Development and validation of IMMUNO-COV™: a high-throughput clinical assay for detecting antibodies that neutralize SARS-CoV-2

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Abstract

We here describe the development and validation of IMMUNO-COV™, a high-throughput clinical test to quantitatively measure SARS-CoV-2-neutralizing antibodies, the specific subset of anti-SARS-CoV-2 antibodies that block viral infection. The test measures the capacity of serum or purified antibodies to neutralize a recombinant Vesicular Stomatitis Virus (VSV) encoding the SARS-CoV-2 spike glycoprotein. This recombinant virus (VSV-SARS-CoV-2-S-Δ19CT) induces fusion in Vero cell monolayers, which is detected as luciferase signal using a dual split protein (DSP) reporter system. VSV-SARS-CoV-2-S-Δ19CT infection was blocked by monoclonal α-SARS-CoV-2-spike antibodies and by plasma or serum from SARS-CoV-2 convalescing individuals. The assay exhibited 100% specificity in validation tests, and across all tests zero false positives were detected. In blinded analyses of 230 serum samples, only two unexpected results were observed based on available clinical data. We observed a perfect correlation between results from our assay and 80 samples that were also assayed using a commercially available ELISA. To quantify the magnitude of the anti-viral response, we generated a calibration curve by adding stepped concentrations of α-SARS-CoV-2-spike monoclonal antibody to pooled SARS-CoV-2 seronegative serum. Using the calibration curve and a single optimal 1:100 serum test dilution, we reliably measured neutralizing antibody levels in each test sample. Virus neutralization units (VNUs) calculated from the assay correlated closely (p < 0.0001) with PRNT EC50 values determined by plaque reduction neutralization test against a clinical isolate of SARS-CoV-2. Taken together, these results demonstrate that the IMMUNO-COV™ assay accurately quantitates SARS-CoV-2 neutralizing antibodies in human sera and therefore is a potentially valuable addition to the currently available serological tests. The assay can provide vital information for comparing immune responses to the various SARS-CoV-2 vaccines that are currently in development, or for evaluating donor eligibility in convalescent plasma therapy studies.

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  1. SciScore for 10.1101/2020.05.26.117549: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.
    Cell Line Authenticationnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    For inhibition studies, mouse α-SARS-CoV-2 spike antibody (GeneTex
    α-SARS-CoV-2
    suggested: None
    #GTX632604), affinity-purified polyclonal α-human-Ace-2 antibody (R&D Systems #AF933), and recombinant human Ace-2 (R&D Systems #933-ZN-010) were diluted in OptiMEM to the desired concentrations.
    α-human-Ace-2
    suggested: None
    After 30 min on ice, cells were rinsed with 1 mL FACS buffer and resuspended in 100 µL FACS buffer containing 5 µL donkey-α-goat IgG-PE secondary antibody.
    IgG-PE
    suggested: None
    After 30 min on ice, samples were washed twice with 1 mL FACS buffer and resuspended in 100 µL of a 0.5% saponin solution containing 2 µL goat α-rabbit IgG-AF647 secondary antibody.
    2 µL goat α-rabbit
    suggested: None
    Membranes were blocked in 5% non-fat dry milk in TBST, washed three times with TBST, and incubated for 1 h at room temperature with primary antibody mouse α-SARS-CoV-2 Spike (1:1000, GeneTex #GTX632604) or rabbit polyclonal α-VSV (1:5000, Imanis Life Sciences #REA005).
    α-VSV
    suggested: None
    Membranes were washed three times with TBST and incubated for 1 h at room temperature with secondary antibody goat α-mouse IgG-HRP (Prometheus #20-304) or goat α-rabbit IgG-HRP (Prometheus #20-303) at 1:20,000.
    α-mouse IgG-HRP
    suggested: None
    α-rabbit IgG-HRP
    suggested: None
    Experimental Models: Cell Lines
    SentencesResources
    Cells: African green monkey Vero cells (ATCC® CCL-81™), Vero-αHis (29), and baby hamster kidney BHK-21 cells (ATCC® CCL-10™) were maintained in high-glucose DMEM supplemented with 5% fetal bovine serum and 1X penicillin/streptomycin (complete media) at 37°C/5% CO2.
    Vero
    suggested: None
    BHK-21
    suggested: None
    Following selection, Vero-DSP cells were maintained in complete media supplemented with 5 µg/mL puromycin.
    Vero-DSP
    suggested: None
    The virus was propagated in Vero-αHis cells by inoculating 80% confluent monolayers in 10-cm plates with 1 mL of virus.
    Vero-αHis
    suggested: None
    Flow cytometry: Vero-DSP1-Puro cells were dislodged using Versene, counted, and transferred to microcentrifuge tubes (5×105 cells/tube was used for Ace-2 staining and 1.5×106 cells/tube was used for TMPRSS2 staining).
    Vero-DSP1-Puro
    suggested: None
    Experimental Models: Organisms/Strains
    SentencesResources
    To generate Vero-DSP1-Puro (Vero-DSP1) and Vero-DSP2-Puro (Vero-DSP2) were generated by transducing Vero cells with lentiviral vectors SFFV-DSP1-7-P2A-Puro or SFFV-DSP8-11-P2A-Puro encoding the Renilla Rluc8 luciferase-GFP split reporter DSP1 or DSP2 (GenBank EF446136.1) (20) under control of the spleen focus forming virus (SFFV) promoter and linked to the puromycin resistance gene via a P2A cleavage peptide.
    Vero-DSP1-Puro (Vero-DSP1)
    suggested: None
    Vero-DSP2-Puro (Vero-DSP2
    suggested: None
    Software and Algorithms
    SentencesResources
    Statistical Analyses: Descriptive statistics, comparisons, and regression analyses were performed in Graph Pad Prism, v8.4.0 (San Diego, CA).
    Graph Pad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)

    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: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).


    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.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.