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Airway antibodies emerge according to COVID-19 severity and wane rapidly but reappear after SARS-CoV-2 vaccination
Alberto Cagigi, … , Karin Loré, Anna Smed-Sörensen
Alberto Cagigi, … , Karin Loré, Anna Smed-Sörensen
Published October 19, 2021
Citation Information: JCI Insight. 2021;6(22):e151463. https://doi.org/10.1172/jci.insight.151463.
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Research Article COVID-19 Immunology

Airway antibodies emerge according to COVID-19 severity and wane rapidly but reappear after SARS-CoV-2 vaccination

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Abstract

Understanding the presence and durability of antibodies against SARS-CoV-2 in the airways is required to provide insights into the ability of individuals to neutralize the virus locally and prevent viral spread. Here, we longitudinally assessed both systemic and airway immune responses upon SARS-CoV-2 infection in a clinically well-characterized cohort of 147 infected individuals representing the full spectrum of COVID-19 severity, from asymptomatic infection to fatal disease. In addition, we evaluated how SARS-CoV-2 vaccination influenced the antibody responses in a subset of these individuals during convalescence as compared with naive individuals. Not only systemic but also airway antibody responses correlated with the degree of COVID-19 disease severity. However, although systemic IgG levels were durable for up to 8 months, airway IgG and IgA declined significantly within 3 months. After vaccination, there was an increase in both systemic and airway antibodies, in particular IgG, often exceeding the levels found during acute disease. In contrast, naive individuals showed low airway antibodies after vaccination. In the former COVID-19 patients, airway antibody levels were significantly elevated after the boost vaccination, highlighting the importance of prime and boost vaccinations for previously infected individuals to obtain optimal mucosal protection.

Authors

Alberto Cagigi, Meng Yu, Björn Österberg, Julia Svensson, Sara Falck-Jones, Sindhu Vangeti, Eric Åhlberg, Lida Azizmohammadi, Anna Warnqvist, Ryan Falck-Jones, Pia C. Gubisch, Mert Ödemis, Farangies Ghafoor, Mona Eisele, Klara Lenart, Max Bell, Niclas Johansson, Jan Albert, Jörgen Sälde, Deleah D. Pettie, Michael P. Murphy, Lauren Carter, Neil P. King, Sebastian Ols, Johan Normark, Clas Ahlm, Mattias N. Forsell, Anna Färnert, Karin Loré, Anna Smed-Sörensen

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Figure 5

Assessment of frequencies of B cells in the respiratory tract and of circulating S-specific memory B cells.

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Assessment of frequencies of B cells in the respiratory tract and of cir...
(A) Representative example with gating strategy for the identification of lymphocytes (identified as negative for CD14/16/123/66) and of total B cells (CD3–CD19+) in respiratory NPA and ETA samples. (B) Lymphocytes and total B cells in NPAs and ETAs in a subset of patients alongside NPAs from healthy controls. Kruskal-Wallis with Dunn’s multiple comparisons test was used and considered statistically significant at P < 0.05. *P < 0.05, **P < 0.01. (C) Representative examples with gating strategy of SARS-CoV-2 S-specific memory B cells from 1 PPHC and 3-month follow-up samples from 1 SARS-CoV-2 PCR– individual and 1 mild and 1 moderate/severe COVID-19 patient. Further characterization of S-positive memory B cells on RBD binding and B cell isotype (IgG+ or IgA+ assumed to correspond to IgD–IgM–IgG– B cells). (D) Bar charts show the cumulative proportion (frequency) of S- (blue) and RBD- (yellow) specific memory B cells as well as the proportion of IgG (green) versus IgA (red) isotypes among the S-specific memory B cells in longitudinal samples from mild (n = 6) and moderate/severe (n = 8) COVID-19 patients. (E) Frequencies of S-specific memory B cells in matched acute and 3-month follow-up PBMCs in relation to days in the subset of individuals analyzed (n = 14) color-coded according to PDS. Dotted lines indicate the average background staining from PCR– and PPHC. (F) Levels of circulating S+ switched memory B cells during acute disease and convalescence in the subset of patients analyzed, as well as PPHCs, color-coded according to PDS. Black triangles symbolize the PPHCs. Differences were assessed using Kruskal-Wallis with Dunn’s multiple comparisons test and considered statistically significant at P < 0.05. **P < 0.01.

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