The role of multiple SARS-CoV-2 viral antigens in a vaccine-induced integrated immune response.
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ABSTRACT:
SUBMITTER: Zhang Y
PROVIDER: S-EPMC7983451 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:COVID-19 pandemic has started in December 2019 in China and quickly extended to become a worldwide health and economic emergency issue. It is caused by the novel coronavirus; SARS-CoV-2. COVID-19 patients' clinical presentations vary from asymptomatic infection or flu like symptoms to serious pneumonia which could be associated with multiple organ failure possibly leading to death. It is understood that the immune response to SARS-CoV-2 includes all elements of the immune system which could altogether succeed in viral elimination and complete cure. Meanwhile, this immune response may also lead to disease progression and could be responsible for the patient's death. Many trials have been done recently to create therapies and vaccines against human coronavirus infections such as MERS or SARS, however, till now, there is some controversy about the effectiveness and safety of antiviral drugs and vaccines which have been developed to treat and prevent this disease and its management depends mainly on supportive care. The spike glycoprotein or protein S of SARS-CoV-2 is the main promoter that induces development of neutralizing antibodies; hence, many attempts of vaccines and antiviral drugs development have been designed to be directed specifically against this protein. While some of these attempts have been proved to be efficient in in vitro settings, only few of them have been proceeded to randomized animal trials and human studies which makes COVID-19 prevention an ongoing challenge. This review describes the natural immune response scenario during COVID-19 and the vaccines development trials to create efficient vaccines thus helping to build more effective approaches for prophylaxis and management.
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Project description:Aims/hypothesisThe aim of the study was to characterise the humoral response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients with diabetes. Demonstrating the ability to mount an appropriate antibody response in the presence of hyperglycaemia is relevant for the comprehension of mechanisms related to the observed worse clinical outcome of coronavirus disease 2019 (COVID-19) pneumonia in patients with diabetes and for the development of any future vaccination campaign to prevent SARS-CoV-2 infection.MethodsUsing a highly specific and sensitive measurement of antibodies by fluid-phase luciferase immunoprecipitation assays, we characterised the IgG, IgM and IgA response against multiple antigens of SARS-CoV-2 in a cohort of 509 patients with documented diagnosis of COVID-19, prospectively followed at our institution. We analysed clinical outcomes and antibody titres according to the presence of hyperglycaemia, i.e., either diagnosed or undiagnosed diabetes, at the time of, or during, hospitalisation.ResultsAmong patients with confirmed COVID-19, 139 (27.3%) had diabetes: 90 (17.7%) had diabetes diagnosed prior to the hospital admission (comorbid diabetes) while 49 (9.6%) had diabetes diagnosed at the time of admission (newly diagnosed). Diabetes was associated with increased levels of inflammatory biomarkers and hypercoagulopathy, as well as leucocytosis and neutrophilia. Diabetes was independently associated with risk of death (HR 2.32 [95% CI 1.44, 3.75], p = 0.001), even after adjustment for age, sex and other relevant comorbidities. Moreover, a strong association between higher glucose levels and risk of death was documented irrespective of diabetes diagnosis (HR 1.14 × 1.1 mmol/l [95% CI 1.08, 1.21], p < 0.001). The humoral response against SARS-CoV-2 in patients with diabetes was present and superimposable, as for timing and antibody titres, to that of non-diabetic patients, with marginal differences, and was not influenced by glucose levels. Of the measured antibody responses, positivity for IgG against the SARS-CoV-2 spike receptor-binding domain (RBD) was predictive of survival rate, both in the presence or absence of diabetes.Conclusions/interpretationThe observed increased severity and mortality risk of COVID-19 pneumonia in patients with hyperglycaemia was not the result of an impaired humoral response against SARS-CoV-2. RBD IgG positivity was associated with a remarkable protective effect, allowing for a cautious optimism about the efficacy of future vaccines against SARs-COV-2 in people with diabetes. Graphical abstract.
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Project description:Variants of SARS-CoV-2 continue to emerge and evade immunity, resulting in breakthrough infections in vaccinated populations. Continued vaccination with vaccines based on the antigens of newly emerged variants does not necessarily result in long-lasting protection. Thus, there is an urgent need for the development of vaccines with a broad spectrum of protective effects. In this study, we selected hotspot mutations in the receptor binding domain (RBD) based on immune escape properties and integrated them into the original RBD protein to obtain a complexed RBD protein (cRBD). We designed a total of three cRBD (cRBD1-3) and thoroughly evaluated their immunological properties. Compared with the BA.1 RBD protein, the cRBDs induced higher levels and broader spectrum of neutralizing antibodies, with cRBD3 being the best performer. In vivo protective capacity of cRBDs was further validated in Balb/c mice attacked by live virus. In order to investigate the reason for the broad protective efficacy of cRBD, whole blood from mice that had completed the immunization process was subjected to BCR sequencing. BCR transcriptome analysis found differences in the use of VJ pairs in IGH among the groups.
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