Evolution of Antibody Immunity to SARS-CoV-2

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Abstract

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected 78 million individuals and is responsible for over 1.7 million deaths to date. Infection is associated with development of variable levels of antibodies with neutralizing activity that can protect against infection in animal models. Antibody levels decrease with time, but the nature and quality of the memory B cells that would be called upon to produce antibodies upon re-infection has not been examined. Here we report on the humoral memory response in a cohort of 87 individuals assessed at 1.3 and 6.2 months after infection. We find that IgM, and IgG anti-SARS-CoV-2 spike protein receptor binding domain (RBD) antibody titers decrease significantly with IgA being less affected. Concurrently, neutralizing activity in plasma decreases by five-fold in pseudotype virus assays. In contrast, the number of RBD-specific memory B cells is unchanged. Memory B cells display clonal turnover after 6.2 months, and the antibodies they express have greater somatic hypermutation, increased potency and resistance to RBD mutations, indicative of continued evolution of the humoral response. Analysis of intestinal biopsies obtained from asymptomatic individuals 4 months after coronavirus disease-2019 (COVID-19) onset, using immunofluorescence, or polymerase chain reaction, revealed persistence of SARS-CoV-2 nucleic acids and immunoreactivity in the small bowel of 7 out of 14 volunteers. We conclude that the memory B cell response to SARS-CoV-2 evolves between 1.3 and 6.2 months after infection in a manner that is consistent with antigen persistence.

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  1. SciScore for 10.1101/2020.11.03.367391: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    RandomizationThe experiments were not randomized and the investigators were not blinded to allocation during experiments and outcome assessment.
    BlindingThe experiments were not randomized and the investigators were not blinded to allocation during experiments and outcome assessment.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.
    Cell Line AuthenticationAuthentication: This laboratory-developed test has been authorized by New York State under an Emergency Use Authorization (EUA) for use by authorized laboratories.

    Table 2: Resources

    Antibodies
    SentencesResources
    The Elecsys antinSARSnCoV-2 assay uses a recombinant protein representing the N antigen for the determination of antibodies against SARSnCoVn2.
    SARSnCoVn2
    suggested: None
    Plates were washed 6 times with washing buffer and then incubated with anti-human IgG, IgM or IgA secondary antibody conjugated to horseradish peroxidase (HRP) (Jackson Immuno Research 109-036-088
    anti-human IgG
    suggested: (Jackson ImmunoResearch Labs Cat# 109-036-088, RRID:AB_2337594)
    IgA
    suggested: None
    The enriched B cells were incubated in FACS buffer (1× PBS, 2% FCS, 1 mM EDTA) with the following anti-human antibodies (all at 1:200 dilution): anti-CD20-PECy7 (BD Biosciences, 335793), anti-CD3-APC-eFluro 780 (Invitrogen, 47-0037-41)
    anti-human
    suggested: (GenWay Biotech Inc. Cat# 18-202-335793-0.1 mg, RRID:AB_1981874)
    anti-CD20-PECy7
    suggested: None
    anti-CD3-APC-eFluro 780
    suggested: None
    The frequency distributions of human V genes in anti-SARS-CoV-2 antibodies from this study was compared to 131,284,220 IgH and IgL sequences generated by 54 and downloaded from cAb-Rep55, a database of human shared BCR clonotypes available at https://cab-rep.c2b2.columbia.edu/.
    anti-SARS-CoV-2
    suggested: None
    Slides were washed 3 times in PBS and then incubated in secondary antibody and 4′,6-diamidino-2-phenylindole (1ug/mL) for 1 hour at room temperature.
    4′,6-diamidino-2-phenylindole
    suggested: None
    Experimental Models: Cell Lines
    SentencesResources
    Briefly, 293T cells were transfected with pNL4-3ΔEnv-nanoluc and pSARS-CoV-2-SΔ19.
    293T
    suggested: None
    Software and Algorithms
    SentencesResources
    Plasma samples were assayed on the Pylon 3D analyzer (ET HealthCare, Palo Alto, CA) as previously described 4.
    ET HealthCare
    suggested: None
    The average of its signal was used for normalization of all of the other values on the same plate with Excel software before calculating the area under the curve using Prism V8.4 (GraphPad).
    Excel
    suggested: None
    Prism
    suggested: (PRISM, RRID:SCR_005375)
    The half-maximal inhibitory concentration for plasma (NT50) or monoclonal antibodies (IC50) was determined using four-parameter nonlinear regression (least squares regression method without weighting; constraints: top=1, bottom=0) (GraphPad Prism).
    GraphPad
    suggested: (GraphPad Prism, RRID:SCR_002798)
    High-dimensional data analysis of flow cytometry data: viSNE and FlowSOM analyses were performed on B cells using the Cytobank platform (https://cytobank.org). viSNE analysis was performed using equal sampling of 4893 cells from each FCS file, with 7500 iterations, a perplexity of 30, and a theta of 0.5.
    FlowSOM
    suggested: (FlowSOM, RRID:SCR_016899)
    Cytobank
    suggested: (Cytobank, RRID:SCR_014043)
    Single CD3−CD8−CD14−CD16−CD20+Ova−RBD-PE+RBD-AF647+ B cells were sorted into individual wells of 96-well plates containing 4 μl of lysis buffer (0.5× PBS, 10 mM DTT, 3,000 units/ml RNasin Ribonuclease Inhibitors (Promega, N2615) per well using a FACS Aria III and FACSDiva software (Becton Dickinson) for acquisition and FlowJo for analysis.
    FACSDiva
    suggested: (BD FACSDiva Software, RRID:SCR_001456)
    FlowJo
    suggested: (FlowJo, RRID:SCR_008520)
    Sequence analysis was performed using MacVector.
    MacVector
    suggested: (MacVector, RRID:SCR_015700)
    7k) was created with R pheatmap package (
    pheatmap
    suggested: (pheatmap, RRID:SCR_016418)
    Probes were assessed by NCBI BLAST to exclude off target binding to other cellular transcripts.
    BLAST
    suggested: (BLASTX, RRID:SCR_001653)
    Data presentation: Figures arranged in Adobe Illustrator 2020.
    Adobe Illustrator
    suggested: (Adobe Illustrator, RRID:SCR_010279)

