Successful vaccine design requires an assessment of antibody responses and their protectivity over time. In this preprint, Sterlin et al. characterize the early humoral immune response to SARS-CoV-2 in 38 patients. Longitudinal serum analysis revealed that IgA and IgG differ in potency and prevalence over time. At onset of disease, mucosal-homing IgA-secreting plasmablasts predominate; these appear to arise in a germinal centre-independent fashion. Most SARS-CoV-2-targeted antibodies bound to the receptor-binding domain region and IgA provided more efficient neutralization than IgG. However, as infection progressed, IgA serum levels declined whereas IgG levels increased. Therefore, testing for virus-specific IgA should be suitable for early diagnosis, whereas testing for IgG is more relevant post-infection. However, bronchoalveolar lavage of patients with severe infection revealed a predominance of IgG, highlighting differences in mucosal and systemic responses to SARS-CoV-2.
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Sterlin, D. et al. IgA dominates the early neutralizing antibody response to SARS-CoV-2. Preprint at medRxiv https://doi.org/10.1101/2020.06.10.20126532 (2020)
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Berthold, D.L., Wormald, C. Transient IgA, steady IgG?. Nat Rev Immunol 20, 462 (2020). https://doi.org/10.1038/s41577-020-0382-6
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DOI: https://doi.org/10.1038/s41577-020-0382-6