duesseldorf, Germany
| | - Verena Kopfnagel
- Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - Vicente Friaza
- Hospital Universitario Virgen del Rocío de Sevilla, Sevilla, Spain,Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain,University of Sevilla, Sevilla, Spain,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain,Consejo Superior de Investigaciones Científicas, Sevilla, Spain
| | - Victor Andrade
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany,Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Medical Faculty, Bonn, Germany
| | - Victor Moreno
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain,Catalan Institute of Oncology (ICO), Barcelona, Spain,Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain,Universitat de Barcelona (UB), Barcelona, Spain
| | - Wolfgang Albrecht
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - Wolfgang Peter
- Stefan-Morsch-Stiftung, Birkenfeld, Germany,Faculty of Medicine and University Hospital Cologne, Institute for Transfusion Medicine, University of Cologne, Cologne, Germany
| | | | - Xavier Farre
- Genomes for Life-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Xiaoli Yi
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - Xiaomin Wang
- Charite Universitätsmedizin Berlin, Berlin, Germany
| | - Yascha Khodamoradi
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt & Goethe University Frankfurt, Frankfurt am Main, Germany
| | | | - Anna Latiano
- Gastroenterology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Siegfried Goerg
- Institute of Transfusionsmedicine, University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - Petra Bacher
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany,Institute of Immunology, Christian-Albrechts-University of Kiel and UKSH Schleswig-Holstein, Kiel, Germany
| | - Philipp Koehler
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany,Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - Florian Tran
- Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany,Klinik für Innere Medizin I, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Heinz Zoller
- Department of Medicine I, Gastroenterology, Hepatology and Endocrinology, Medical University of Innsbruck, Innsbruck, Austria,Christian Doppler Laboratory of Iron and Phosphate Biology at the Department of Medicine I, Medical University of Innsbruck, Innsbruck, Austria
| | - Eva C Schulte
- Institute of Virology, Technical University Munich/Helmholtz Zentrum München, Munich, Germany,Institute of Psychiatric Phenomics and Genomics, University Medical Center, University of Munich, Munich, Germany,Department of Psychiatry, University Medical Center, University of Munich, Munich, Germany
| | | | - Kerstin U Ludwig
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Javier Fernández
- Hospital Clinic, University of Barcelona, and IDIBAPS, Barcelona, Spain,European Foundation for the Study of Chronic Liver Failure (EF-CLIF), Barcelona, Spain
| | - Manuel Romero-Gómez
- Hospital Universitario Virgen del Rocío de Sevilla, Sevilla, Spain,Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain,University of Sevilla, Sevilla, Spain,Digestive Diseases Unit, Virgen del Rocio University Hospital, Institute of Biomedicine of Seville, University of Seville, Seville, Spain
| | - Agustín Albillos
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,Department of Gastroenterology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain
| | - Pietro Invernizzi
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy,Division of Gastroenterology, School of Medicine and Surgery, Center for Autoimmune Liver Diseases, University of Milano-Bicocca, Milan, Italy
| | - Maria Buti
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain,Universitat Autònoma de Barcelona, Bellatera, Spain
| | - Stefano Duga
- IRCCS Humanitas Research Hospital, Milan, Italy,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Luis Bujanda
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,Department of Liver and Gastrointestinal Diseases, Biodonostia Health Research Institute—Donostia University Hospital, University of the Basque Country (UPV/EHU), CIBERehd, Ikerbasque, San Sebastian, Spain
| | | | | | | | | | | | | | | | - Andre Franke
- To whom correspondence should be addressed. (Frauke Degenhardt) and (Andre Franke)
