Changes in nasal, pharyngeal and salivary secretory IgA levels in patients with COVID-19 and the possibility of correction of their secretion using combined intranasal and oral administration of a pharmaceutical containing antigens of opportunistic microorganisms

Abstract

Background Although extensive research has been conducted on the role of local immunity in patients with SARS-CoV-2, little is known about the production and concentrations of secretory IgA (SIgA) in different mucosal compartments. This article aims to assess the secretion of SIgA in the nasal and pharyngeal compartments and saliva of patients with COVID-19 and to investigate the possibility and efficiency of correction of their secretion using combined intranasal and oral administration of a pharmaceutical containing antigens of opportunistic microorganisms. Methods This study included 78 inpatients, aged between 18 and 60 years, who had confirmed COVID-19 with moderate lung involvement. The control group ( n =45) received basic therapy, and the treatment group ( n =33) was additionally administered the bacteria-based pharmaceutical Immunovac VP4 from day 1 to day 10 of hospitalization. SIgA levels were measured by ELISA at baseline and on days 14 and 30. Results No systemic or local reactions associated with Immunovac VP4 were reported. We observed a statistically significant reduction in the duration of fever and hospitalization in patients who received Immunovac VP4 compared with those from the control group ( p =0.03 and p =0.05, respectively). Changes over time in SIgA levels in nasal swabs were found to be significantly different in the two treatment groups (F=7.9, p [78.0]<0.001). On day 14 of observation, patients in the control group showed a statistically significant reduction in SIgA levels from baseline ( p =0.02), whereas patients in the Immunovac VP4 group had stable SIgA levels ( p =0.07). On day 30 after the start of treatment, there was a statistically significant increase in SIgA levels in the Immunovac VP4 group compared with baseline (from 77.7 (40.5–98.7) μg/L to 113.4 (39.8–156.7) μg/L; p =0.05) and the levels measured on day 14 (from 60.2 (23.3–102.9) μg/L to 113.4 (39.8–156.7) μg/L; p =0.03). The control group showed a statistically significant decrease in levels of nasal SIgA (to 37.3) on day 30 ( p =0.007 for comparison with baseline values and p =0.04 for comparison with levels measured on day 14). Changes over time in SIgA levels measured in pharyngeal swabs were also different between the two treatment groups, and this difference reached statistical significance (F=6.5, p [73.0]=0.003). In the control group, this parameter did not change throughout the study ( p =0.17 for a comparison between the levels measured on day 14 and the baseline values, and p =0.12 for a comparison between the levels measured on day 30 and the baseline values)....

Secretory IgA and course of COVID-19 in patients receiving a bacteria-based immunostimulant agent in addition to background therapy

“…Evaluation of clinical markers of effectiveness of Immunovac VP4 for IN-SC administration showed that in the Immunovac VP4 group the patients experienced a more significant reduction in inflammation on day 5, as seen by a statistically significant decrease in CRP, reduction in the duration of fever and the length of hospital stay. Thus, an analysis of the temperature reaction revealed that with IN-SC regimen of immunotropic drug administration, the duration of fever was also lower (1 [0.5–2] days) than in the control group of patients (4 [1–7] days, p = 0.002 but did not differ significantly from the group of patients receiving another—IN-per os (1 [from 0.5 to 2] day)—method of admission 19 . Comparing the duration of hospitalization stay (16 [13 to 19] days) administrating Immunovac VP4 in a combined IN-SC regimen with IN-per os use (16 [11 to 20] days) no differences were identified.…”

“…Since we have already previously conducted a study of the assessment of mucosal immunity in IN—per os use of the Immunovac VP4 vaccine 19 , we were interested which way of administration of the drug is the most effective in the complex treatment of patients with COVID-19 associated lung lesions of moderate severity. The obtained results indicate that the levels of sIgA in the secretions of the salivary glands when prescribed an immunotropic drug according to IN and per os regimen during the entire observation period remain in high values: at the beginning of hospitalization 168.7 (95.8–233.8) mcg/l and 140.6 (86.4–213.4) and 154.6 (121.0–200.3) mcg/l after 14 and 30 days from the start of the vaccine, respectively.…”

“…Enhanced production of sIgA detected in nasal epithelial secretion may activate the mechanisms of mucosal immune response and contribute to a favorable course and outcome of COVID-19 disease; there may also be a correlation between sIgA levels and the clinical symptoms 16 – 18 . A previously published study on the use of bacterial ligands (Immunovac VP4) in the comprehensive treatment of patients with COVID-19 with moderate damage of lung tissue showed that in the group of patients receiving this drug, normalization of temperature was reached faster and the length of hospital stay was significantly reduced 19 . The obtained clinical effect of the administration of Immunovac VP4 is associated with the activation of sIgA synthesis in mucous membranes from various loci of the upper respiratory tract.…”