An epidemiological survey of COVID-19 serology and its association with clinical infection among older adults- does antibody titer matter?

BACKGROUND

Older adults are at increased risk of severe SARS-CoV-2 infection. In this study we assessed the response to COVID-19 vaccination and infection rates among nursing homes (NH) and assisted-living care home (ALCH) residents.

METHODS

The study was conducted between August 2021 and January 2022, after widespread population vaccination with the third dose of Pfizer-BioNtech mRNA COVID-19 vaccine in Israel. Three groups were addressed: hospitalized older patients; NH and ALCH residents. Demographic data, COVID-19 serology (anti-spike IgG antibodies) and PCR test results were obtained to assess the dynamics of antibody titers and its correlation to infection rates.

RESULTS

Two-hundred eighty-five individuals were evaluated; 92 hospitalized patients; 100 ALCH residents and 93 NH residents. In the latter two groups two serology surveys were conducted three months apart. Hospitalized patients were younger than ALCH and NH residents (mean age 80.4 ± 8 versus 82.6 ± 8 and 83.6 ± 5, respectively, p = 0.01), and had more comorbidities (p = 0.003). The degree of decline in the antibody level overtime was similar in ALCH and NH residents. Infection rates were higher among NH residents than ALCH residents [35/91 (38.4%) versus 11/100 (11%), p < 0.001]. Antibody level was lower among those infected [2113 (1271-3512) Au/ml versus 4113 (3364-5029) Au/ml, p < 0.001]. Adjusted analysis showed that NH residence, but not antibody levels, were significantly associated with infection.

CONCLUSION

Among older adults, infection rates inversely correlated with antibody level. However, only nursing home residence was significantly associated with infection, suggesting that other factors such as crowding considerably contribute to the risk of infection.

Evaluation of antibody and T Cell immunity response in different immunization groups of inactive and mRNA COVID-19 vaccines

This study aimed to evaluate the antibody and T cell responses of homologous and heterologous booster doses for SARS-CoV-2 vaccines. Our study was performed on those with two doses of mRNA vaccine BNT162b2 (2B, n:44), those with heterologous booster dose BNT162b2 vaccine after two doses of inactivated vaccine CoronaVac (2S+1B, n:44), those with homologous booster dose vaccine CoronaVac after two doses of vaccine CoronaVac (3S, n:44) SARS-CoV-2 IgG antibody levels were significantly higher in individuals who received heterologous boosters(p<0.001). IFN-Ɣ, IL-2 and IL-13 median values were detected higher in 2S+1B group than in 3S group, respectively (p=0.112, p=0.057, p=0.341). Although the antibody levels in 2S+1B group were similar (p=0.153) to the 2B group; IFN-Ɣ, IL-2 and IL-13 levels were higher (p<0.001). In conclusion, supplementing an improved strategy based on inactivated vaccines with an mRNA vaccine as a heterologous booster is likely to be more beneficial in the course of the pandemic.

Comparison of diagnostic methods for assessment of Ostertagia ostertagi exposure in Norwegian dairy herds

BACKGROUND

The gastrointestinal nematode (GIN) Ostertagia ostertagi can cause severe disease in first season grazers (FSG) and impaired performance due to subclinical infections in adult cows. Diagnostic methods to assess exposure include faecal egg count and detection of specific antibodies using antibody-ELISAs resulting in an optical density ratio (ODR). Using the ELISA test on bulk tank milk (BTM) allows for a herd level diagnosis. Appropriate use of diagnostic methods for evaluation of O. ostertagi exposure is required to optimize herd parasite surveillance and aid in a sustainable control regime. The aim of this study was to describe the relationship between different diagnostic tests used to assess GIN exposure in Norwegian production systems. A cross-sectional field study was carried out in twenty herds in Norway in the fall of 2020. Serum and faecal samples were taken from 380 individuals, of which 181 were FSG and 199 were cows. In addition, milk was collected from every cow and one BTM sample was taken from each herd. Faecal egg counts were performed. The distribution of ODR values in individual samples within and between herds and the associations between BTM ODR and individual ODR values were described. The data were analysed using visual assessment of scatter plots, Pearson correlation coefficients and linear regression.

