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Peluso MJ, Swank ZN, Goldberg SA, Lu S, Dalhuisen T, Borberg E, Senussi Y, Luna MA, Chang Song C, Clark A, Zamora A, Lew M, Viswanathan B, Huang B, Anglin K, Hoh R, Hsue PY, Durstenfeld MS, Spinelli MA, Glidden DV, Henrich TJ, Kelly JD, Deeks SG, Walt DR, Martin JN. Plasma-based antigen persistence in the post-acute phase of COVID-19. Lancet Infect Dis 2024:S1473-3099(24)00211-1. [PMID: 38604216 DOI: 10.1016/s1473-3099(24)00211-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 04/13/2024]
Affiliation(s)
- Michael J Peluso
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, University of California San Francisco, San Francisco, CA 94110, USA.
| | - Zoe N Swank
- Harvard Medical School, Boston, MA, USA; Department of Pathology, Brigham & Women's Hospital, Boston, MA, USA; Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - Sarah A Goldberg
- Department of Epidemiology and Biostatistics, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - Scott Lu
- Department of Epidemiology and Biostatistics, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - Thomas Dalhuisen
- Department of Epidemiology and Biostatistics, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - Ella Borberg
- Harvard Medical School, Boston, MA, USA; Department of Pathology, Brigham & Women's Hospital, Boston, MA, USA; Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - Yasmeen Senussi
- Harvard Medical School, Boston, MA, USA; Department of Pathology, Brigham & Women's Hospital, Boston, MA, USA; Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - Michael A Luna
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - Celina Chang Song
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - Alexus Clark
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - Andhy Zamora
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - Megan Lew
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - Badri Viswanathan
- Department of Epidemiology and Biostatistics, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - Beatrice Huang
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - Khamal Anglin
- Department of Epidemiology and Biostatistics, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - Rebecca Hoh
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - Priscila Y Hsue
- Division of Cardiology, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - Matthew S Durstenfeld
- Division of Cardiology, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - Matthew A Spinelli
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - David V Glidden
- Department of Epidemiology and Biostatistics, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - Timothy J Henrich
- Division of Experimental Medicine, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - J Daniel Kelly
- Department of Epidemiology and Biostatistics, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - Steven G Deeks
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, University of California San Francisco, San Francisco, CA 94110, USA
| | - David R Walt
- Harvard Medical School, Boston, MA, USA; Department of Pathology, Brigham & Women's Hospital, Boston, MA, USA; Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - Jeffrey N Martin
- Department of Epidemiology and Biostatistics, University of California, University of California San Francisco, San Francisco, CA 94110, USA
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Nkolola JP, Liu J, Collier ARY, Jacob-Dolan C, Senussi Y, Borberg E, Swank Z, Walt DR, Barouch DH. High Frequency of Prior SARS-CoV-2 Infection by Sensitive Nucleocapsid Assays. J Infect Dis 2024:jiae174. [PMID: 38566610 DOI: 10.1093/infdis/jiae174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 03/08/2024] [Accepted: 04/01/2024] [Indexed: 04/04/2024] Open
Abstract
Prior infection with SARS-CoV-2 is typically measured by nucleocapsid serology assays. In this study, we show that the Simoa serology assays and T cell intracellular cytokine staining assays are more sensitive than the clinical Elecsys assay for detection of nucleocapsid-specific immune responses. These data suggest that the prevalence of prior SARS-CoV-2 infection in the population may be higher than currently appreciated.
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Affiliation(s)
| | - Jinyan Liu
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | | | | | | | - Zoe Swank
- Brigham and Women's Hospital, Boston, MA, USA
| | | | - Dan H Barouch
- Beth Israel Deaconess Medical Center, Boston, MA, USA
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3
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Peluso MJ, Swank ZN, Goldberg SA, Lu S, Dalhuisen T, Borberg E, Senussi Y, Luna MA, Song CC, Clark A, Zamora A, Lew M, Viswanathan B, Huang B, Anglin K, Hoh R, Hsue PY, Durstenfeld MS, Spinelli MA, Glidden DV, Henrich TJ, Daniel Kelly J, Deeks SG, Walt DR, Martin JN. Plasma-based antigen persistence in the post-acute phase of SARS-CoV-2 infection. medRxiv 2023:2023.10.24.23297114. [PMID: 37961239 PMCID: PMC10635183 DOI: 10.1101/2023.10.24.23297114] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
BACKGROUND Persistent symptoms among some persons who develop COVID-19 has led to the hypothesis that SARS-CoV-2 may, in some form or location, persist for long periods following acute infection. Several studies have shown data in this regard but are limited by non-representative and small study populations, short duration since acute infection, and lack of a true-negative comparator group to assess assay specificity. METHODS We evaluated adults with RNA-confirmed COVID-19 at multiple time points following acute infection (pandemic-era participants) and adults with specimens collected prior to 2020 (pre-pandemic era). Using once-thawed plasma, we employed the Simoa® (Quanterix) single molecule array detection platform to measure SARS-CoV-2 spike, S1, and nucleocapsid antigens. RESULTS Compared to 250 pre-pandemic participants who had 2% assay positivity, detection of any SARS-CoV-2 antigen was significantly more frequent among 171 pandemic-era participants at three different time periods in the post-acute phase of infection. The absolute difference in SARS-CoV-2 plasma antigen prevalence was +11% (95% CI: +5.0% to +16%) at 3.0-6.0 months post-onset of COVID-19; +8.7% (95% CI: +3.1% to +14%) at 6.1 to 10.0 months; and +5.4% (95% CI: +0.42% to +10%) at 10.1-14.1 months. Hospitalization for acute COVID-19 and, among the non-hospitalized, worse self-reported health during acute COVID-19 were associated with greater post-acute phase antigen detection. CONCLUSIONS Compared to uninfected persons, there is an excess prevalence of SARS-CoV-2 antigenemia in SARS-CoV-2-infected individuals up to 14 months after acute COVID-19. These findings motivate an urgent research agenda regarding the short-term and long-term clinical manifestations of this viral persistence.
