Evaluation of a commercial ELISA as alternative to plaque reduction neutralization test to detect neutralizing antibodies against SARS-CoV-2

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Abstract

High-throughput detection of neutralizing antibodies against SARS-CoV-2 presents a valuable tool for vaccine trials or investigations of population immunity. We evaluate the performance of the first commercial surrogate virus neutralization test (sVNT, GenScript Biotech) against SARS-CoV-2 plaque reduction neutralization test (PRNT) in convalescent and vaccinated individuals. We compare it to five other ELISAs, two of which are designed to detect neutralizing antibodies. In 491 pre-vaccination serum samples, sVNT missed 23.6% of PRNT-positive samples when using the manufacturer-recommended cutoff of 30% binding inhibition. Introducing an equivocal area between 15 and 35% maximized sensitivity and specificity against PRNT to 72.8–93.1% and 73.5–97.6%, respectively. The overall diagnostic performance of the other ELISAs for neutralizing antibodies was below that of sVNT. Vaccinated individuals exhibited higher antibody titers by PRNT (median 119.8, IQR 56.7–160) and binding inhibition by sVNT (median 95.7, IQR 88.1–96.8) than convalescent patients (median 49.1, IQR 20–62; median 52.9, IQR 31.2–76.2). GenScript sVNT is suitable to screen for SARS-CoV-2-neutralizing antibodies; however, to obtain accurate results, confirmatory testing by PRNT in a equivocal area is required. This equivocal area may require adaptation for use in vaccinated individuals, due to higher antibody titers.

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  1. SciScore for 10.1101/2021.10.12.21264881: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Cell Line Authenticationnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Neutralizing antibodies are considered to block the binding between RBD and ACE2, hence increasing the amount of free RBD that can bind to the plate.
    ACE2
    suggested: None
    Next, the plate was washed 4x with the supplied wash buffer and 100 μL of Spike-RBD antibodies conjugated to HRP were added per well.
    Spike-RBD
    suggested: None
    Binding antibody ELISA tests: The Euroimmun SARS-CoV-2 IgG antibody ELISA (“S1 IgG”), Euroimmun SARS-CoV-2-NCP IgG ELISA (“NCP IgG”, both Euroimmun AG, Lübeck, Germany) and the Wantai SARS-CoV-2 Ab ELISA (Beijing Wantai Biological Pharmacy Enterprise; Beijing, China) were carried out according to the manufacturer’s instructions, with the exception that 50 μl of serum were used in the Wantai Ab ELISA.
    The Euroimmun SARS-CoV-2 IgG antibody ELISA
    suggested: None
    SARS-CoV-2 IgG
    suggested: None
    “S1 IgG”
    suggested: None
    Experimental Models: Cell Lines
    SentencesResources
    Next, 100 μL of diluted serum–virus mix were added to wells containing 2 × 104 Vero E6 cells per well (#85020206, European Collection of Authenticated Cell Cultures (ECACC), Porton Down, UK) in a 96-well plate.
    Vero E6
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There are some technical limitations concerning the use of the GenScript sVNT for high-throughput sample analysis. We have identified pipetting speed as one of the main factors involved in the generation of false positive results, as the strength of the signal is strongly correlated with incubation time. If pipetting occurs slowly (e.g. when using a single-channel pipette), HRP-coupled RBD will have more time to bind to the coated ACE receptor, and will thus create a stronger OD signal, in negative samples at the beginning of the plate compared to negative samples at the end of the plate. In our laboratory, where the GenScript sVNT is performed manually, we were able to address this “OD drift” over the plate by using a multichannel pipette and by processing only half plates at a time. However, for full automation this time-dependent drift can be problematic as many pipetting robots use a single-tip dispenser and, hence, robots often cannot adhere to the 2-min pipetting time per plate as recommended by the manufacturer. Nonetheless, the throughput achievable by using the GenScript sVNT remains much higher than that of a cell-culture-based PRNT, even if only half plates are processed. However, it impairs the large-scale testing of vaccinated individuals on a routine basis. Another parameter that remains to be evaluated when using the GenScript sVNT is the influence of emerging variants with mutations in the RBD, e.g. B1.1.7, B.1.351 and P1. A possible solution would be the deve...

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.


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