1
|
Wolff ASB, Hansen L, Grytaas MA, Oftedal BE, Breivik L, Zhou F, Hufthammer KO, Sjøgren T, Olofsson JS, Trieu MC, Meager A, Jørgensen AP, Lima K, Greve-Isdahl Mohn K, Langeland N, Cox RJ, Husebye ES. Vaccination prevents severe COVID-19 outcome in patients with neutralizing type 1 interferon autoantibodies. iScience 2023; 26:107084. [PMID: 37346050 PMCID: PMC10251722 DOI: 10.1016/j.isci.2023.107084] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/05/2023] [Accepted: 06/06/2023] [Indexed: 06/23/2023] Open
Abstract
A hallmark of patients with autoimmune polyendocrine syndrome type 1 (APS-1) is serological neutralizing autoantibodies against type 1 interferons (IFN-I). The presence of these antibodies has been associated with severe course of COVID-19. The aims of this study were to investigate SARS-CoV-2 vaccine tolerability and immune responses in a large cohort of patients with APS-1 (N = 33) and how these vaccinated patients coped with subsequent infections. We report that adult patients with APS-1 were able to mount adequate SARS-CoV-2 spike-specific antibody responses after vaccination and observed no signs of decreased tolerability. Compared with age- and gender-matched healthy controls, patients with APS-1 had considerably lower peak antibody responses resembling elderly persons, but antibody decline was more rapid in the elderly. We demonstrate that vaccination protected patients with APS-1 from severe illness when infected with SARS-CoV-2 virus, overriding the systemic danger of IFN-I autoantibodies observed in previous studies.
Collapse
Affiliation(s)
- Anette S B Wolff
- Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Lena Hansen
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
- Influenza Centre, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | | | - Bergithe E Oftedal
- Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Lars Breivik
- Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Fan Zhou
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
- Influenza Centre, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Karl Ove Hufthammer
- Centre for Clinical Research, Haukeland University Hospital, 5021 Bergen, Norway
| | - Thea Sjøgren
- Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Jan Stefan Olofsson
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
- Influenza Centre, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Mai Chi Trieu
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
- Influenza Centre, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Anthony Meager
- Biotherapeutics Group, The National Institute for Biological Standards and Control, South Mimms, Potters Bar EN6 3QG, UK
| | - Anders P Jørgensen
- Department of Endocrinology, Oslo University Hospital, 0372 Oslo, Norway
| | - Kari Lima
- Department of Paediatric Medicine, Oslo University Hospital, 0372 Oslo, Norway
- Department of Endocrinology, Akershus University Hospital, 1478 Lørenskog, Norway
| | - Kristin Greve-Isdahl Mohn
- Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
- Influenza Centre, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Nina Langeland
- Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Rebecca Jane Cox
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
- Influenza Centre, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
- Department of Microbiology, Haukeland University Hospital, 5021 Bergen, Norway
| | - Eystein S Husebye
- Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
| |
Collapse
|
2
|
Kuwelker K, Zhou F, Blomberg B, Lartey S, Brokstad KA, Trieu MC, Bansal A, Madsen A, Krammer F, Mohn KG, Tøndel C, Linchausen DW, Cox RJ, Langeland N. Attack rates amongst household members of outpatients with confirmed COVID-19 in Bergen, Norway: A case-ascertained study. Lancet Reg Health Eur 2021; 3:100014. [PMID: 33871470 PMCID: PMC8009692 DOI: 10.1016/j.lanepe.2020.100014] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Households studies reflect the natural spread of SARS-CoV-2 in immunologically naive populations with limited preventive measures to control transmission.We hypothesise that seropositivity provides more accurate household attack rates than RT-PCR. Here, we investigated the importance of age in household transmission dynamics. METHODS We enroled 112 households (291 participants) in a case-ascertained study in Bergen, Norway from 28th February to 4th April 2020, collecting demographic and clinical data from index patients and household members. SARS-CoV-2-specific antibodies were measured in sera collected 6-8 weeks after index patient nasopharyngeal testing to define household attack rates. FINDINGS The overall attack rate was 45% (95% CI 38-53) assessed by serology, and 47% when also including seronegative RT-PCR positives. Serology identified a higher number of infected household members than RT-PCR. Attack rates were equally high in children (48%) and young adults (42%). The attack rate was 16% in asymptomatic household members and 42% in RT-PCR negative contacts. Older adults had higher antibody titres than younger adults. The risk of household transmission was higher when the index patient had fever (aOR 3.31 [95% CI 1.52-7.24]; p = 0.003) or dyspnoea (aOR 2.25 [95% CI 1.80-4.62]; p = 0.027) during acute illness. INTERPRETATION Serological assays provide more sensitive and robust estimates of household attack rates than RT-PCR. Children are equally susceptible to infection as young adults. Negative RT-PCR or lack of symptoms are not sufficient to rule out infection in household members. FUNDING Helse Vest (F-11628), Trond Mohn Foundation (TMS2020TMT05).