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Affiliation(s)
- Michael J. Peluso
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Zoe N. Swank
- Harvard Medical School, Boston, MA, USA
- Department of Pathology, Brigham & Women’s Hospital, Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - Sarah A. Goldberg
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Scott Lu
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Thomas Dalhuisen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Ella Borberg
- Harvard Medical School, Boston, MA, USA
- Department of Pathology, Brigham & Women’s Hospital, Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - Yasmeen Senussi
- Harvard Medical School, Boston, MA, USA
- Department of Pathology, Brigham & Women’s Hospital, Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - Michael A. Luna
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Celina Chang Song
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Alexus Clark
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Andhy Zamora
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Megan Lew
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Badri Viswanathan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Beatrice Huang
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Khamal Anglin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Rebecca Hoh
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Priscila Y. Hsue
- Division of Cardiology, University of California, San Francisco, San Francisco, CA, USA
| | | | - Matthew A. Spinelli
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - David V. Glidden
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Timothy J. Henrich
- Division of Experimental Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - J. Daniel Kelly
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Steven G. Deeks
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - David R. Walt
- Harvard Medical School, Boston, MA, USA
- Department of Pathology, Brigham & Women’s Hospital, Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - Jeffrey N. Martin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
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Taylor MS, Wu C, Fridy PC, Zhang SJ, Senussi Y, Wolters JC, Cajuso T, Cheng WC, Heaps JD, Miller BD, Mori K, Cohen L, Jiang H, Molloy KR, Chait BT, Goggins MG, Bhan I, Franses JW, Yang X, Taplin ME, Wang X, Christiani DC, Johnson BE, Meyerson M, Uppaluri R, Egloff AM, Denault EN, Spring LM, Wang TL, Shih IM, Fairman JE, Jung E, Arora KS, Yilmaz OH, Cohen S, Sharova T, Chi G, Norden BL, Song Y, Nieman LT, Pappas L, Parikh AR, Strickland MR, Corcoran RB, Mustelin T, Eng G, Yilmaz ÖH, Matulonis UA, Chan AT, Skates SJ, Rueda BR, Drapkin R, Klempner SJ, Deshpande V, Ting DT, Rout MP, LaCava J, Walt DR, Burns KH. Ultrasensitive Detection of Circulating LINE-1 ORF1p as a Specific Multicancer Biomarker. Cancer Discov 2023; 13:2532-2547. [PMID: 37698949 PMCID: PMC10773488 DOI: 10.1158/2159-8290.cd-23-0313] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/09/2023] [Accepted: 09/08/2023] [Indexed: 09/14/2023]
Abstract
Improved biomarkers are needed for early cancer detection, risk stratification, treatment selection, and monitoring treatment response. Although proteins can be useful blood-based biomarkers, many have limited sensitivity or specificity for these applications. Long INterspersed Element-1 (LINE-1) open reading frame 1 protein (ORF1p) is a transposable element protein overexpressed in carcinomas and high-risk precursors during carcinogenesis with negligible expression in normal tissues, suggesting ORF1p could be a highly specific cancer biomarker. To explore ORF1p as a blood-based biomarker, we engineered ultrasensitive digital immunoassays that detect mid-attomolar (10-17 mol/L) ORF1p concentrations in plasma across multiple cancers with high specificity. Plasma ORF1p shows promise for early detection of ovarian cancer, improves diagnostic performance in a multianalyte panel, provides early therapeutic response monitoring in gastroesophageal cancers, and is prognostic for overall survival in gastroesophageal and colorectal cancers. Together, these observations nominate ORF1p as a multicancer biomarker with potential utility for disease detection and monitoring. SIGNIFICANCE The LINE-1 ORF1p transposon protein is pervasively expressed in many cancers and is a highly specific biomarker of multiple common, lethal carcinomas and their high-risk precursors in tissue and blood. Ultrasensitive ORF1p assays from as little as 25 μL plasma are novel, rapid, cost-effective tools in cancer detection and monitoring. See related commentary by Doucet and Cristofari, p. 2502. This article is featured in Selected Articles from This Issue, p. 2489.
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Affiliation(s)
- Martin S. Taylor
- Department of Pathology, Mass General Brigham and Harvard Medical School, Boston, Massachusetts
| | - Connie Wu
- Department of Pathology, Mass General Brigham and Harvard Medical School, Boston, Massachusetts
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
| | - Peter C. Fridy
- Laboratory of Cellular and Structural Biology, The Rockefeller University, New York, New York
| | - Stephanie J. Zhang
- Department of Pathology, Mass General Brigham and Harvard Medical School, Boston, Massachusetts
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
| | - Yasmeen Senussi
- Department of Pathology, Mass General Brigham and Harvard Medical School, Boston, Massachusetts
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
| | - Justina C. Wolters
- Department of Pediatrics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Tatiana Cajuso
- Department of Pathology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Wen-Chih Cheng
- Department of Pathology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - John D. Heaps
- Department of Pathology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Bryant D. Miller
- Department of Pathology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Kei Mori
- Department of Pathology, Mass General Brigham and Harvard Medical School, Boston, Massachusetts
- Healthcare Optics Research Laboratory, Canon U.S.A., Inc., Cambridge, Massachusetts
| | - Limor Cohen
- Department of Pathology, Mass General Brigham and Harvard Medical School, Boston, Massachusetts
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
- Department of Chemistry and Chemical Biology, Harvard University, Cambridge, Massachusetts
| | - Hua Jiang
- Laboratory of Cellular and Structural Biology, The Rockefeller University, New York, New York
| | - Kelly R. Molloy
- Laboratory of Mass Spectrometry and Gaseous Ion Chemistry, The Rockefeller University, New York, New York
| | - Brian T. Chait
- Laboratory of Mass Spectrometry and Gaseous Ion Chemistry, The Rockefeller University, New York, New York
| | | | - Irun Bhan
- Mass General Cancer Center and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Joseph W. Franses
- Mass General Cancer Center and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Xiaoyu Yang
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Mary-Ellen Taplin
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Xinan Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - David C. Christiani
- Mass General Cancer Center and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Bruce E. Johnson
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Matthew Meyerson
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Ravindra Uppaluri
- Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ann Marie Egloff
- Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Elyssa N. Denault
- Mass General Cancer Center and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Laura M. Spring
- Mass General Cancer Center and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Tian-Li Wang
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ie-Ming Shih
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Euihye Jung
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Kshitij S. Arora
- Department of Pathology, Mass General Brigham and Harvard Medical School, Boston, Massachusetts
| | - Osman H. Yilmaz
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Sonia Cohen
- Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Tatyana Sharova
- Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Gary Chi
- Mass General Cancer Center and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Bryanna L. Norden
- Mass General Cancer Center and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Yuhui Song
- Mass General Cancer Center and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Linda T. Nieman
- Mass General Cancer Center and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Leontios Pappas
- Mass General Cancer Center and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Aparna R. Parikh
- Mass General Cancer Center and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Matthew R. Strickland
- Mass General Cancer Center and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ryan B. Corcoran
- Mass General Cancer Center and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Tomas Mustelin
- Division of Rheumatology, Department of Medicine, University of Washington, Seattle, Washington
| | - George Eng
- Department of Pathology, Mass General Brigham and Harvard Medical School, Boston, Massachusetts
- The David H. Koch Institute for Integrative Cancer Research at MIT, Department of Biology, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Ömer H. Yilmaz
- Department of Pathology, Mass General Brigham and Harvard Medical School, Boston, Massachusetts
- The David H. Koch Institute for Integrative Cancer Research at MIT, Department of Biology, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Ursula A. Matulonis
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Andrew T. Chan
- Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Steven J. Skates
- MGH Biostatistics, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Bo R. Rueda
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Ronny Drapkin
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Samuel J. Klempner
- Mass General Cancer Center and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Vikram Deshpande
- Department of Pathology, Mass General Brigham and Harvard Medical School, Boston, Massachusetts
| | - David T. Ting
- Mass General Cancer Center and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Michael P. Rout
- Laboratory of Cellular and Structural Biology, The Rockefeller University, New York, New York
| | - John LaCava
- Laboratory of Cellular and Structural Biology, The Rockefeller University, New York, New York
- European Research Institute for the Biology of Ageing, University Medical Center Groningen, Groningen, the Netherlands
| | - David R. Walt
- Department of Pathology, Mass General Brigham and Harvard Medical School, Boston, Massachusetts
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
| | - Kathleen H. Burns
- Department of Pathology, Mass General Brigham and Harvard Medical School, Boston, Massachusetts
- Department of Pathology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
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5
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Bean DJ, Monroe J, Liang YM, Borberg E, Senussi Y, Swank Z, Chalise S, Walt D, Weinberg J, Sagar M. Heterotypic responses against nsp12/nsp13 from prior SARS-CoV-2 infection associates with lower subsequent endemic coronavirus incidence. bioRxiv 2023:2023.10.23.563621. [PMID: 37961343 PMCID: PMC10634759 DOI: 10.1101/2023.10.23.563621] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Immune responses from prior SARS-CoV-2 infection and COVID-19 vaccination do not prevent re-infections and may not protect against future novel coronaviruses (CoVs). We examined the incidence of and immune differences against human endemic CoVs (eCoV) as a proxy for response against future emerging CoVs. Assessment was among those with known SARS-CoV-2 infection, COVID-19 vaccination but no documented SARS-CoV-2 infection, or neither exposure. Retrospective cohort analyses suggest that prior SARS-CoV-2 infection, but not COVID-19 vaccination alone, protects against subsequent symptomatic eCoV infection. CD8+ T cell responses to the non-structural eCoV proteins, nsp12 and nsp13, were significantly higher in individuals with previous SARS-CoV-2 infection as compared to the other groups. The three groups had similar cellular responses against the eCoV spike and nucleocapsid, and those with prior spike exposure had lower eCoV-directed neutralizing antibodies. Incorporation of non-structural viral antigens in a future pan-CoV vaccine may improve protection against future heterologous CoV infections.