RESULTS

A high variability of the within-herd individual ODR values in serum and milk in every herd was detected. The ODR in BTM explained a low degree of the variation in the individual serum and milk samples. When plotting the ODR results in milk or serum according to four BTM categories, the distribution of ODR values were notably different in the highest and lowest BTM categories. The correlation between individual milk and serum samples was moderate (r = 0.68), while the highest correlation (r = 0.81) was between the BTM ODR and the group average individual milk samples.

CONCLUSIONS

A poor predictive ability for BTM ODR to assess individual ODR values in both FSG and cows was demonstrated. However, the study indicates that the evaluation by ELISA test on BTM to assess exposure to GIN could be useful in herds with a very high or low BTM ODR.

The effects of methotrexate on the immune responses to the COVID-19 vaccines in the patients with immune-mediated inflammatory disease: A systematic review of clinical evidence

COVID-19 vaccines exhibit high levels of immunogenicity in the overall population. Data on the effects of immunomodulators on the consequences of COVID-19 in patients with Immune-mediated inflammatory diseases (IMIDs) remains scarce. This systematic review aimed to evaluate the immune responses to the COVID-19 vaccines in IMID patients receiving methotrexate (MTX) compared to healthy individuals. A comprehensive literature search was carried out using electronic databases such as PubMed, Web of Science, Scopus, Google Scholar, and Embase up to August 2022 to identify eligible RCTs evaluating the effect of MTX on immune responses in patients with COVID-19. The PRISMA checklist protocol was applied for the quality assessment of the selected trials. Our findings demonstrated that MTX lowered the responses of T cells and antibodies in IMID patients compared to healthy controls. We also discovered that young age (<60 years) was the main parameter influencing the antibody response after vaccination, while MTX had little effect. Following vaccination, MTX-hold and age were considered the main factors influencing the antibody response. In patients older than 60 years of age, the time point of 10 days of MTX discontinuation was critical to boosting the humoral response to anti-SARS-CoV-2 IgG. Because many IMID patients did not have adequate humoral and cellular responses, our findings highlighted the importance of second or booster doses of vaccine and temporary MTX discontinuation. As a result, it implies that individuals with IMIDs should be subjected to more research, particularly humoral and cellular immunity efficiency trials after COVID-19 vaccination, until credible information is achieved.

Investigation of the baseline tetanus antibody level and its persistence in a military unit

OBJECTIVES

To determine tetanus antibody levels in army recruits and evaluate the persistence of immunity following tetanus booster immunization in adults.

METHODS

A total of 680 recruits were selected for observation of their tetanus antibody levels. From 2005 to 2015, 691 peacekeepers with tetanus vaccination were included in the questionnaire-based and serological survey based on cluster stratification. The tetanus antibody-positive rate, geometric mean concentration (GMC), and their respective changes over time were analyzed in different age groups, regions, and years after tetanus booster immunization.

RESULTS

The positivity rates of tetanus antibodies in the recruits and peacekeepers were 74.85% and 99.86%, respectively (χ² = 193.00, P < 0.05) and the antibody GMCs were 0.05 and 0.70 IU/mL (t = 15.73, P < 0.05). The antibody positivity rates of recruits from 12 provinces ranged from 47.62% (Hubei) to 100% (Inner Mongolia) (χ² = 37.24, P < 0.05) and the antibody GMCs ranged from 0.02 (Hubei) to 0.09 IU/mL (Heilongjiang) (F = 5.19, P < 0.01). Among the 691 peacekeepers, no statistically significant difference in antibody positivity rate was detected between men and women. After administration of one booster dose of the tetanus vaccine, a protective antibody level was calculated to persist up to 22 years; a significant difference in antibody levels was observed within 10 years between one and two or more booster doses.