    Results from OddPub: Thank you for sharing your code and data.


    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 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.

    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.

  2. SciScore for 10.1101/2020.11.03.367391: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementInformed consent was obtained from all participants.RandomizationThe experiments were not randomized and the investigators were not blinded to allocation during experiments and outcome assessment.BlindingThe experiments were not randomized and the investigators were not blinded to allocation during experiments and outcome assessment.Power Analysisnot detected.Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    7,8,27-31 . 9,10,12,34-37, . a–d, Results of serological assays measuring plasma reactivity to RBD (a,b,c) and N protein (d) at the initial 1.3 and 6.2 month follow-up visit, respectively. a, Anti-RBD IgM. b, Anti-RBD IgG. c, Anti-RBD IgA d, Anti-N total antibodies.
    Anti-RBD IgM.
    suggested: None
    Anti-RBD IgG
    suggested: None
    Anti-RBD IgA
    suggested: None
    Positive and negative controls were included for validation 1. e, Relative change in plasma antibody levels between 1.3 and 6.2 months for anti-RBD IgM, IgG, IgA and anti-N total Ig, respectively. f-i, Relative change in antibody levels between 1.3 and 6.2 months plotted against the corresponding antibody levels at 1.3 months. i, Anti-N total antibodies.
    anti-RBD IgM, IgG
    suggested: None
    anti-N total Ig,
    suggested: None
    Anti-N total antibodies.
    suggested: None
    The Elecsys anti‐SARS‐CoV-2 assay uses a recombinant protein representing the N antigen for the determination of antibodies against SARS‐CoV‐2.
    SARS‐CoV‐2
    suggested: None
    Plates were washed 6 times with washing buffer and then incubated with anti-human IgG, IgM or IgA secondary antibody conjugated to horseradish peroxidase (HRP) (Jackson Immuno Research
    anti-human IgG
    suggested: None
    IgA
    suggested: None
    The enriched B cells were incubated in FACS buffer (1× PBS, 2% FCS, 1 mM EDTA) with the following anti-human antibodies (all at 1:200 dilution): anti-CD20-PECy7 (BD Biosciences, 335793), anti-CD3-APC- eFluro 780 (Invitrogen, 47-0037-41)
    anti-human
    suggested: (GenWay Biotech Inc. Cat# 18-202-335793-0.1 mg, RRID:AB_1981874)
    anti-CD20-PECy7
    suggested: None
    anti-CD3-APC- eFluro 780
    suggested: None
    2: Correlations of plasma antibody measurements. a, Normalized AUC for IgG anti-RBD plotted against Pylon IgG anti-RBD index values at 1.3 months. b, Normalized AUC for IgG anti-RBD plotted against Pylon IgG anti-RBD index values at 6.2 months. c, Normalized AUC for IgM anti-RBD plotted against Pylon IgM anti-RBD index values at 1.3 months. d, Normalized AUC for IgM anti-RBD plotted against Pylon IgM anti-RBD index values at 6.2 months. e, Normalized AUC for IgM anti-RBD at 6.2 months plotted against IgM anti-RBD at 1.3 months. f, Normalized AUC for IgG anti-RBD at 6.2 months plotted against IgG anti-RBD at 1.3 months. g, Normalized AUC for IgA anti-RBD at 6.2 months plotted against IgA anti-RBD at 1.3 months. h, COI values for anti-N total Ig titres at 6.2 months