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Affiliation(s)
- David J. Bean
- Department of Virology, Immunology and Microbiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
| | - Janet Monroe
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
| | - Yan Mei Liang
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
| | - Ella Borberg
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA
| | - Yasmeen Senussi
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA
| | - Zoe Swank
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA
| | - Sujata Chalise
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA
| | - David Walt
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA
| | - Janice Weinberg
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Manish Sagar
- Department of Virology, Immunology and Microbiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
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6
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Swank Z, Senussi Y, Manickas-Hill Z, Yu XG, Li JZ, Alter G, Walt DR. Reply to Alaedini and Wormser. Clin Infect Dis 2023; 76:1342-1343. [PMID: 36385394 DOI: 10.1093/cid/ciac896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/10/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Zoe Swank
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Yasmeen Senussi
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | | | - Xu G Yu
- Harvard Medical School, Boston, Massachusetts, USA
- Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts, USA
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Jonathan Z Li
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Galit Alter
- Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts, USA
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - David R Walt
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
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7
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Taylor MS, Connie W, Fridy PC, Zhang SJ, Senussi Y, Wolters JC, Cheng WC, Heaps J, Miller BD, Mori K, Cohen L, Jiang H, Molloy KR, Norden BL, Chait BT, Goggins M, Bhan I, Franses JW, Yang X, Taplin ME, Wang X, Christiani DC, Johnson BE, Meyerson M, Uppaluri R, Egloff AM, Denault EN, Spring LM, Wang TL, Shih IM, Jung E, Arora KS, Zukerberg LR, Yilmaz OH, Chi G, Matulonis UA, Song Y, Nieman L, Parikh AR, Strickland M, Corcoran RB, Mustelin T, Eng G, Yilmaz ÃMH, Skates SJ, Rueda BR, Drapkin R, Klempner SJ, Deshpande V, Ting DT, Rout MP, LaCava J, Walt DR, Burns KH. Ultrasensitive detection of circulating LINE-1 ORF1p as a specific multi-cancer biomarker. bioRxiv 2023:2023.01.25.525462. [PMID: 36747644 PMCID: PMC9900799 DOI: 10.1101/2023.01.25.525462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Improved biomarkers are needed for early cancer detection, risk stratification, treatment selection, and monitoring treatment response. While proteins can be useful blood-based biomarkers, many have limited sensitivity or specificity for these applications. Long INterspersed Element-1 (LINE-1, L1) open reading frame 1 protein (ORF1p) is a transposable element protein overexpressed in carcinomas and high-risk precursors during carcinogenesis with negligible detectable expression in corresponding normal tissues, suggesting ORF1p could be a highly specific cancer biomarker. To explore the potential of ORF1p as a blood-based biomarker, we engineered ultrasensitive digital immunoassays that detect mid-attomolar (10-17 M) ORF1p concentrations in patient plasma samples across multiple cancers with high specificity. Plasma ORF1p shows promise for early detection of ovarian cancer, improves diagnostic performance in a multi-analyte panel, and provides early therapeutic response monitoring in gastric and esophageal cancers. Together, these observations nominate ORF1p as a multi-cancer biomarker with potential utility for disease detection and monitoring.
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8
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Yonker LM, Swank Z, Bartsch YC, Burns MD, Kane A, Boribong BP, Davis JP, Loiselle M, Novak T, Senussi Y, Cheng CA, Burgess E, Edlow AG, Chou J, Dionne A, Balaguru D, Lahoud-Rahme M, Arditi M, Julg B, Randolph AG, Alter G, Fasano A, Walt DR. Circulating Spike Protein Detected in Post-COVID-19 mRNA Vaccine Myocarditis. Circulation 2023; 147:867-876. [PMID: 36597886 PMCID: PMC10010667 DOI: 10.1161/circulationaha.122.061025] [Citation(s) in RCA: 64] [Impact Index Per Article: 64.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 11/23/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Cases of adolescents and young adults developing myocarditis after vaccination with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-targeted mRNA vaccines have been reported globally, but the underlying immunoprofiles of these individuals have not been described in detail. METHODS From January 2021 through February 2022, we prospectively collected blood from 16 patients who were hospitalized at Massachusetts General for Children or Boston Children's Hospital for myocarditis, presenting with chest pain with elevated cardiac troponin T after SARS-CoV-2 vaccination. We performed extensive antibody profiling, including tests for SARS-CoV-2-specific humoral responses and assessment for autoantibodies or antibodies against the human-relevant virome, SARS-CoV-2-specific T-cell analysis, and cytokine and SARS-CoV-2 antigen profiling. Results were compared with those from 45 healthy, asymptomatic, age-matched vaccinated control subjects. RESULTS Extensive antibody profiling and T-cell responses in the individuals who developed postvaccine myocarditis were essentially indistinguishable from those of vaccinated control subjects, despite a modest increase in cytokine production. A notable finding was that markedly elevated levels of full-length spike protein (33.9±22.4 pg/mL), unbound by antibodies, were detected in the plasma of individuals with postvaccine myocarditis, whereas no free spike was detected in asymptomatic vaccinated control subjects (unpaired t test; P<0.0001). CONCLUSIONS Immunoprofiling of vaccinated adolescents and young adults revealed that the mRNA vaccine-induced immune responses did not differ between individuals who developed myocarditis and individuals who did not. However, free spike antigen was detected in the blood of adolescents and young adults who developed post-mRNA vaccine myocarditis, advancing insight into its potential underlying cause.