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Delbrück M, Hoehl S, Toptan T, Schenk B, Grikscheit K, Metzler M, Herrmann E, Ciesek S. Low But Recoverable Markers of Humoral Immune Response to BNT162b2 in Elderly LTCF Residents Five to Seven Months After Two-Dose Vaccination. Front Aging 2022; 3:883724. [PMID: 35821813 PMCID: PMC9261435 DOI: 10.3389/fragi.2022.883724] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/29/2022] [Indexed: 12/31/2022]
Abstract
The immune response is known to wane after vaccination with BNT162b2, but the role of age, morbidity and body composition is not well understood. We conducted a cross-sectional study in long-term care facilities (LTCFs) for the elderly. All study participants had completed two-dose vaccination with BNT162b2 five to 7 months before sample collection. In 298 residents (median age 86 years, range 75–101), anti-SARS-CoV-2 rector binding IgG antibody (anti-RBD-IgG) concentrations were low and inversely correlated with age (mean 51.60 BAU/ml). We compared the results to Health Care Workers (HCW) aged 18–70 years (n = 114, median age: 53 years), who had a higher mean anti-RBD-IgG concentration of 156.99 BAU/ml. Neutralization against the Delta variant was low in both groups (9.5% in LTCF residents and 31.6% in HCWs). The Charlson Comorbidity Index was inversely correlated with anti-RBD-IgG, but not the body mass index (BMI). A control group of 14 LTCF residents with known breakthrough infection had significant higher antibody concentrations (mean 3,199.65 BAU/ml), and 85.7% had detectable neutralization against the Delta variant. Our results demonstrate low but recoverable markers of immunity in LTCF residents five to 7 months after vaccination.
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Affiliation(s)
- Marla Delbrück
- Institute of Medical Virology, Goethe University Frankfurt, Frankfurt, Germany
| | - Sebastian Hoehl
- Institute of Medical Virology, Goethe University Frankfurt, Frankfurt, Germany
| | - Tuna Toptan
- Institute of Medical Virology, Goethe University Frankfurt, Frankfurt, Germany
| | - Barbara Schenk
- Institute of Medical Virology, Goethe University Frankfurt, Frankfurt, Germany
| | | | - Melinda Metzler
- Institute of Medical Virology, Goethe University Frankfurt, Frankfurt, Germany
| | - Eva Herrmann
- Institute of Biostatistics and Mathematical Modeling, Goethe University Frankfurt, Frankfurt, Germany
| | - Sandra Ciesek
- Institute of Medical Virology, Goethe University Frankfurt, Frankfurt, Germany.,Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, Frankfurt, Germany.,German Center for Infection Research, DZIF, External Partner Site Frankfurt, Braunschweig, Germany
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46
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Jarisch A, Wiercinska E, Huenecke S, Bremm M, Cappel C, Hauler J, Rettinger E, Soerensen J, Hellstern H, Klusmann JH, Ciesek S, Bonig H, Bader P. Immune Responses to SARS-CoV-2 Vaccination in Young Patients with Anti-CD19 Chimeric Antigen Receptor T Cell-Induced B Cell Aplasia. Transplant Cell Ther 2022; 28:366.e1-366.e7. [PMID: 35472554 PMCID: PMC9040419 DOI: 10.1016/j.jtct.2022.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 01/27/2022] [Revised: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 01/06/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are capable of inducing combined humoral and cellular immunity. Which effect is more relevant for their potent protective effects is unclear, but isolated T cell responses without seroconversion in healthy household members of individuals with Coronavirus disease 19 (COVID-19) suggest that T cell responses effectively protect against clinical infection. Oncologic patients have an outsize risk of unfavorable outcomes after SARS-CoV-2 infection and therefore were prioritized when vaccines first became available, although the quality of their immune response to vaccination was expected to be suboptimal, as has been confirmed in subsequent studies. Inherently, patients with anti-CD19 chimeric antigen receptor (CAR) T cell therapy-mediated B cell aplasia would be incapable of generating humoral responses, so that assessment of the vaccine-induced cellular immunity is all the more important to gauge whether the vaccine can induce meaningful protection. A salient difference between T cell and humoral responses is the former's relative impassiveness to mutations of the antigen, which is more relevant than ever since the advent of the omicron variant. The objective of this study was to assess the immune cell