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

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

doi:10.1172/jci.insight.151463

Cited by 31 publications

(24 citation statements)

References 62 publications

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“…Whilst a Dutch study of healthcare workers found that nasal antibody lasted 9 months after mild infection, others demonstrated rapid waning after 3 months. 8,9 Neither study examined a large cohort of hospitalised patients, and our findings confirm that COVID-19 can induce durable mucosal immunity. We also found that disease severity and age did not impact the longevity of the nasal responses in keeping with a recent study of 26 unvaccinated individuals.…”

Section: Discussionsupporting

confidence: 65%

“…vaccination, highlighting that an independent response must occur at mucosal sites. 9,27 Moreover, previous work has demonstrated that transudation of plasma antibody makes minimal contribution to total antibody concentrations in the mucosa, even in cases of paraproteinaemia where plasma concentrations are extremely high. 28 This would explain why i.m.…”

Section: Discussionmentioning

confidence: 99%

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Nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination

Liew

Talwar

Cross

et al. 2022

Preprint

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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 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. Nasal and plasma anti-S IgG remained elevated for at least 12 months with high plasma neutralising titres against all variants. Of 180 with complete data, 160 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. Samples 12 months after admission showed no association between nasal IgA and plasma IgG responses, 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.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination

Liew

Talwar

Cross

et al. 2022

Preprint

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“…In paired sampling of nasopharyngeal (NP) samples and plasma, anti‐S and RBD antibody levels in NP samples correlated with levels in plasma, were mostly IgA, and were increased in severe compared with mild‐or‐moderate COVID‐19. 75 Antibodies in the respiratory tract further correlated with the presence of virus‐specific B‐cells and lower viral load, 75 , 76 indicating potential protective capacity of these locally produced antibodies through direct neutralization or targeting the virus for clearance by innate cells.…”

Section: Site‐specific and Systemic Immune Responses During Acute Inf...mentioning

confidence: 99%

“…Memory B‐cells residing in lymph nodes may be sufficient for rapid mobilization of humoral immunity, even if the levels of antibody maintained in circulation decline. For local antibody‐mediated protection, there is evidence for maintenance of IgA antibodies in the nasal passages, 74 though the longevity of mucosal IgA is variable 75 and their ability to block local infection is not known.…”

Section: Immune Correlates Of Protection Generated By Sars‐cov‐2 Infe...mentioning

confidence: 99%

Tissue immunity to SARS‐CoV‐2: Role in protection and immunopathology*

Rybkina

Davis-Porada

Farber

2022

Immunological Reviews

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The global pandemic caused by severe acute respiratory syndromecoronavirus-2 (SARS-CoV-2) has now persisted for two years and impacted nearly everyone on the planet; resulting in nearly half a billion people infected, close to 6 million deaths worldwide, and immeasurable effects on overall health and well-being of the population. In contrast to other ubiquitous respiratory viruses, SARS-CoV-2 infection is unique in its wide range of clinical manifestations that comprise COVID-19, from minimal symptoms and mild disease to severe lung damage, acute respiratory distress syndrome (ARDS), multiorgan failure, and death. COVID-19 can also vary in durations from several days, to weeks, to persistence for months in the form of long COVID. In addition, the high transmissibility of SARS-CoV-2, along with the increasing mutation burden in emerging variant strains, has led to infectious spread even among individuals who have developed immunity through previous infection or vaccination. [1][2][3] In order to develop improved treatments for those at risk for severe COVID-19 and establish protective immunity to SARS-CoV-2 strains that continue to mutate and disseminate infections globally, new insights into the immune mechanisms that control infection severity and establish long-term protection are needed.The disease outcome to SARS-CoV-2 infection depends on the immune response, which occurs at the site of infection in the lung and respiratory tract. In many individuals, virus is cleared from the lung with minimal damage, while in others, the immune response becomes dysregulated, resulting in extensive inflammation, severe lung damage, organ failure, and/or long-term effects even in those who recover. Characterizing the immune response to SARS-CoV-2 both in circulation and in the tissue sites of infection is necessary to gain new insights and develop strategies for protecting the population from current and future pandemic strains.Coordinated processes between the innate and adaptive immune systems are essential to neutralize infections with minimal

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“… To the Editor: Mucosal IgA can provide immunity against respiratory viruses. 1 Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) boosts mucosal IgA responses, 2 and neutralizing IgA, including neutralizing IgA against the B.1.1.529 (omicron) variant of SARS-CoV-2, has been detected after infection with wild-type SARS-CoV-2. 3 However, the potential role of mucosal IgA in protection against SARS-CoV-2 infection is still largely unknown.…”

mentioning

confidence: 99%