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Affiliation(s)
- Lael M. Yonker
- Mucosal Immunology and Biology Research Center (L.M.Y., M.D.B., A.K., B.P.B., J.P.D., M.L., A.F.), Division of Infectious Disease, Massachusetts General Hospital, Boston
- Department of Pediatrics (L.M.Y., M.D.B., A.K., B.P.B., J.P.D., M.L., D.B., M.L.-R., A.F.), Division of Infectious Disease, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA (L.M.Y., Z.S., Y.C.B., B.P.B., T.N., Y.S., C.-A.C., J.C., A.D., D.B., M.L.-R., B.J., A.G.R., G.A., A.F., D.R.W.)
| | - Zoe Swank
- Harvard Medical School, Boston, MA (L.M.Y., Z.S., Y.C.B., B.P.B., T.N., Y.S., C.-A.C., J.C., A.D., D.B., M.L.-R., B.J., A.G.R., G.A., A.F., D.R.W.)
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA (Z.S., Y.S., C.-A.C., D.R.W.)
| | - Yannic C. Bartsch
- Harvard Medical School, Boston, MA (L.M.Y., Z.S., Y.C.B., B.P.B., T.N., Y.S., C.-A.C., J.C., A.D., D.B., M.L.-R., B.J., A.G.R., G.A., A.F., D.R.W.)
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA (Y.C.B., E.B., B.J., G.A.)
| | - Madeleine D. Burns
- Mucosal Immunology and Biology Research Center (L.M.Y., M.D.B., A.K., B.P.B., J.P.D., M.L., A.F.), Division of Infectious Disease, Massachusetts General Hospital, Boston
- Department of Pediatrics (L.M.Y., M.D.B., A.K., B.P.B., J.P.D., M.L., D.B., M.L.-R., A.F.), Division of Infectious Disease, Massachusetts General Hospital, Boston
| | - Abigail Kane
- Mucosal Immunology and Biology Research Center (L.M.Y., M.D.B., A.K., B.P.B., J.P.D., M.L., A.F.), Division of Infectious Disease, Massachusetts General Hospital, Boston
- Department of Pediatrics (L.M.Y., M.D.B., A.K., B.P.B., J.P.D., M.L., D.B., M.L.-R., A.F.), Division of Infectious Disease, Massachusetts General Hospital, Boston
| | - Brittany P. Boribong
- Mucosal Immunology and Biology Research Center (L.M.Y., M.D.B., A.K., B.P.B., J.P.D., M.L., A.F.), Division of Infectious Disease, Massachusetts General Hospital, Boston
- Department of Pediatrics (L.M.Y., M.D.B., A.K., B.P.B., J.P.D., M.L., D.B., M.L.-R., A.F.), Division of Infectious Disease, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA (L.M.Y., Z.S., Y.C.B., B.P.B., T.N., Y.S., C.-A.C., J.C., A.D., D.B., M.L.-R., B.J., A.G.R., G.A., A.F., D.R.W.)
| | - Jameson P. Davis
- Mucosal Immunology and Biology Research Center (L.M.Y., M.D.B., A.K., B.P.B., J.P.D., M.L., A.F.), Division of Infectious Disease, Massachusetts General Hospital, Boston
- Department of Pediatrics (L.M.Y., M.D.B., A.K., B.P.B., J.P.D., M.L., D.B., M.L.-R., A.F.), Division of Infectious Disease, Massachusetts General Hospital, Boston
| | - Maggie Loiselle
- Mucosal Immunology and Biology Research Center (L.M.Y., M.D.B., A.K., B.P.B., J.P.D., M.L., A.F.), Division of Infectious Disease, Massachusetts General Hospital, Boston
- Department of Pediatrics (L.M.Y., M.D.B., A.K., B.P.B., J.P.D., M.L., D.B., M.L.-R., A.F.), Division of Infectious Disease, Massachusetts General Hospital, Boston
| | - Tanya Novak
- Harvard Medical School, Boston, MA (L.M.Y., Z.S., Y.C.B., B.P.B., T.N., Y.S., C.-A.C., J.C., A.D., D.B., M.L.-R., B.J., A.G.R., G.A., A.F., D.R.W.)
- Department of Anesthesiology, Critical Care and Pain Medicine (T.N., A.G.R.), Boston Children’s Hospital, MA
| | - Yasmeen Senussi
- Harvard Medical School, Boston, MA (L.M.Y., Z.S., Y.C.B., B.P.B., T.N., Y.S., C.-A.C., J.C., A.D., D.B., M.L.-R., B.J., A.G.R., G.A., A.F., D.R.W.)
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA (Z.S., Y.S., C.-A.C., D.R.W.)
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA (Z.S., Y.S., C.-A.C., D.R.W.)
| | - Chi-An Cheng
- Harvard Medical School, Boston, MA (L.M.Y., Z.S., Y.C.B., B.P.B., T.N., Y.S., C.-A.C., J.C., A.D., D.B., M.L.-R., B.J., A.G.R., G.A., A.F., D.R.W.)
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA (Z.S., Y.S., C.-A.C., D.R.W.)
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA (Z.S., Y.S., C.-A.C., D.R.W.)
| | - Eleanor Burgess
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA (Y.C.B., E.B., B.J., G.A.)
| | - Andrea G. Edlow
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (A.G.E.), Division of Infectious Disease, Massachusetts General Hospital, Boston
- Vincent Center for Reproductive Biology (A.G.E.), Division of Infectious Disease, Massachusetts General Hospital, Boston
- Department of Anesthesiology, Critical Care and Pain Medicine (T.N., A.G.R.), Boston Children’s Hospital, MA
| | - Janet Chou
- Harvard Medical School, Boston, MA (L.M.Y., Z.S., Y.C.B., B.P.B., T.N., Y.S., C.-A.C., J.C., A.D., D.B., M.L.-R., B.J., A.G.R., G.A., A.F., D.R.W.)
- Department of Pediatrics, Division of Immunology (J.C.), Boston Children’s Hospital, MA
| | - Audrey Dionne
- Harvard Medical School, Boston, MA (L.M.Y., Z.S., Y.C.B., B.P.B., T.N., Y.S., C.-A.C., J.C., A.D., D.B., M.L.-R., B.J., A.G.R., G.A., A.F., D.R.W.)
- Department of Cardiology (A.D.), Boston Children’s Hospital, MA
| | - Duraisamy Balaguru
- Department of Pediatrics (L.M.Y., M.D.B., A.K., B.P.B., J.P.D., M.L., D.B., M.L.-R., A.F.), Division of Infectious Disease, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA (L.M.Y., Z.S., Y.C.B., B.P.B., T.N., Y.S., C.-A.C., J.C., A.D., D.B., M.L.-R., B.J., A.G.R., G.A., A.F., D.R.W.)
| | - Manuella Lahoud-Rahme
- Department of Pediatrics (L.M.Y., M.D.B., A.K., B.P.B., J.P.D., M.L., D.B., M.L.-R., A.F.), Division of Infectious Disease, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA (L.M.Y., Z.S., Y.C.B., B.P.B., T.N., Y.S., C.-A.C., J.C., A.D., D.B., M.L.-R., B.J., A.G.R., G.A., A.F., D.R.W.)
| | - Moshe Arditi
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Infectious and Immunologic Diseases Research Center, and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA (M.A.)
| | - Boris Julg
- Department of Medicine (B.J.), Division of Infectious Disease, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA (L.M.Y., Z.S., Y.C.B., B.P.B., T.N., Y.S., C.-A.C., J.C., A.D., D.B., M.L.-R., B.J., A.G.R., G.A., A.F., D.R.W.)