composition and spike protein-specific T cell responses before and after the first and second doses of SARS-CoV-2 mRNA vaccine in a cohort of juvenile CD19 CAR T cell therapy recipients with enduring B cell aplasia. The prospective study included all patients age >12 years diagnosed with multiply relapsed B cell precursor acute lymphoblastic leukemia and treated with anti-CD19 CAR T cell (CAR-T19) therapy in our center. The primary endpoint was the detection of cell-mediated and humoral responses to vaccine (flow cytometry and anti-S immunoglobulin G, respectively). Secondary endpoints included the incidence of vaccine-related grade 3 or 4 adverse events, exacerbation of graft-versus-host disease (GVHD), relapse, and the influence of the vaccine on CAR T cells and lymphocyte subsets. Even though one-half of the patients exhibited subnormal lymphocyte counts and marginal CD4/CD8 ratios, after 2 vaccinations all showed brisk T-cell responsiveness to spike protein, predominantly in the CD4 compartment, which quantitatively was well within the range of healthy controls. No severe vaccine-related grade 3 or 4 adverse events, GVHD exacerbation, or relapse was observed in our cohort. We posit that SARS-CoV-2 mRNA vaccines induce meaningful cellular immunity in patients with isolated B cell deficiency due to CAR-T19 therapy.
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Affiliation(s)
- Andrea Jarisch
- Division of Pediatric Stem Cell Transplantation and Immunology, Department of Child and Adolescent Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
| | - Eliza Wiercinska
- German Red Cross Blood Service, Baden-Württemberg-Hessen, Institute Frankfurt, Frankfurt, Germany
| | - Sabine Huenecke
- Division of Pediatric Stem Cell Transplantation and Immunology, Department of Child and Adolescent Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Melanie Bremm
- Division of Pediatric Stem Cell Transplantation and Immunology, Department of Child and Adolescent Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Claudia Cappel
- Division of Pediatric Stem Cell Transplantation and Immunology, Department of Child and Adolescent Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Julian Hauler
- Division of Pediatric Stem Cell Transplantation and Immunology, Department of Child and Adolescent Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Eva Rettinger
- Division of Pediatric Stem Cell Transplantation and Immunology, Department of Child and Adolescent Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Jan Soerensen
- Division of Pediatric Stem Cell Transplantation and Immunology, Department of Child and Adolescent Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Helen Hellstern
- German Red Cross Blood Service, Baden-Württemberg-Hessen, Institute Frankfurt, Frankfurt, Germany
| | - Jan-Henning Klusmann
- Division of Pediatric Stem Cell Transplantation and Immunology, Department of Child and Adolescent Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Department of Child and Adolescent Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Halvard Bonig
- German Red Cross Blood Service, Baden-Württemberg-Hessen, Institute Frankfurt, Frankfurt, Germany; Institute for Transfusion Medicine and Immunohematology of Goethe University and German Red Cross Blood Service, Baden-Württemberg-Hessen, Frankfurt am Main, Germany; Department of Medicine/Hematology, University of Washington, Seattle, Washington
| | - Peter Bader
- Division of Pediatric Stem Cell Transplantation and Immunology, Department of Child and Adolescent Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
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47
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Bojkova D, Stack R, Rothenburger T, Kandler JD, Ciesek S, Wass MN, Michaelis M, Cinatl J. Synergism of interferon-beta with antiviral drugs against SARS-CoV-2 variants. J Infect 2022; 85:573-607. [PMID: 35917841 PMCID: PMC9339084 DOI: 10.1016/j.jinf.2022.07.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 02/05/2023]
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48
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Chiu W, Verschueren L, Van den Eynde C, Buyck C, De Meyer S, Jochmans D, Bojkova D, Ciesek S, Cinatl J, De Jonghe S, Leyssen P, Neyts J, Van Loock M, Van Damme E. Development and optimization of a high-throughput screening assay for in vitro anti-SARS-CoV-2 activity: Evaluation of 5676 Phase 1 Passed Structures. J Med Virol 2022; 94:3101-3111. [PMID: 35229317 PMCID: PMC9088669 DOI: 10.1002/jmv.27683] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 02/02/2022] [Revised: 02/25/2022] [Accepted: 02/27/2022] [Indexed: 01/09/2023]
