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SARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination

BACKGROUND: Most studies of immunity to SARS-CoV-2 focus on circulating antibody, giving limited insights into mucosal defences that prevent viral replication and onward transmission. We studied nasal and plasma antibody responses one year after hospitalisation for COVID-19, including a period when...

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Autores principales: Liew, Felicity, Talwar, Shubha, Cross, Andy, Willett, Brian J., Scott, Sam, Logan, Nicola, Siggins, Matthew K., Swieboda, Dawid, Sidhu, Jasmin K., Efstathiou, Claudia, Moore, Shona C., Davis, Chris, Mohamed, Noura, Nunag, Jose, King, Clara, Thompson, A.A. Roger, Rowland-Jones, Sarah L., Docherty, Annemarie B., Chalmers, James D., Ho, Ling-Pei, Horsley, Alexander, Raman, Betty, Poinasamy, Krisnah, Marks, Michael, Kon, Onn Min, Howard, Luke, Wootton, Daniel G., Dunachie, Susanna, Quint, Jennifer K., Evans, Rachael A., Wain, Louise V., Fontanella, Sara, de Silva, Thushan I., Ho, Antonia, Harrison, Ewen, Baillie, J. Kenneth, Semple, Malcolm G., Brightling, Christopher, Thwaites, Ryan S., Turtle, Lance, Openshaw, Peter J.M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9762734/
https://www.ncbi.nlm.nih.gov/pubmed/36543718
http://dx.doi.org/10.1016/j.ebiom.2022.104402
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author Liew, Felicity
Talwar, Shubha
Cross, Andy
Willett, Brian J.
Scott, Sam
Logan, Nicola
Siggins, Matthew K.
Swieboda, Dawid
Sidhu, Jasmin K.
Efstathiou, Claudia
Moore, Shona C.
Davis, Chris
Mohamed, Noura
Nunag, Jose
King, Clara
Thompson, A.A. Roger
Rowland-Jones, Sarah L.
Docherty, Annemarie B.
Chalmers, James D.
Ho, Ling-Pei
Horsley, Alexander
Raman, Betty
Poinasamy, Krisnah
Marks, Michael
Kon, Onn Min
Howard, Luke
Wootton, Daniel G.
Dunachie, Susanna
Quint, Jennifer K.
Evans, Rachael A.
Wain, Louise V.
Fontanella, Sara
de Silva, Thushan I.
Ho, Antonia
Harrison, Ewen
Baillie, J. Kenneth
Semple, Malcolm G.
Brightling, Christopher
Thwaites, Ryan S.
Turtle, Lance
Openshaw, Peter J.M.
author_facet Liew, Felicity
Talwar, Shubha
Cross, Andy
Willett, Brian J.
Scott, Sam
Logan, Nicola
Siggins, Matthew K.
Swieboda, Dawid
Sidhu, Jasmin K.
Efstathiou, Claudia
Moore, Shona C.
Davis, Chris
Mohamed, Noura
Nunag, Jose
King, Clara
Thompson, A.A. Roger
Rowland-Jones, Sarah L.
Docherty, Annemarie B.
Chalmers, James D.
Ho, Ling-Pei
Horsley, Alexander
Raman, Betty
Poinasamy, Krisnah
Marks, Michael
Kon, Onn Min
Howard, Luke
Wootton, Daniel G.
Dunachie, Susanna
Quint, Jennifer K.
Evans, Rachael A.
Wain, Louise V.
Fontanella, Sara
de Silva, Thushan I.
Ho, Antonia
Harrison, Ewen
Baillie, J. Kenneth
Semple, Malcolm G.
Brightling, Christopher
Thwaites, Ryan S.
Turtle, Lance
Openshaw, Peter J.M.
author_sort Liew, Felicity
collection PubMed
description BACKGROUND: Most studies of immunity to SARS-CoV-2 focus on circulating antibody, giving limited insights into mucosal defences that prevent viral replication and onward transmission. We studied nasal and plasma antibody responses one year after hospitalisation for COVID-19, including a period when SARS-CoV-2 vaccination was introduced. METHODS: In this follow up study, plasma and nasosorption samples were prospectively collected from 446 adults hospitalised for COVID-19 between February 2020 and March 2021 via the ISARIC4C and PHOSP-COVID consortia. IgA and IgG responses to NP and S of ancestral SARS-CoV-2, Delta and Omicron (BA.1) variants were measured by electrochemiluminescence and compared with plasma neutralisation data. FINDINGS: Strong and consistent nasal anti-NP and anti-S IgA responses were demonstrated, which remained elevated for nine months (p < 0.0001). Nasal and plasma anti-S IgG remained elevated for at least 12 months (p < 0.0001) with plasma neutralising titres that were raised against all variants compared to controls (p < 0.0001). Of 323 with complete data, 307 were vaccinated between 6 and 12 months; coinciding with rises in nasal and plasma IgA and IgG anti-S titres for all SARS-CoV-2 variants, although the change in nasal IgA was minimal (1.46-fold change after 10 months, p = 0.011) and the median remained below the positive threshold determined by pre-pandemic controls. Samples 12 months after admission showed no association between nasal IgA and plasma IgG anti-S responses (R = 0.05, p = 0.18), indicating that nasal IgA responses are distinct from those in plasma and minimally boosted by vaccination. INTERPRETATION: The decline in nasal IgA responses 9 months after infection and minimal impact of subsequent vaccination may explain the lack of long-lasting nasal defence against reinfection and the limited effects of vaccination on transmission. These findings highlight the need to develop vaccines that enhance nasal immunity. FUNDING: This study has been supported by ISARIC4C and PHOSP-COVID consortia. ISARIC4C is supported by grants from the 10.13039/501100000272National Institute for Health and Care Research and the 10.13039/501100000265Medical Research Council. Liverpool Experimental Cancer Medicine Centre provided infrastructure support for this research. The PHOSP-COVD study is jointly funded by 10.13039/100014013UK Research and Innovation and National Institute of Health and Care Research. The funders were not involved in the study design, interpretation of data or the writing of this manuscript.