CONCLUSION

The rate at which recruits tested positive for tetanus antibodies was low. Thus, it is necessary to screen for tetanus antibodies during military recruitment and implement a precision-based booster immunization protocol for tetanus vaccine. Moreover, one dose of the tetanus vaccine booster has been calculated to maintain a protective antibody level up to 22 years, without the need for repeated reinforcements during this period.

pylori virulence factors VacA and CagA among African Americans and whites in the Southeast USA

PURPOSE

Helicobacter pylori (H. pylori) is the leading cause of gastric cancer. High antibody levels to H. pylori virulence factors Vacuolating cytotoxin A (VacA) and Cytotoxin-associated gene A (CagA) have been suggested as gastric cancer risk markers. In the USA, H. pylori sero-prevalence is twofold higher in African Americans compared to whites. We sought to assess whether African Americans also exhibit higher antibody levels to VacA and CagA.

METHODS

Antibody responses to H. pylori proteins were measured by multiplex serology in 686 African Americans and whites of the Southern Community Cohort Study. Among VacA- and CagA-seropositives, we analyzed the association of race with antibody level using logistic regression models to produce odds ratios (OR) and 95% confidence intervals (CI).

RESULTS

Sero-positive African Americans had significantly higher mean antibody levels to both VacA and CagA, which resulted in increased odds for the highest quartile of antibody levels compared to sero-positive whites (VacA, OR: 6.08; 95% CI 3.41, 10.86; CagA, OR: 3.77; 95% CI 1.61, 8.84).

CONCLUSION

Our findings support future studies to assess the association of differential antibody responses by race with risk of gastric cancer in the USA, which could then aid in developing targeted H. pylori eradication strategies.

Comparison of antibody response between boys and girls after infant and childhood vaccinations in the Netherlands

BACKGROUND

Infectious diseases can differ by sex in their incidence, prevalence, or severity of disease. These differences may be induced by sex-dependent immune responses and resulting protection, for example after vaccination. Therefore, this study aims to assess possible sex-differences in immunoglobulin levels (IgG) after infant and childhood vaccination.

METHODS

Data from a national cross-sectional serosurvey conducted in 2006/2007 were used (Pienter 2). We compared IgG levels against measles, mumps, rubella, diphtheria, tetanus, poliomyelitis, pertussis, Haemophilus influenzae type b (Hib), and Neisseria meningitidis serogroup C (MenC) between girls and boys both short term (1 month to 1 year) and long term (1-3 year) after infant and childhood vaccinations, using linear regression analysis. Proportions of boys and girls reaching a protective IgG level were compared using Fishers exact test.

RESULTS

Differences in IgG were found at specific time points after vaccination against measles, mumps, rubella, MenC, and polio. The geometric mean concentration or titer (GMC/T) girls:boys ratios ranged between 1.10 for polio type 1 <1 year after the first childhood booster to 1.90 for MenC <1 year after infant vaccination, indicating higher antibody levels in girls. No significant differences were found between boys and girls for diphtheria, tetanus, pertussis, and Hib at either time point. Proportions with protective levels differed only at 1-3 years after infant vaccination for mumps (82.5% boys vs. 91.9% girls, p = 0.046), and at the same time point for MenC (7.0% boys vs. 18.2% girls, p = 0.015), and polio type 1 (87.8% boys vs. 95.9% girls, p = 0.047).

CONCLUSION

Differences in IgG between boys and girls were generally small and not consistent, neither between pathogens nor within pathogens. If differences were observed, girls were favored over boys. On the whole, the results suggest that there are no major sex differences in protection from the studied pathogens in the Netherlands.

Prenatal exposure to perfluoroalkyl substances is associated with lower hand, foot and mouth disease viruses antibody response in infancy: Findings from the Guangzhou Birth Cohort Study

BACKGROUND

Perfluoroalkyl substances (PFASs) are synthetic chemicals widely used in industry and for commercial products. Their immunomodulatory effects are a growing health concern in children. Hand, Foot and Mouth Disease (HFMD) is a common childhood viral infection, and increased incidence of which has parallel the rise in PFAS exposure in the Asia-Pacific region.

OBJECTIVE

We conducted the first study to assess whether prenatal exposure to PFAS was associated with a reduction in HFMD virus antibodies in infants.

METHODS

We enrolled 201 mother-infant pairs from the Guangzhou Birth Cohort Study from July to October 2013. High performance liquid chromatography-mass spectrometry was employed to determine concentrations of specific PFAS isomers in cord blood. Neutralizing antibodies titers were measured against two HFMD viruses, enterovirus 71 (EV71) and coxsackievirus A 16 (CA16), in cord blood serum and blood serum at three months of age.