Collapse
Affiliation(s)
- Kanika Kuwelker
- Influenza Centre (KK, RJC, FZ, SL, MCT, AM, KGIM), Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway
- National Advisory Unit for Tropical Infectious Diseases (KK, BB, NL) Haukeland University Hospital, N-5021 Bergen, Norway
| | - Fan Zhou
- Influenza Centre (KK, RJC, FZ, SL, MCT, AM, KGIM), Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway
| | - Bjørn Blomberg
- Department of Clinical Science (NL, BB), University of Bergen, N-5021 Bergen, Norway
- National Advisory Unit for Tropical Infectious Diseases (KK, BB, NL) Haukeland University Hospital, N-5021 Bergen, Norway
| | - Sarah Lartey
- Influenza Centre (KK, RJC, FZ, SL, MCT, AM, KGIM), Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway
| | - Karl Albert Brokstad
- Broeglemann Research Laboratory (KAB), Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway
- Department of Safety, Chemistry and Biomedical Laboratory Sciences (KAB), Western Norway University of Applied Sciences, Bergen N-5020, Norway
| | - Mai Chi Trieu
- Influenza Centre (KK, RJC, FZ, SL, MCT, AM, KGIM), Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway
| | - Amit Bansal
- Influenza Centre (KK, RJC, FZ, SL, MCT, AM, KGIM), Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway
| | - Anders Madsen
- Influenza Centre (KK, RJC, FZ, SL, MCT, AM, KGIM), Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway
| | - Florian Krammer
- Department of Microbiology (FK), Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Kristin Gi Mohn
- Influenza Centre (KK, RJC, FZ, SL, MCT, AM, KGIM), Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway
- Department of Medicine (KGIM), Haukeland University Hospital, N-5021 Bergen, Norway
| | - Camilla Tøndel
- Department of Paediatrics (CT), Haukeland University Hospital, N-5021 Bergen, Norway
| | | | - Rebecca J Cox
- Influenza Centre (KK, RJC, FZ, SL, MCT, AM, KGIM), Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway
- Department of Microbiology (RJC), Haukeland University Hospital, N-5021 Bergen, Norway
| | - Nina Langeland
- Department of Clinical Science (NL, BB), University of Bergen, N-5021 Bergen, Norway
- National Advisory Unit for Tropical Infectious Diseases (KK, BB, NL) Haukeland University Hospital, N-5021 Bergen, Norway
| |
Collapse
|
3
|
Mohn KGI, Brokstad KA, Pathirana RD, Bredholt G, Jul-Larsen Å, Trieu MC, Lartey SL, Montomoli E, Tøndel C, Aarstad HJ, Cox RJ. Live Attenuated Influenza Vaccine in Children Induces B-Cell Responses in Tonsils. J Infect Dis 2016; 214:722-31. [PMID: 27247344 PMCID: PMC4978372 DOI: 10.1093/infdis/jiw230] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 05/23/2016] [Indexed: 11/17/2022] Open
Abstract
Background. Tonsils play a key role in eliciting immune responses against respiratory pathogens. Little is known about how tonsils contribute to the local immune response after intranasal vaccination. Here, we uniquely report the mucosal humoral responses in tonsils and saliva after intranasal live attenuated influenza vaccine (LAIV) vaccination in children. Methods. Blood, saliva, and tonsils samples were collected from 39 children before and after LAIV vaccination and from 16 age-matched, nonvaccinated controls. Serum antibody responses were determined by a hemagglutination inhibition (HI) assay. The salivary immunoglobulin A (IgA) level was measured by an enzyme-linked immunosorbent assay. Antibody-secreting cell (ASC) and memory B-cell (MBC) responses were enumerated in tonsils and blood. Results. Significant increases were observed in levels of serum antibodies and salivary IgA