Abstract
Although vaccines are currently used to control the coronavirus disease 2019 (COVID-19) pandemic, treatment options are urgently needed for those who cannot be vaccinated and for future outbreaks involving new severe acute respiratory syndrome coronavirus virus 2 (SARS-CoV-2) strains or coronaviruses not covered by current vaccines. Thus far, few existing antivirals are known to be effective against SARS-CoV-2 and clinically successful against COVID-19. As part of an immediate response to the COVID-19 pandemic, a high-throughput, high content imaging-based SARS-CoV-2 infection assay was developed in VeroE6 African green monkey kidney epithelial cells expressing a stable enhanced green fluorescent protein (VeroE6-eGFP cells) and was used to screen a library of 5676 compounds that passed Phase 1 clinical trials. Eight drugs (nelfinavir, RG-12915, itraconazole, chloroquine, hydroxychloroquine, sematilide, remdesivir, and doxorubicin) were identified as inhibitors of in vitro anti-SARS-CoV-2 activity in VeroE6-eGFP and/or Caco-2 cell lines. However, apart from remdesivir, toxicity and pharmacokinetic data did not support further clinical development of these compounds for COVID-19 treatment.
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Affiliation(s)
- Winston Chiu
- KU Leuven, Department of Microbiology, Immunology and TransplantationRega Institute, Laboratory of Virology and ChemotherapyLeuvenBelgium
| | | | | | | | | | - Dirk Jochmans
- KU Leuven, Department of Microbiology, Immunology and TransplantationRega Institute, Laboratory of Virology and ChemotherapyLeuvenBelgium
| | - Denisa Bojkova
- Institute of Medical VirologyUniversity Hospital Frankfurt, Goethe UniversityFrankfurt am MainGermany
| | - Sandra Ciesek
- Institute of Medical VirologyUniversity Hospital Frankfurt, Goethe UniversityFrankfurt am MainGermany
| | - Jindrich Cinatl
- Institute of Medical VirologyUniversity Hospital Frankfurt, Goethe UniversityFrankfurt am MainGermany
| | - Steven De Jonghe
- KU Leuven, Department of Microbiology, Immunology and TransplantationRega Institute, Laboratory of Virology and ChemotherapyLeuvenBelgium
| | - Pieter Leyssen
- KU Leuven, Department of Microbiology, Immunology and TransplantationRega Institute, Laboratory of Virology and ChemotherapyLeuvenBelgium
| | - Johan Neyts
- KU Leuven, Department of Microbiology, Immunology and TransplantationRega Institute, Laboratory of Virology and ChemotherapyLeuvenBelgium
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Kohmer N, Kortenbusch M, Berger A, Rühl C, Ciesek S, Salla S, Rabenau HF. Suitability of Different Diagnostic Platforms for Virological Testing of Blood Samples from Cornea Donors. Transfus Med Hemother 2022; 49:379-387. [PMID: 36654977 PMCID: PMC9768292 DOI: 10.1159/000524250] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/09/2022] [Indexed: 01/21/2023] Open
Abstract
Background To minimize the risk of disease transmission in cornea transplantation, donor screening for blood-derived viral infections is mandatory. Ideally, pre-mortem blood samples are used, but based on availability, cadaveric blood samples of cornea donors may also be used. However, serological and nucleic acid amplification tests (NATs) need to be validated for the use of cadaveric specimens. Methods Hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), human T-lymphotropic virus (HTLV) 1/2, and Treponema pallidum (syphilis)-specific serological and/or NAT assays were validated on different platforms (Abbott Alinity i, Alinity m, Roche Cobas 6800, and Roche Cobas AmpliPrep/Cobas TaqMan (CAP/CTM)) using (un)spiked paired pre- and post-mortem cornea donor blood samples from the same individual (up to 23.83 h after death) of 28 individuals in accordance with the specifications of the German Federal Institute for Vaccines and Biomedicines (Paul-Ehrlich-Institut [PEI]). In addition, routinely HBV-, HCV- and HIV-PCR-negative tested post-mortem blood samples of 24 individuals were used to assess NAT specificity. Results For the majority of serological parameters on the Abbott Alinity i (HBsAg, anti-HBc, anti-HBs, anti-HCV, anti-HIV, anti-HTLV 1/2, and anti-Treponema pallidum), ratios of generated test results of (un)spiked