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA (Y.C.B., E.B., B.J., G.A.)
| | - Adrienne G. Randolph
- Harvard Medical School, Boston, MA (L.M.Y., Z.S., Y.C.B., B.P.B., T.N., Y.S., C.-A.C., J.C., A.D., D.B., M.L.-R., B.J., A.G.R., G.A., A.F., D.R.W.)
| | - Galit Alter
- Harvard Medical School, Boston, MA (L.M.Y., Z.S., Y.C.B., B.P.B., T.N., Y.S., C.-A.C., J.C., A.D., D.B., M.L.-R., B.J., A.G.R., G.A., A.F., D.R.W.)
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA (Y.C.B., E.B., B.J., G.A.)
| | - Alessio Fasano
- Mucosal Immunology and Biology Research Center (L.M.Y., M.D.B., A.K., B.P.B., J.P.D., M.L., A.F.), Division of Infectious Disease, Massachusetts General Hospital, Boston
- Department of Pediatrics (L.M.Y., M.D.B., A.K., B.P.B., J.P.D., M.L., D.B., M.L.-R., A.F.), Division of Infectious Disease, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA (L.M.Y., Z.S., Y.C.B., B.P.B., T.N., Y.S., C.-A.C., J.C., A.D., D.B., M.L.-R., B.J., A.G.R., G.A., A.F., D.R.W.)
| | - David R. Walt
- Harvard Medical School, Boston, MA (L.M.Y., Z.S., Y.C.B., B.P.B., T.N., Y.S., C.-A.C., J.C., A.D., D.B., M.L.-R., B.J., A.G.R., G.A., A.F., D.R.W.)
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA (Z.S., Y.S., C.-A.C., D.R.W.)
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA (Z.S., Y.S., C.-A.C., D.R.W.)
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9
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Swank Z, Senussi Y, Manickas-Hill Z, Yu XG, Li JZ, Alter G, Walt DR. Persistent Circulating Severe Acute Respiratory Syndrome Coronavirus 2 Spike Is Associated With Post-acute Coronavirus Disease 2019 Sequelae. Clin Infect Dis 2023; 76:e487-e490. [PMID: 36052466 PMCID: PMC10169416 DOI: 10.1093/cid/ciac722] [Citation(s) in RCA: 147] [Impact Index Per Article: 147.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/25/2022] [Accepted: 08/30/2022] [Indexed: 02/02/2023] Open
Abstract
The diagnosis of postacute sequelae of coronavirus disease 2019 (PASC) poses an ongoing medical challenge. To identify biomarkers associated with PASC we analyzed plasma samples collected from PASC and coronavirus disease 2019 patients to quantify viral antigens and inflammatory markers. We detect severe acute respiratory syndrome coronavirus 2 spike predominantly in PASC patients up to 12 months after diagnosis.
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Affiliation(s)
- Zoe Swank
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Yasmeen Senussi
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | | | - Xu G Yu
- Harvard Medical School, Boston, Massachusetts, USA
- Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts, USA
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Jonathan Z Li
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Galit Alter
- Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts, USA
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - David R Walt
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
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10
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Sherman AC, Crombie JL, Cheng CA, Desjardins M, Zhou G, Ometoruwa O, Rooks R, Senussi Y, McDonough M, Guerrero LI, Kupelian J, Doss-Gollin S, Smolen KK, van Haren SD, Armand P, Levy O, Walt DR, Baden LR, Issa NC. Immunogenicity of a three-dose primary series of mRNA COVID-19 vaccines in patients with lymphoid malignancies. Open Forum Infect Dis 2022; 9:ofac417. [PMID: 36043177 PMCID: PMC9384786 DOI: 10.1093/ofid/ofac417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Patients with lymphoid malignancies are at risk for poor COVID-19 related outcomes and have reduced vaccine-induced immune responses. Currently a three-dose primary regimen of mRNA vaccines is recommended in the U.S. for immunocompromised hosts.
Methods
A prospective cohort study of healthy adults (n = 27) and patients with lymphoid malignancies (n = 94) was conducted, with longitudinal follow-up through completion of a two or three-dose primary mRNA COVID vaccine series, respectively. Humoral responses were assessed in all participants, and cellular immunity in a subset of participants.
Results
The rate of seroconversion (68.1% v. 100%) and the magnitude of peak anti-S IgG titer (median anti-S IgG 32.4, IQR 0.48-75.0 v. 72.6, IQR 51.1-100.1; p = 0.0202) were both significantly lower in patients with lymphoid malignancies as compared to the healthy cohort. However, peak titers of patients with lymphoid malignancies who responded to vaccination were similar to healthy cohort titers (median anti-S IgG 64.3, IQR 23.7 - 161.5, p = 0.7424). The third dose seroconverted 7/41 (17.1%) patients who were seronegative after the first two doses. Although most patients with lymphoid malignancies produced vaccine-induced T-cell responses in the subset studied, B-cell frequencies were low with minimal memory cell formation.
Conclusions
A three-dose primary mRNA series enhanced anti-S IgG responses to titers equivalent to healthy adults in patients with lymphoid malignancies who were seropositive after the first two doses and seroconverted 17.1% who were seronegative after the first two doses. T-cell responses were present, raising the possibility that the vaccines may confer some cell-based protection even if not measurable by anti-S IgG.