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spelling pubmed-97627342022-12-20 SARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination Liew, Felicity Talwar, Shubha Cross, Andy Willett, Brian J. Scott, Sam Logan, Nicola Siggins, Matthew K. Swieboda, Dawid Sidhu, Jasmin K. Efstathiou, Claudia Moore, Shona C. Davis, Chris Mohamed, Noura Nunag, Jose King, Clara Thompson, A.A. Roger Rowland-Jones, Sarah L. Docherty, Annemarie B. Chalmers, James D. Ho, Ling-Pei Horsley, Alexander Raman, Betty Poinasamy, Krisnah Marks, Michael Kon, Onn Min Howard, Luke Wootton, Daniel G. Dunachie, Susanna Quint, Jennifer K. Evans, Rachael A. Wain, Louise V. Fontanella, Sara de Silva, Thushan I. Ho, Antonia Harrison, Ewen Baillie, J. Kenneth Semple, Malcolm G. Brightling, Christopher Thwaites, Ryan S. Turtle, Lance Openshaw, Peter J.M. eBioMedicine Articles BACKGROUND: Most studies of immunity to SARS-CoV-2 focus on circulating antibody, giving limited insights into mucosal defences that prevent viral replication and onward transmission. We studied nasal and plasma antibody responses one year after hospitalisation for COVID-19, including a period when SARS-CoV-2 vaccination was introduced. METHODS: In this follow up study, plasma and nasosorption samples were prospectively collected from 446 adults hospitalised for COVID-19 between February 2020 and March 2021 via the ISARIC4C and PHOSP-COVID consortia. IgA and IgG responses to NP and S of ancestral SARS-CoV-2, Delta and Omicron (BA.1) variants were measured by electrochemiluminescence and compared with plasma neutralisation data. FINDINGS: Strong and consistent nasal anti-NP and anti-S IgA responses were demonstrated, which remained elevated for nine months (p < 0.0001). Nasal and plasma anti-S IgG remained elevated for at least 12 months (p < 0.0001) with plasma neutralising titres that were raised against all variants compared to controls (p < 0.0001). Of 323 with complete data, 307 were vaccinated between 6 and 12 months; coinciding with rises in nasal and plasma IgA and IgG anti-S titres for all SARS-CoV-2 variants, although the change in nasal IgA was minimal (1.46-fold change after 10 months, p = 0.011) and the median remained below the positive threshold determined by pre-pandemic controls. Samples 12 months after admission showed no association between nasal IgA and plasma IgG anti-S responses (R = 0.05, p = 0.18), indicating that nasal IgA responses are distinct from those in plasma and minimally boosted by vaccination. INTERPRETATION: The decline in nasal IgA responses 9 months after infection and minimal impact of subsequent vaccination may explain the lack of long-lasting nasal defence against reinfection and the limited effects of vaccination on transmission. These findings highlight the need to develop vaccines that enhance nasal immunity. FUNDING: This study has been supported by ISARIC4C and PHOSP-COVID consortia. ISARIC4C is supported by grants from the 10.13039/501100000272National Institute for Health and Care Research and the 10.13039/501100000265Medical Research Council. Liverpool Experimental Cancer Medicine Centre provided infrastructure support for this research. The PHOSP-COVD study is jointly funded by 10.13039/100014013UK Research and Innovation and National Institute of Health and Care Research. The funders were not involved in the study design, interpretation of data or the writing of this manuscript. Elsevier 2022-12-19 /pmc/articles/PMC9762734/ /pubmed/36543718 http://dx.doi.org/10.1016/j.ebiom.2022.104402 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Articles
Liew, Felicity
Talwar, Shubha
Cross, Andy
Willett, Brian J.
Scott, Sam
Logan, Nicola
Siggins, Matthew K.
Swieboda, Dawid
Sidhu, Jasmin K.
Efstathiou, Claudia
Moore, Shona C.
Davis, Chris
Mohamed, Noura
Nunag, Jose
King, Clara
Thompson, A.A. Roger
Rowland-Jones, Sarah L.
Docherty, Annemarie B.
Chalmers, James D.
Ho, Ling-Pei
Horsley, Alexander
Raman, Betty
Poinasamy, Krisnah
Marks, Michael
Kon, Onn Min
Howard, Luke
Wootton, Daniel G.
Dunachie, Susanna
Quint, Jennifer K.
Evans, Rachael A.
Wain, Louise V.
Fontanella, Sara
de Silva, Thushan I.
Ho, Antonia
Harrison, Ewen
Baillie, J. Kenneth
Semple, Malcolm G.
Brightling, Christopher
Thwaites, Ryan S.
Turtle, Lance
Openshaw, Peter J.M.
SARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination
title SARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination
title_full SARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination
title_fullStr SARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination
title_full_unstemmed SARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination
title_short SARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination
title_sort sars-cov-2-specific nasal iga wanes 9 months after hospitalisation with covid-19 and is not induced by subsequent vaccination
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9762734/
https://www.ncbi.nlm.nih.gov/pubmed/36543718
http://dx.doi.org/10.1016/j.ebiom.2022.104402
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