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Robust Antibody and T Cell Responses to SARS-CoV-2 in Patients with Antibody Deficiency

  1. Author:
    Kinoshita, Hannah
    Durkee-Shock, Jessica
    Jensen-Wachspress, Mariah
    Kankate, Vaishnavi V
    Lang, Haili
    Lazarski, Christopher A
    Keswani, Anjeni
    Webber, Kathleen C
    Montgomery-Recht, Kimberly
    Walkiewicz, Magdalena
    Notarangelo, Luigi D
    Burbelo, Peter D
    Fuss, Ivan
    Cohen, Jeffrey I
    Bollard, Catherine M
    Keller, Michael D [ORCID]

  2. Author Address

    Center for Cancer and Immunology Research, Children 39;s Research Institute, Children 39;s National Hospital, Washington, DC, USA., National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA., Division of Allergy and Immunology, George Washington University, Washington, DC, USA., Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA., Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA., Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA., National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA., Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA., GW Cancer Center, George Washington University, Washington, DC, USA., Center for Cancer and Immunology Research, Children 39;s Research Institute, Children 39;s National Hospital, Washington, DC, USA. mkeller@childrensnational.org., GW Cancer Center, George Washington University, Washington, DC, USA. mkeller@childrensnational.org., Division of Allergy & Immunology, Children 39;s National Hospital, Washington, DC, USA. mkeller@childrensnational.org.,
    1. Year: 2021
    2. Date: Aug
    3. Epub Date: 2021 May 13
  2. Journal: Journal of Clinical Immunology
    1. 41
    2. 6
  4. Type of Article: Article
  5. ISSN: 0271-9142
  1. Abstract:

    Immunocompromised patients, including those with inborn errors of immunity (IEI), may be at increased risk for severe or prolonged infections with SARS-CoV-2 (Zhu et al. N Engl J Med. 382:727-33, 2020; Guan et al. 2020; Minotti et al. J Infect. 81:e61-6, 2020). While antibody and T cell responses to SARS-CoV-2 structural proteins are well described in healthy convalescent donors, adaptive humoral and cellular immunity has not yet been characterized in patients with antibody deficiency (Grifoni et al. Cell. 181:1489-1501 e1415, 2020; Burbelo et al. 2020; Long et al. Nat Med. 26:845-8, 2020; Braun et al. 2020). Herein, we describe the clinical course, antibody, and T cell responses to SARS-CoV-2 structural proteins in a cohort of adult and pediatric patients with antibody deficiencies (n?=?5) and controls (related and unrelated) infected with SARS-CoV-2. Five patients within the same family (3 with antibody deficiency, 2 immunocompetent controls) showed antibody responses to nucleocapsid and spike proteins, as well as SARS-CoV-2 specific T cell immunity at days 65-84 from onset of symptoms. No significant difference was identified between immunocompromised patients and controls. Two additional unrelated, adult patients with common variable immune deficiency were assessed. One did not show antibody response, but both demonstrated SARS-CoV-2-specific T cell immunity when evaluated 33 and 76 160;days, respectively, following SARS-CoV-2 diagnosis. This report is the first to show robust T cell activity and humoral immunity against SARS-CoV-2 structural proteins in some patients with antibody deficiency. Given the reliance on spike protein in most candidate vaccines (Folegatti et al. Lancet. 396:467-78, 2020; Jackson et al. N Engl J Med. 383:1920-31, 2020), the responses are encouraging. Additional studies will be needed to further define the timing of onset of immunity, longevity of the immune response, and variability of response in immunocompromised patients.

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External Sources

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  2. DOI: 10.1007/s10875-021-01046-y
  3. PMID: 33983545
  4. PMCID: PMC8117127
  5. View record in Web of Science®
  6. WOS: 000650115100001
  7. PII : 10.1007/s10875-021-01046-y

Library Notes

  1. Fiscal Year: FY2020-2021
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