paired pre- and post-mortem blood samples differed ≤25%, with an agreement of qualitative pre- and post-mortem test results ranging from 91.2 to 100%. For NAT parameters (HBV, HCV, and HIV) on the Cobas 6800, Alinity m, and CAP/CTM, no significant deviation in virus concentrations (factor >5) of spiked pre- and post-mortem blood samples could be observed. Ct-values of corresponding internal controls did also not differ significantly (>1.5 Ct-values). In addition, no false-positive test results were generated when specificity was assessed. Conclusion Overall, fluctuations of test results for serological and NAT parameters in pre- and post-mortem blood samples examined in this study, were only limited and within the range of what is also observed when routinely testing fresh patient specimens. We conclude that all examined assays are eligible for the screening of blood samples taken up to about 24 h after the occurrence of death.
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Affiliation(s)
- Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Marhild Kortenbusch
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Cornelia Rühl
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany,German Centre for Infection Research, External Partner Site Frankfurt, Frankfurt, Germany,Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, Frankfurt, Germany
| | - Sabine Salla
- Department of Ophthalmology, RTWH Aachen University, Aachen, Germany
| | - Holger F. Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany,*Holger F. Rabenau,
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50
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Enssle JC, Campe J, Büchel S, Moter A, See F, Grießbaum K, Rieger MA, Wolf S, Ballo O, Steffen B, Serve H, Rabenau HF, Widera M, Bremm M, Huenecke S, Ciesek S, von Metzler I, Ullrich E. Enhanced but variant-dependent serological and cellular immune responses to third-dose BNT162b2 vaccination in patients with multiple myeloma. Cancer Cell 2022; 40:587-589. [PMID: 35588736 PMCID: PMC9116569 DOI: 10.1016/j.ccell.2022.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Affiliation(s)
- Julius C Enssle
- Department of Medicine, Hematology/Oncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Frankfurt partner site, Germany
| | - Julia Campe
- Experimental Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
| | - Sarah Büchel
- Experimental Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
| | - Alina Moter
- Experimental Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
| | - Frederic See
- Experimental Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
| | - Katharina Grießbaum
- Experimental Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
| | - Michael A Rieger
- Department of Medicine, Hematology/Oncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Frankfurt partner site, Germany; Cardio-Pulmonary Institute, Frankfurt am Main, Germany
| | - Sebastian Wolf
- Department of Medicine, Hematology/Oncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Frankfurt partner site, Germany
| | - Olivier Ballo
- Department of Medicine, Hematology/Oncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Björn Steffen
- Department of Medicine, Hematology/Oncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Hubert Serve
- Department of Medicine, Hematology/Oncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Frankfurt partner site, Germany
| | - Holger F Rabenau
- Insitute for Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Marek Widera
- Insitute for Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Melanie Bremm
- Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Sabine Huenecke
- Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Insitute for Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; German Centre for Infection Research (DZIF), External partner site, Frankfurt am Main, Germany; Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, Frankfurt am Main, Germany
| | - Ivana von Metzler
- Department of Medicine, Hematology/Oncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Frankfurt partner site, Germany.
| | - Evelyn Ullrich
- Experimental Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Division of Pediatric Stem Cell Transplantation and Immunology, Department for Children and Adolescents Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Frankfurt partner site, Germany
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