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Affiliation(s)
- Amy C Sherman
- Division of Infectious Diseases, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
- Dana-Farber Cancer Institute , Boston, MA, 02115 , USA
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital , Boston, MA 02115 , USA
- Harvard Medical School , Boston, MA, 02115 , USA
| | - Jennifer L Crombie
- Dana-Farber Cancer Institute , Boston, MA, 02115 , USA
- Harvard Medical School , Boston, MA, 02115 , USA
| | - Chi An Cheng
- Harvard Medical School , Boston, MA, 02115 , USA
- Department of Pathology, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University , Boston, MA, 02115 , USA
| | - Michaël Desjardins
- Division of Infectious Diseases, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
- Division of Infectious Diseases, Centre Hospitalier de l’Université de Montréal , Montreal, Qc , Canada
| | - Guohai Zhou
- Division of Infectious Diseases, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
| | - Omolola Ometoruwa
- Division of Infectious Diseases, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
| | - Rebecca Rooks
- Division of Infectious Diseases, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
| | - Yasmeen Senussi
- Harvard Medical School , Boston, MA, 02115 , USA
- Department of Pathology, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University , Boston, MA, 02115 , USA
| | | | | | - John Kupelian
- Division of Infectious Diseases, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
| | - Simon Doss-Gollin
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital , Boston, MA 02115 , USA
| | - Kinga K Smolen
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital , Boston, MA 02115 , USA
- Harvard Medical School , Boston, MA, 02115 , USA
| | - Simon D van Haren
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital , Boston, MA 02115 , USA
- Harvard Medical School , Boston, MA, 02115 , USA
| | - Philippe Armand
- Dana-Farber Cancer Institute , Boston, MA, 02115 , USA
- Harvard Medical School , Boston, MA, 02115 , USA
| | - Ofer Levy
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital , Boston, MA 02115 , USA
- Harvard Medical School , Boston, MA, 02115 , USA
- Broad Institute of MIT & Harvard , Cambridge, 02142, MA USA
| | - David R Walt
- Harvard Medical School , Boston, MA, 02115 , USA
- Department of Pathology, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University , Boston, MA, 02115 , USA
| | - Lindsey R Baden
- Division of Infectious Diseases, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
- Dana-Farber Cancer Institute , Boston, MA, 02115 , USA
- Harvard Medical School , Boston, MA, 02115 , USA
| | - Nicolas C Issa
- Division of Infectious Diseases, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
- Dana-Farber Cancer Institute , Boston, MA, 02115 , USA
- Harvard Medical School , Boston, MA, 02115 , USA
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11
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Rajurkar M, Parikh AR, Solovyov A, You E, Kulkarni AS, Chu C, Xu KH, Jaicks C, Taylor MS, Wu C, Alexander KA, Good CR, Szabolcs A, Gerstberger S, Tran AV, Xu N, Ebright RY, Van Seventer EE, Vo KD, Tai EC, Lu C, Joseph-Chazan J, Raabe MJ, Nieman LT, Desai N, Arora KS, Ligorio M, Thapar V, Cohen L, Garden PM, Senussi Y, Zheng H, Allen JN, Blaszkowsky LS, Clark JW, Goyal L, Wo JY, Ryan DP, Corcoran RB, Deshpande V, Rivera MN, Aryee MJ, Hong TS, Berger SL, Walt DR, Burns KH, Park PJ, Greenbaum BD, Ting DT. Reverse Transcriptase Inhibition Disrupts Repeat Element Life Cycle in Colorectal Cancer. Cancer Discov 2022; 12:1462-1481. [PMID: 35320348 PMCID: PMC9167735 DOI: 10.1158/2159-8290.cd-21-1117] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/27/2022] [Accepted: 03/08/2022] [Indexed: 11/16/2022]
Abstract
Altered RNA expression of repetitive sequences and retrotransposition are frequently seen in colorectal cancer, implicating a functional importance of repeat activity in cancer progression. We show the nucleoside reverse transcriptase inhibitor 3TC targets activities of these repeat elements in colorectal cancer preclinical models with a preferential effect in p53-mutant cell lines linked with direct binding of p53 to repeat elements. We translate these findings to a human phase II trial of single-agent 3TC treatment in metastatic colorectal cancer with demonstration of clinical benefit in 9 of 32 patients. Analysis of 3TC effects on colorectal cancer tumorspheres demonstrates accumulation of immunogenic RNA:DNA hybrids linked with induction of interferon response genes and DNA damage response. Epigenetic and DNA-damaging agents induce repeat RNAs and have enhanced cytotoxicity with 3TC. These findings identify a vulnerability in colorectal cancer by targeting the viral mimicry of repeat elements. SIGNIFICANCE Colorectal cancers express abundant repeat elements that have a viral-like life cycle that can be therapeutically targeted with nucleoside reverse transcriptase inhibitors (NRTI) commonly used for viral diseases. NRTIs induce DNA damage and interferon response that provide a new anticancer therapeutic strategy. This article is highlighted in the In This Issue feature, p. 1397.
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Affiliation(s)
- Mihir Rajurkar
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
| | - Aparna R. Parikh
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School; Boston, MA, USA
| | - Alexander Solovyov
- Computational Oncology, Department of Epidemiology and Biostatistics; Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Eunae You
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
| | | | - Chong Chu
- Department of Biomedical Informatics, Harvard Medical School; Boston, MA, USA
| | - Katherine H. Xu
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
| | - Christopher Jaicks
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
| | - Martin S. Taylor
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School; Boston, MA, USA
| | - Connie Wu
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School; Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard Medical School; Boston, MA, USA
| | - Katherine A. Alexander
- Epigenetics Institute, Departments of Cell and Developmental Biology, Genetics, and Biology, Perelman School of Medicine, University of Pennsylvania; Philadelphia, PA, USA
| | - Charly R. Good
- Epigenetics Institute, Departments of Cell and Developmental Biology, Genetics, and Biology, Perelman School of Medicine, University of Pennsylvania; Philadelphia, PA, USA
| | - Annamaria Szabolcs
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
| | - Stefanie Gerstberger
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School; Boston, MA, USA
| | - Antuan V. Tran
- Department of Biomedical Informatics, Harvard Medical School; Boston, MA, USA
| | - Nova Xu
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
| | - Richard Y. Ebright
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
| | | | - Kevin D. Vo
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
| | - Eric C. Tai
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
| | - Chenyue Lu
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
| | | | - Michael J. Raabe
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
| | - Linda T. Nieman
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
| | - Niyati Desai
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
| | - Kshitij S. Arora
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School; Boston, MA, USA
| | - Matteo Ligorio
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School; Boston, MA, USA
| | - Vishal Thapar
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
| | - Limor Cohen
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School; Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard Medical School; Boston, MA, USA
| | - Padric M. Garden
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School; Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard Medical School; Boston, MA, USA
| | - Yasmeen Senussi
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School; Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard Medical School; Boston, MA, USA
| | - Hui Zheng
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
| | - Jill N. Allen
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School; Boston, MA, USA
| | - Lawrence S. Blaszkowsky
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School; Boston, MA, USA
| | - Jeffrey W. Clark
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School; Boston, MA, USA
| | - Lipika Goyal
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School; Boston, MA, USA
| | - Jennifer Y. Wo
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School; Boston, MA, USA
| | - David P. Ryan
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School; Boston, MA, USA
| | - Ryan B. Corcoran
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School; Boston, MA, USA
| | - Vikram Deshpande
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School; Boston, MA, USA
| | - Miguel N. Rivera
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School; Boston, MA, USA
