Spike protein antibody levels12/28/2023 ![]() Assessing and understanding this aspect is important as it offers the opportunity to simplify testing through use of less invasive approaches, e.g. In the context of SARS-CoV-2 infection, the relationship between systemic and mucosal antibody responses is not completely understood. Nevertheless, other studies have shown that mucosal immunity can drive systemic responses demonstrating that an inter-relationship often occurs 6, 7. ![]() ![]() A clear example demonstrating the segregation of antibodies in the blood and mucosal compartments is the finding that in multiple myeloma patients, the monoclonal antibody and free light chains secreted by the malignant plasma cells is clearly detected in blood but not in saliva (unpublished observations). Systemic and mucosal immune responses can share significant overlap, yet the two immune systems are semi-autonomous. Most pathogens that enter via mucosal surfaces can induce immune responses within the mucosa and associated secondary lymphoid organs as well as systemic immunity in distant lymphoid organs, like the spleen. For instance, antibodies such as IgM, and the IgG subclasses IgG1 and IgG3 are efficient at activating complement, whereas IgA and IgG2 are not 5. Little is known about the role of different antibody subclasses offering protection versus driving immunopathology in COVID-19. ![]() This includes the degree of antigen recognition and the antibody subclasses involved. Understanding the relationship between the varied clinical presentations of COVID-19 and the serological response that arises during and following infection will be of major significance in understanding the immunopathogenesis of disease and selecting appropriate treatments. Therefore, the development of assays to detect low levels of anti-viral antibodies need to consider multiple variables in order to be of use in seroepidemiological studies. Antigen choice and purity are other elements that can influence performance of the assay, not least by detecting cross-reactive antibodies induced by previous infection to other coronaviruses 4. We have previously reported that asymptomatic seroconversion associates with lower levels of antibody to viral spike protein, which may complicate discriminating between asymptomatically infected individuals and those who were never infected 3. Understanding antibody responses in individuals with the lowest symptomatology will be of major importance for monitoring viral transmission within this SARS-CoV-2 pandemic 2. An important factor is the variable clinical presentation of infection that can influence the concentration of antibody induced within a subject. The development of novel antibody tests requires a comprehensive understanding of the humoral response to a specific pathogen across the spectrum of disease caused by that pathogen. Antibody testing is useful to determine historic exposure to the virus, may provide insight into the immunological status of the individual and could be a measure of protection against re-infection. Detection of active infection is routinely achieved by testing for viral RNA, but this approach cannot be used once symptoms have resolved. COVID-19, caused by SARS-CoV-2, has resulted in millions of cases and more than 400,000 deaths around the world 1.
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