Humoral and cell-mediated response in colostrum after exposure to severe acute respiratory syndrome coronavirus 2

Abstract

BackgroundColostrum provides an immune sharing between a mother and her infant. The transfer in colostrum of antibodies against SARS-CoV-2 and the elicited cytokines may provide crucial protection to the infant. There is limited literature on the immune response to SARS-CoV-2 present in colostrum.ObjectiveTo evaluate the presence of antibodies specific to SARS-CoV-2 and the associated cytokines in colostrum from women who tested positive for the virus.Study DesignBetween March and September 2020 we obtained bilateral colostrum samples collected on spot cards within 48 hours of delivery from 15 new mothers who had previously tested positive for SARS-CoV-2. Five of these 15 COVID-19 positive women also provided bilateral liquid colostrum within 1-2 days of providing the spot card samples. Archived bilateral colostrum samples collected from 8 women during 2011-2013 were used as pre-COVID-19 controls. All samples were tested for reactivity to the Receptor Binding Domain (RBD) of the SARS-CoV-2 spike protein using an ELISA that measures SARS-CoV-2 RBD-specific IgA, IgG, and IgM, and for concentrations of 10 inflammatory cytokines (IFNγ, TNFα, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-13) using a multiplex electrochemiluminescent sandwich assay.ResultsBilateral colostrum samples from 73%, 73% and 33% of the 15 COVID-19 mothers exhibited IgA, IgG, and IgM reactivity to RBD respectively. Colostrum samples from two of the 8 pre-pandemic controls showed IgA and IgG reactivity to RBD. Additionally, COVID-19 mothers had significantly higher levels of 9 of the 10 inflammatory markers (all except IFNγ) as compared to the pre-COVID-19 controls. Comparable results were obtained with both the spot card-eluates and liquid samples.ConclusionsA strong humoral immune response is present in the colostrum of women who were infected with SARS-CoV-2 before delivering. High levels of 9 inflammatory markers were also present in the colostrum. The evolution and duration of the antibody response, as well as dynamics of the cytokine response, remain to be determined. Our results also indicate that future large-scale studies can be conducted with milk easily collected on paper spot cards.

COVID‐19 and novel mRNA vaccines in pregnancy: an updated literature review

“…Bilateral colostrum samples were collected from the 15 COVID‐19 mothers and exhibited 73% IgA, 73% IgG, and 33% IgM reactivity to the receptor binding domain of the SARS‐CoV‐2 spike protein. High levels of nine inflammatory markers were also present in the colostrum 38 . The presence of these antibodies could indicate a prior infection that elicited a humoral response that cross‐reacted with SARS‐CoV‐2 receptor binding domain.…”

“… 37 Recently, a group of UMass researchers found that of 15 participants in their study, all of whom had COVID‐19 at some point before giving birth, 14 had antibodies in their early breast milk. 38 Bilateral colostrum samples were collected from the 15 COVID‐19 mothers and exhibited 73% IgA, 73% IgG, and 33% IgM reactivity to the receptor binding domain of the SARS‐CoV‐2 spike protein. High levels of nine inflammatory markers were also present in the colostrum.…”

“…High levels of nine inflammatory markers were also present in the colostrum. 38 The presence of these antibodies could indicate a prior infection that elicited a humoral response that cross‐reacted with SARS‐CoV‐2 receptor binding domain. This study provides objective data for the value of initiating breast‐feeding despite SARS‐CoV‐2 infection.…”

“…This study provides objective data for the value of initiating breast‐feeding despite SARS‐CoV‐2 infection. 38 …”

“…reported on 77 nursing mothers from 37 studies and concluded that there was no convincing evidence of transmission of SARS‐CoV‐2 via breastmilk 37 . Recently, a group of UMass researchers found that of 15 participants in their study, all of whom had COVID‐19 at some point before giving birth, 14 had antibodies in their early breast milk 38 . Bilateral colostrum samples were collected from the 15 COVID‐19 mothers and exhibited 73% IgA, 73% IgG, and 33% IgM reactivity to the receptor binding domain of the SARS‐CoV‐2 spike protein.…”