Most newly discharged patients who recently recovered from COVID-19
produce virus-specific antibodies and T cells, suggests a study
published on May 3rd in the journal
Immunity, but the responses
of different patients are not all the same. While the 14 patients
examined in the study showed wide-ranging immune responses, results from
the 6 of them that were assessed at two weeks after discharge suggest
that antibodies were maintained for at least that long. Additional
results from the study indicate which parts of the virus are most
effective at triggering these immune responses and should therefore be
targeted by potential vaccines.
It is not clear why immune responses varied widely across the
patients. The authors say this variability may be related to the initial
quantities of virus that the patients encountered, their physical
states, or their microbiota. Other open questions include whether these
immune responses protect against COVID-19 upon re-exposure to
SARS-CoV-2, as well as which types of T cells are activated by infection
with the virus. It is also important to note that the laboratory tests
that are used to detect antibodies to SARS-CoV-2 in humans still need
further validation to determine their accuracy and reliability.
“These findings suggest both B and T cells participate in
immune-mediated protection against the viral infection,” says co-senior
study author Chen Dong of Tsinghua University. “Our work has provided a
basis for further analysis of protective immunity and for understanding
the mechanism underlying the development of COVID-19, especially in
severe cases. It also has implications for designing an effective
vaccine to protect against infection.”
Relatively little is known about the protective immune responses
induced by the disease-causing virus, SARS-CoV-2, and addressing this
gap in knowledge may accelerate the development of an effective vaccine,
adds co-senior study author Cheng-Feng Qin of the Academy of Military
Medical Sciences in Beijing, China.
With this goal in mind, the researchers compared the immune responses
of 14 COVID-19 patients who had recently become virus-free to those of
six healthy donors. Eight of the patients were newly discharged, and the
remaining six were follow-up patients who were discharged two weeks
prior to the analyses. Specifically, the researchers collected blood
samples and assessed the levels of immunoglobulin M (IgM) antibodies,
which are the first to appear in response to an infection, as well as
immunoglobulin G (IgG) antibodies, which are the most common type found
in blood circulation.
Compared to healthy controls, both newly discharged and follow-up
patients showed higher levels of IgM and IgG antibodies that bind to the
SARS-CoV-2 nucleocapsid protein, which encapsulates the viral genomic
RNA, as well as the S protein’s receptor-binding domain (S-RBD), which
binds to receptors on host cells during the process of viral entry.
Taken together, these findings show that COVID-19 patients can mount
antibody responses to SARS-CoV-2 proteins and suggest that these
antibodies are maintained for at least two weeks after discharge.
In addition, five newly discharged patients had high concentrations
of neutralizing antibodies that bind to a pseudovirus expressing the
SARS-CoV-2 S protein. Neutralizing antibodies prevent infectious
particles from interacting with host cells. In addition, all except one
follow-up patient had detectable neutralizing antibodies against the
pseudovirus.
Compared to healthy controls, five newly discharged patients had
higher concentrations of T cells that secrete interferon gamma (IFNγ) – a
signaling molecule that plays a critical role in immunity – in response
to the SARS-CoV-2 nucleocapsid protein. These are the same patients who
had high concentrations of neutralizing antibodies. In addition, three
newly discharged patients showed detectable levels of IFNγ-secreting T
cells specific to the SARS-CoV-2 main protease – a protein that plays a
critical role in viral replication. Meanwhile, seven newly discharged
patients showed detectable levels of IFNγ-secreting T cells specific to
the S-RBD of SARS-CoV-2. By contrast, only one follow-up patient had a
high concentration of IFNγ-secreting T cells responsive to the
nucleocapsid protein, the main protease, and S-RBD.
One finding with potential clinical relevance is that the amount of
neutralizing antibodies was positively associated with IgG antibodies
against S-RBD, but not with those that bind to the nucleocapsid protein.
Moreover, S-RBD induced both antibody and T cell responses. “Our
results suggest that S-RBD is a promising target for SARS-CoV-2
vaccines,” says co-senior study author Fang Chen of Chui Yang Liu
Hospital affiliated to Tsinghua University. “But our findings need
further confirmation in a large cohort of COVID-19 patients.”
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This work was supported by from the National Key Research and
Development Program of China, Natural Science Foundation of China,
Beijing Municipal Science and Technology, Zhejiang University
Foundation, and Tsinghua University. L.N., Y.F., W.P., and C.D. have
filed a provisional patent on the methodology of detecting
SARS-CoV-2-specific antibody responses.
Immunity, Ni, Ye, and Cheng et al.: “Detection of
SARS-CoV-2-specific humoral and cellular immunity in COVID-19
convalescent individuals”
https://www.cell.com/immunity/fulltext/S1074-7613(20)30181-3
https://www.eurekalert.org/pub_releases/2020-05/cp-rrc050420.php