to influenza A(H3N2) and influenza B virus strains as early as 14 days after vaccination but not to influenza A(H1N1). Influenza virus–specific salivary IgA levels correlated with serum HI responses, making this a new possible indicator of vaccine immunogenicity in children. LAIV augmented influenza virus–specific B-cell responses in tonsils and blood. Tonsillar MBC responses correlated with systemic MBC and serological responses. Naive children showed significant increases in MBC counts after LAIV vaccination. Conclusions. This is the first study to demonstrate that LAIV elicits humoral B-cell responses in tonsils of young children. Furthermore, salivary IgA analysis represents an easy method for measuring immunogenicity after vaccination.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena VisMederi, Siena, Italy
| | - Camilla Tøndel
- Department of Clinical Medicine, University of Bergen Department of Pediatrics
| | - Hans Jørgen Aarstad
- Department of Clinical Medicine, University of Bergen Department of Otolaryngology/Head and Neck Surgery
| | - Rebecca Jane Cox
- The Influenza Center Department of Research & Development, Haukeland University Hospital, Bergen K.G. Jebsen Center for Influenza Vaccines, University of Bergen, Norway
| |
Collapse
|
4
|
Trondsen M, Aqrawi LA, Zhou F, Pedersen G, Trieu MC, Zhou P, Cox RJ. Induction of Local Secretory IgA and Multifunctional CD4⁺ T-helper Cells Following Intranasal Immunization with a H5N1 Whole Inactivated Influenza Virus Vaccine in BALB/c Mice. Scand J Immunol 2015; 81:305-17. [PMID: 25737202 DOI: 10.1111/sji.12288] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 02/24/2015] [Indexed: 02/05/2023]
Abstract
Avian influenza subunit vaccines have been shown to be poorly immunogenic, leading to the re-evaluation of the immunogenic and dose-sparing potential of whole virus vaccines. In this study, we investigated the immune responses after one or two doses of intramuscular or intranasal whole inactivated influenza H5N1 virus vaccine in BALB/c mice. Serum samples and nasal washings were collected weekly post-vaccination and analysed using enzyme-linked immunosorbent assay (ELISA). Sera were also analysed by the haemagglutination inhibition (HI) assay. Antibody-secreting cells were measured in lymphocytes from spleen and bone marrow via enzyme-linked immunospot (ELISPOT). Splenocytes were stimulated in vitro, and T-helper profiles were measured through multiplex bead assay in the supernatants, or intracellularly by multiparametric flow cytometry. Both vaccine routes induced high HI titres following the second immunization (intramuscular = 370, intranasal = 230). Moreover, the intramuscular group showed significantly higher levels of serum IgG (P < 0.01), IgG1 (P < 0.01) and IgG2a (P < 0.01) following the second vaccine dose, while the intranasal group exhibited significantly higher levels of serum IgA (P < 0.05) and local IgA (P < 0.01) in the nasal washings. Also, IgA antibody-secreting cells were found in significantly higher numbers in the intranasal group in both the spleen (P < 0.01) and the bone marrow (P < 0.01). Moreover, Th1 (TNF-α, IL-2, IFN-γ) and Th2 (IL-4, IL-5, IL-10) cytokines were expressed by both groups, yet only the intranasal group expressed the Th17 marker IL-17. As the intranasal vaccines induce local IgA and are easily administered, we suggest the intranasally administered whole virus vaccine as a promising candidate for a pandemic H5N1 vaccine.
Collapse
Affiliation(s)
- M Trondsen
- The Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | | | | | | | | | | |
Collapse
|