RESULTS

Higher umbilical cord blood PFAS concentrations were associated with lower EV71 and CA16 antibody concentrations. A doubling in the composite sum of cord blood PFASs in three month old infants was associated with significant increase in the risk of HFMD antibody concentration below clinical protection level (≥1:8 titers) for CA16 (odds ratio, OR: 2.74 [95% confidence interval (CI): 1.33, 5.61] and for EV71 (OR = 4.55, 95% CI: 1.45, 4.28). This association was higher in boys at three months of age for CA16.

CONCLUSIONS

Our findings suggest that cord blood PFAS exposure is associated with lower HFMD antibody in infancy. Given the widespread nature of PFAS exposures and the high global incidence of HFMD globally, these findings have substantial public health implications and therefore, these associations need to be replicated in a larger study to more definitively address the risk.

Vaccine-induced antibody level as the parameter of the influence of environmental salinity on vaccine efficacy in Nile tilapia

To effectively increase production and improve economic returns, the co-culture of Nile tilapia (Oreochromis niloticus) and marine shrimp has been adopted in many countries, including China. Although O. niloticus is an euryhaline fish that can tolerate elevated salinities and even full-strength seawater, fluctuations in salinity levels can undoubtedly induce stress and affect the immune response of this fish. Therefore, this study assessed the impact of salinity on vaccine efficacy in Nile tilapia, which used serum antibody level as a surrogate marker to detect vaccine efficacy. Nile tilapia were acclimatized to 0, 10, 20, or 30 ppt salinity, and then immunized with a formalin-inactivated Streptococcus agalactiae vaccine. Significantly lower levels of antibody in vaccinated fish were found at 20 and 30 ppt salinity compared to 0 and 10 ppt salinity. White blood cell counts, absolute blood lymphocyte counts, and serum bactericidal activity levels were all significantly lower in vaccinated fish at 20 and 30 ppt salinity. Elevated cortisol levels were detected in all of the fish exposure to salinity. Concentrations of serum electrolytes (Na⁺ and Cl^-) were significantly higher in fish at 30 ppt salinity, as compared to fish at lower salinities. Furthermore, the mRNA transcription levels of three of the immune-related genes analyzed (IgM, IL-1β, and IFN-γ, but not Hsp70) were significantly inhibited in the vaccinated fish at 20 and 30 ppt salinity. A suppressed immune response and decreased vaccine efficacy were also indicated by the lower survival rate of vaccinated fish at 20 ppt salinity when challenged with S. agalactiae. Therefore, salinities ≥20 ppt negatively affected antibody production in Nile tilapia, ultimately affecting vaccine efficacy.

The declining antibody level of measles virus in China population, 2009-2015

Background

To eliminate measles, the coverage of more than 90% vaccine is required in China. Nonetheless, the measles incidence still reached to 3.88 per 100,000 in 2014, which is far more than the target of 1 per 1,000,000. Moreover, there is little national surveillance to measles antibody level indicating herd immunity status in China.

Methods

We detected the level of antibody to measles using commercially available indirect enzyme-linked immunosorbent IgG assays, and calculated the protection rate of population (PRP) to measles virus infection among health peoples in China.

Results

During the years 2009–2015, among the Chinese population aged 0–56, PRP was 94.7, 91.6, 91.6, 84.2, 82.1, 81.0, 75.4%, respectively. Among all age bands, the PRP is lowest among children less than 12-month-age, followed by people over 15 years old.

Conclusion

Measles antibody level among healthy population has been declined since 2012, supplemented measles vaccination activity may be necessary to eliminate measles in China.