plotted against anti-N total Ig titres at 1.3 months. i, Anti-RBD IgG titres at 1.3 months plotted against anti-N total Ig titres at 1.3 months. j, Anti-RBD IgG titres at 6.2 months plotted against anti-N total Ig titres at 6.2 months. k, Anti-RBD IgM titres at 1.3 months plotted against anti-N total Ig titres at 1.3 months. l, Anti-RBD IgM titres at 6.2 months plotted against anti-N total Ig titres at 6.2 months. m, Anti-RBD IgA titres at 1.3 months plotted against anti-N total Ig titres at 1.3 months. l
    IgM
    suggested: None
    anti-RBD
    suggested: None
    anti-N
    suggested: None
    Repertoire ** IGLV4−69 IGKV1−16 IGKV2−26 * IGLV1−36 IGKV1−6 IGLV7−43 **** IGKV2−40 IGLV4−3 IGKV1−43 IGLV2−18 ** Extended Data Fig. 4: Frequency distributions of human V genes. a, Two-sided binomial tests were used to compare the frequency distributions of human V genes of anti-SARS-CoV-2 antibodies from donors at 1.3 months to 6.2 months 1. b, Two-sided binomial tests were used to compared the frequency distributions of human V genes of anti-SARS-CoV-2 antibodies from this study to sequence from C. Soto et al. 49. b, For each patient, the number of IgG heavy chain sequences (black) analyzed from six individuals at month 1.3 (left panel) or month 6.2 post- infection (right panel).
    anti-SARS-CoV-2
    suggested: None
    Software and Algorithms
    SentencesResources
    Plasma samples were assayed on the Pylon 3D analyzer (ET HealthCare, Palo Alto, CA) as previously described 4.
    ET HealthCare
    suggested: None
    The average of its signal was used for normalization of all of the other values on the same plate with Excel software before calculating the area under the curve using Prism V8.4 (GraphPad).
    Excel
    suggested: None
    Prism
    suggested: (PRISM, RRID:SCR_005375)
    GraphPad
    suggested: (GraphPad Prism, RRID:SCR_002798)
    Single CD3−CD8−CD14−CD16−CD20+Ova−RBD- PE+RBD-AF647+ B cells were sorted into individual wells of 96-well plates containing 4 μl of lysis buffer (0.5× PBS, 10 mM DTT, 3,000 units/ml RNasin Ribonuclease Inhibitors (Promega, N2615) per well using a FACS Aria III and FACSDiva software (Becton Dickinson) for acquisition and FlowJo for analysis.
    FACSDiva
    suggested: (BD FACSDiva Software, RRID:SCR_001456)
    FlowJo
    suggested: (FlowJo, RRID:SCR_008520)
    Sequence analysis was performed using MacVector.
    MacVector
    suggested: (MacVector, RRID:SCR_015700)
    8k) was created with R pheatmap package (
    pheatmap
    suggested: (pheatmap, RRID:SCR_016418)
    Tomographic tilt series and large-area montages were acquired automatically using the SerialEM software package were collected at 1° intervals as samples were tilted +/- 62°.
    SerialEM
    suggested: (SerialEM, RRID:SCR_017293)
    Tomograms were calculated, analyzed and modeled using the IMOD software package 56,57 on MacPro and iMac Pro computers (Apple, Inc).
    IMOD
    suggested: (IMOD, RRID:SCR_003297)

    Results from OddPub: Thank you for sharing your data.


    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 did not find any issues relating to the usage of bar graphs.


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


    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.