| | - Martin J. Aryee
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School; Boston, MA, USA
| | - Theodore S. Hong
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School; Boston, MA, USA
| | - Shelley L. Berger
- Epigenetics Institute, Departments of Cell and Developmental Biology, Genetics, and Biology, Perelman School of Medicine, University of Pennsylvania; Philadelphia, PA, USA
| | - David R. Walt
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School; Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard Medical School; Boston, MA, USA
| | - Kathleen H. Burns
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School; Boston, MA, USA
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School; Boston, MA, USA
| | - Peter J. Park
- Department of Biomedical Informatics, Harvard Medical School; Boston, MA, USA
| | - Benjamin D. Greenbaum
- Computational Oncology, Department of Epidemiology and Biostatistics; Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Physiology, Biophysics & Systems Biology, Weill Cornell Medicine, Weill Cornell Medical College, New York, NY, USA
| | - David T. Ting
- Mass General Cancer Center, Harvard Medical School; Charlestown, MA, USA
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School; Boston, MA, USA
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12
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Bausk BP, Sherman AC, Desjardins M, Izaguirre NE, Cheng CA, Powell M, Senussi Y, Gilboa T, Krauss JH, Dirr B, Power E, Joyce A, Stewart L, Ometoruwa O, Novack LA, Evans B, Woods T, Tong A, Walt D, Soiffer R, Ho VT, Issa NC, Baden LR. 25. Immunogenicity and Reactogenicity of COVID-19 mRNA Vaccines in Allogeneic Stem Cell Transplant Recipients. Open Forum Infect Dis 2021. [PMCID: PMC8644500 DOI: 10.1093/ofid/ofab466.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Allogeneic stem cell transplant (SCT) recipients are at an increased risk of poor outcomes from COVID-19. While the mRNA-1273 (Moderna) and BNT162b2 (Pfizer) COVID-19 mRNA vaccines are highly immunogenic in the general population, the immune response in SCT recipients is poorly understood. We characterized the immunogenicity and reactogenicity of COVID-19 mRNA vaccines in a cohort of SCT patients. Methods We performed a prospective cohort study of 16 allogeneic SCT patients and 23 healthy controls. Blood samples for both cohorts were collected prior to first vaccination (baseline), at the time of second vaccination, and approximately 28 days post-second vaccination. Anti-Spike (S), anti-S1, anti-receptor binding domain (RBD), and anti-Nucleocapsid (N) IgG levels were measured quantitatively from plasma using a multiplexed single molecule array (Simoa) immunoassay. Reactogenicity was captured for the SCT cohort via a self-reported post-vaccination diary for 7 days after each dose. Results Demographics and SCT recipients’ characteristics are shown in Table 1. In the SCT cohort, we observed a significantly lower anti-S (p< 0.0001), S1 (p< 0.0001), and RBD (p< 0.0001) IgG responses as compared to healthy controls, both at the time of dose 2 and 28 days post-vaccine series (Fig 1). Overall, 62.5% of SCT recipients were responders after vaccine series completion, as compared to 100% of healthy controls (Fig 2). While no patients had a reported history of COVID-19 diagnosis, 2 patients in the SCT cohort had elevated anti-S IgG levels and 1 showed elevated anti-N at baseline. 10/16 participants in the SCT cohort completed at least one post-vaccination diary. Local and systemic reactions were reported by 67% and 22% of participants, respectively, after dose 1, and 63% and 50% after dose 2 (Figure 3). All reported events were mild. Table 1: Demographics ![]()
Figure 1: Plasma IgG Titers ![]()
Anti-Spike (A), anti-S1 (B), anti-RBD (C), and anti-nucleocapsid (D) IgG titers were measured at baseline, time of second dose, and approximately 28 days after second vaccination. IgG levels were measured quantitatively using multiplexed single molecule array (Simoa) immunoassays, and are reported as Normalized Average Enzymes per Bead (AEB). Allogeneic stem cell transplant recipients (mauve) showed significantly lower anti-S, S1, and RBD IgG responses as compared to healthy controls (mint). Low titers of anti-N IgG demonstrates no history of COVID-19 natural infection during the course of the study. Figure 3. Solicited Local and Systemic Adverse Events ![]()
10 allogeneic stem cell transplant recipients completed at least one diary for 7 days after vaccination. Reactions after dose 1 are shown in light blue, and reactions after dose 2 are shown in dark blue. Local reactions (A) were reported by 67% (6/9) of participants after dose 1, and 63% (5/8) after dose 2. Systemic reactions (B) were reported by 22% (2/9) of participants after dose 1, and 50% (4/8) after dose 2. All reported events were mild (Grade 1). Conclusion Among SCT recipients, mRNA COVID-19 vaccines were well-tolerated but less immunogenic than in healthy controls. Further study is warranted to better understand heterogeneous characteristics that may affect the immune response in order to optimize COVID-19 vaccination strategies for SCT recipients. Figure 2: Response Rate to COVID-19 Vaccination ![]()
An internally validated threshold for responders was established using pre-pandemic sera from healthy adults. A positive antibody response was was defined as individuals with anti-Spike IgG levels above the 1.07 Normalized AEB threshold. Disclosures Amy Joyce, NP, Kadmon (Advisor or Review Panel member) Lewis A. Novack, MS, Lumicell Inc. (Scientific Research Study Investigator, Research Grant or Support)Precision Healing, Inc. (Scientific Research Study Investigator, Research Grant or Support) David Walt, PhD, Quanterix Corporation (Board Member, Shareholder) Robert Soiffer, MD, alexion (Consultant)gilead (Advisor or Review Panel member)jazz (Advisor or Review Panel member)juno/bms (Advisor or Review Panel member)kiadis (Board Member)precision bioscience (Consultant)Rheos (Consultant)takeda (Consultant) Nicolas C. Issa, MD, AiCuris (Scientific Research Study Investigator)Astellas (Scientific Research Study Investigator)GSK (Scientific Research Study Investigator)Merck (Scientific Research Study Investigator)
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Affiliation(s)
| | - Amy C Sherman
- Harvard Medical School/Brigham and Women’s Hospital, Boston, Massachusetts
| | | | | | - Chi-An Cheng
- Brigham and Women’s Hospital, Boston, Massachusetts
| | - Megan Powell
- BWH Division of Infectious Diseases, Boston, Massachusetts
| | | | - Tal Gilboa
- Brigham and Womens' hospital, Brookline, Massachusetts
| | | | - Bonnie Dirr
- Dana Farber Cancer Institute, Boston, Massachusetts
| | - Elyssa Power
- Dana Farber Cancer Institute, Boston, Massachusetts
| | - Amy Joyce
- Dana Farber Cancer Institute, Boston, Massachusetts
| | - Lisa Stewart
- Dana Farber Cancer Institute, Boston, Massachusetts
| | | | | | | | | | | | - David Walt
- Harvard Medical School/Brigham and Women’s Hospital/Wyss Institute, Boston, Massachusetts
| | | | - Vincent T Ho
- Dana-Farber Cancer Institute, Boston, Massachusetts
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13
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Senussi Y, Swank ZN, Walt DR. The optimization of an ultra-sensitive single molecule assay for the multiplexed detection of SARS-CoV-2 antigens. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction/Objective
SARS-CoV-2 antigens, including the nucleocapsid (N) protein, spike protein, and its S1 subunit have served as key biomarkers for research and diagnostic purposes. We previously developed quantitative single molecule array (Simoa) assays to measure the concentration of spike, S1 subunit and N protein in plasma samples with femtomolar limits of detection. We aimed to test antibodies that were not available early in the pandemic, reduce assay cross-reactivity, develop a multiplexed assay for spike, S1, and N protein in order to minimize the sample volume needed.
Methods/Case Report
Using the Simoa platform, a bead-based digital enzyme-linked immunosorbent assay, we cross-tested 17 S1 subunit and spike antibodies for a total of 130 antibody-pair combinations, we performed dilution linearity experiments to determine the ideal dilution factor, spike and recovery experiments, tested the assay using S1 subunit from other human coronavirus HKV1, NL63, and 229E, pre-pandemic plasma samples from patients that were sick with viral or bacterial respiratory infections. We then used the best antibody pairs to measure S1 and spike in plasma samples collected from patients with severe SARS-CoV-2. Lastly, we conjugated the best-performing capture antibodies for spike, S1 and N to beads labeled with different fluorophores to test if the assay for all three antigens could be multiplexed.
Results (if a Case Study enter NA)
We observed no cross-reactivity with S1 from other coronavirus strains, no detection of S1 or spike in a cohort of 30 pre-pandemic samples and successfully developed a multiplexed assay for the detection of spike, S1, and N protein, enabling us to use 50% less sample volume.