Serological lessons from the bovine lungworm Dictyocaulus viviparus: Antibody titre development is independent of the infection dose and reinfection shortens seropositivity

Infections with the bovine lungworm Dictyocaulus viviparus, the causative agent of parasitic bronchitis, are accompanied by substantial economic losses due to impacts on production, clinical respiratory disease or even death of diseased cattle. To detect lungworm antibodies in cattle, an enzyme-linked immunosorbent assay (ELISA) based on recombinant major sperm protein (MSP) has been developed. However, it remained unknown whether the infection dose influences antibody levels, and how acquired immunity influences antibody level patterns during reinfections. The latter may lead to low within-herd seroprevalence and thus to negative MSP-ELISA results in examination of bulk tank milk (BTM). Thus, infection experiments with 12 different doses ranging from 10 to 3000 D. viviparus larvae were performed to assess whether the antibody response is dose-dependent. Second, the impact of reinfections on the antibody response was evaluated in infection experiments, and third, antibody patterns in dairy cows during naturally occurring reinfections were assessed in a longitudinal field study based on individual milk samples. Results of this study demonstrate that the rise in MSP antibodies during first infection is dose-independent at infection doses of 25 lungworm larvae and above. However, following reinfections the magnitude and duration of the MSP antibody response are reduced or lacking, depending on the interval to reinfection. The field study revealed short periods of seropositivity as a common pattern in dairy cows subjected to natural D. viviparus reinfections. Low within-herd seroprevalence in dairy herds can thus be a result of continuous reinfections. Low infection doses should not be a barrier to serodiagnosis of lungworm infection in first-time infected cattle.

Infection and inflammation in schizophrenia and bipolar disorder

The present study investigated the relationship between exposure to infectious agents and inflammation markers in individuals with schizophrenia (SZ), bipolar disorder (BP), and controls without a psychiatric disorder. We measured plasma levels of antibodies and innate immune markers and correlated them with clinical symptoms and cognitive function. In both SZ and BP, we found an increase in soluble CD14, and in BP an increase in C-reactive protein, IgM class antibodies against cytomegalovirus (CMV), and IgG class antibodies against herpes simplex virus 2. Furthermore in BP, we observed a negative relationship between IgG antibodies against CMV and scores for cognitive function.

Persistence of antibodies acquired by natural hepatitis E virus infection and effects of vaccination

OBJECTIVE

Naturally acquired anti-hepatitis E virus (HEV) immunity can protect against new HEV infections. The aim of this study was to analyse the persistence of naturally acquired anti-HEV immunoglobulin (Ig) G and anti-HEV IgG concentrations after vaccination.

METHODS

We examined the seropositivity rates of participants included in a phase 3 clinical efficacy trial (67 months' follow-up) for a HEV vaccine (Hecolin; Xiamen Innovax Biotech, China) and predicted long-term persistence using mixed-effect models.

RESULTS

The analysis focused on 2242 baseline seropositive participants in a control group (placebo recipients) and 2031 baseline seropositive participants in an vaccine group (vaccine recipients) who received 1 to 3 doses of Hecolin. Naturally acquired anti-HEV IgG levels decreased steadily independent of the initial antibody level; 50% of the placebo recipients were expected to have undetectable antibody concentrations after 14.5 years. After immunization with Hecolin, the power-law model and the modified power-law model predicted that 82.1 and 99.4% of the participants, respectively, would remain seropositive for anti-HEV IgG for 30 years after vaccination.

CONCLUSIONS

Whereas naturally acquired anti-HEV IgG levels decrease steadily, HEV vaccination induces long-lasting, high-level anti-HEV IgG concentrations.

Protection against hepatitis E virus infection by naturally acquired and vaccine-induced immunity

Immunity acquired from infection or vaccination protects humans from symptomatic hepatitis E. However, whether the risk of hepatitis E virus (HEV) infection is reduced by the immunity remains unknown. To understand this issue, a cohort with 12 409 participants randomized to receive the hepatitis E vaccine Hecolin(®) or placebo were serologically followed up for 2 years after vaccination. About half (47%) of participants were initially seropositive. A total of 139 infection episodes, evidenced by four-fold or greater rise of anti-HEV level or positive seroconversion, occurred in participants who received three doses of treatment. Risk of infection was highest among the baseline seronegative placebo group participants (2.04%). Pre-existing immunity and vaccine-induced immunity lower the risk significantly, to 0.52% and 0.30%, respectively. In conclusion, both vaccine-induced and naturally acquired immunity can effectively protect against HEV infection.