Conclusion
Reduction of necessary sample volume is important for studies involving multisystem inflammatory syndrome in children (MIS-C), and possible adverse effects of SARS-CoV-2 vaccinations on children and young adults. An improved assay with minimal cross-reactivity will also be useful to study individuals with post-acute sequelae of SARS-CoV-2 infection (PASC).
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Affiliation(s)
- Y Senussi
- Pathology, Brigham and Women’s Hospital, Boston, Massachusetts, UNITED STATES
| | - Z N Swank
- Pathology, Brigham and Women’s Hospital, Boston, Massachusetts, UNITED STATES
| | - D R Walt
- Pathology, Brigham and Women’s Hospital, Boston, Massachusetts, UNITED STATES
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14
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Yonker LM, Gilboa T, Ogata AF, Senussi Y, Lazarovits R, Boribong BP, Bartsch YC, Loiselle M, Rivas MN, Porritt RA, Lima R, Davis JP, Farkas EJ, Burns MD, Young N, Mahajan VS, Hajizadeh S, Lopez XIH, Kreuzer J, Morris R, Martinez EE, Han I, Griswold K, Barry NC, Thompson DB, Church G, Edlow AG, Haas W, Pillai S, Arditi M, Alter G, Walt DR, Fasano A. Multisystem inflammatory syndrome in children is driven by zonulin-dependent loss of gut mucosal barrier. J Clin Invest 2021; 131:149633. [PMID: 34032635 DOI: 10.1172/jci149633] [Citation(s) in RCA: 146] [Impact Index Per Article: 48.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/19/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUNDWeeks after SARS-CoV-2 infection or exposure, some children develop a severe, life-threatening illness called multisystem inflammatory syndrome in children (MIS-C). Gastrointestinal (GI) symptoms are common in patients with MIS-C, and a severe hyperinflammatory response ensues with potential for cardiac complications. The cause of MIS-C has not been identified to date.METHODSHere, we analyzed biospecimens from 100 children: 19 with MIS-C, 26 with acute COVID-19, and 55 controls. Stools were assessed for SARS-CoV-2 by reverse transcription PCR (RT-PCR), and plasma was examined for markers of breakdown of mucosal barrier integrity, including zonulin. Ultrasensitive antigen detection was used to probe for SARS-CoV-2 antigenemia in plasma, and immune responses were characterized. As a proof of concept, we treated a patient with MIS-C with larazotide, a zonulin antagonist, and monitored the effect on antigenemia and the patient's clinical response.RESULTSWe showed that in children with MIS-C, a prolonged presence of SARS-CoV-2 in the GI tract led to the release of zonulin, a biomarker of intestinal permeability, with subsequent trafficking of SARS-CoV-2 antigens into the bloodstream, leading to hyperinflammation. The patient with MIS-C treated with larazotide had a coinciding decrease in plasma SARS-CoV-2 spike antigen levels and inflammatory markers and a resultant clinical improvement above that achieved with currently available treatments.CONCLUSIONThese mechanistic data on MIS-C pathogenesis provide insight into targets for diagnosing, treating, and preventing MIS-C, which are urgently needed for this increasingly common severe COVID-19-related disease in children.
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Affiliation(s)
- Lael M Yonker
- Mucosal Immunology and Biology Research Center and.,Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Tal Gilboa
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Alana F Ogata
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Yasmeen Senussi
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Roey Lazarovits
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Brittany P Boribong
- Mucosal Immunology and Biology Research Center and.,Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Yannic C Bartsch
- Harvard Medical School, Boston, Massachusetts, USA.,Ragon Institute of MIT, MGH and Harvard, Cambridge, Massachusetts, USA
| | | | - Magali Noval Rivas
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Infectious and Immunologic Diseases Research Center (IIDRC) and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Rebecca A Porritt
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Infectious and Immunologic Diseases Research Center (IIDRC) and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Rosiane Lima
- Mucosal Immunology and Biology Research Center and
| | | | - Eva J Farkas
- Mucosal Immunology and Biology Research Center and
| | | | - Nicola Young
- Mucosal Immunology and Biology Research Center and
| | - Vinay S Mahajan
- Harvard Medical School, Boston, Massachusetts, USA.,Ragon Institute of MIT, MGH and Harvard, Cambridge, Massachusetts, USA
| | - Soroush Hajizadeh
- Harvard Medical School, Boston, Massachusetts, USA.,Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - Xcanda I Herrera Lopez
- Harvard Medical School, Boston, Massachusetts, USA.,Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - Johannes Kreuzer
- Harvard Medical School, Boston, Massachusetts, USA.,Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - Robert Morris
- Harvard Medical School, Boston, Massachusetts, USA.,Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - Enid E Martinez
- Mucosal Immunology and Biology Research Center and.,Harvard Medical School, Boston, Massachusetts, USA.,Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Isaac Han
- Harvard Medical School, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Kettner Griswold
- Harvard Medical School, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Nicholas C Barry
- Harvard Medical School, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - David B Thompson
- Harvard Medical School, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - George Church
- Harvard Medical School, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA.,Department of Genetics, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrea G Edlow
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and.,Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Wilhelm Haas
- Harvard Medical School, Boston, Massachusetts, USA.,Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - Shiv Pillai
- Harvard Medical School, Boston, Massachusetts, USA.,Ragon Institute of MIT, MGH and Harvard, Cambridge, Massachusetts, USA
| | - Moshe Arditi
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Infectious and Immunologic Diseases Research Center (IIDRC) and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Galit Alter
- Harvard Medical School, Boston, Massachusetts, USA.,Ragon Institute of MIT, MGH and Harvard, Cambridge, Massachusetts, USA
| | - David R Walt
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Alessio Fasano
- Mucosal Immunology and Biology Research Center and.,Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,European Biomedical Research Institute of Salerno (EBRIS), Salerno, Italy
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15
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Ogata AF, Cheng CA, Desjardins M, Senussi Y, Sherman AC, Powell M, Novack L, Von S, Li X, Baden LR, Walt DR. Circulating SARS-CoV-2 Vaccine Antigen Detected in the Plasma of mRNA-1273 Vaccine Recipients. Clin Infect Dis 2021; 74:715-718. [PMID: 34015087 PMCID: PMC8241425 DOI: 10.1093/cid/ciab465] [Citation(s) in RCA: 109] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Indexed: 01/16/2023] Open
Abstract
SARS-CoV-2 proteins were measured in longitudinal plasma samples collected from
13 participants who received two doses of mRNA-1273 vaccine. 11 of 13
participants showed detectable levels of SARS-CoV-2 protein as early as day one
after first vaccine injection. Clearance of detectable SARS-CoV-2 protein
correlated with production of IgG and IgA.
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Affiliation(s)
- Alana F Ogata
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Chi-An Cheng
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Michaël Desjardins
- Harvard Medical School, Boston, MA, USA.,Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA.,Division of Infectious Diseases, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Yasmeen Senussi
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | - Amy C Sherman
- Harvard Medical School, Boston, MA, USA.,Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Megan Powell
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Lewis Novack
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Salena Von
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Xiaofang Li
- Center for Clinical Investigation, Brigham and Women's Hospital, Boston, MA, USA
| | - Lindsey R Baden
- Harvard Medical School, Boston, MA, USA.,Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA.,Center for Clinical Investigation, Brigham and Women's Hospital, Boston, MA, USA
| | - David R Walt
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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