A role for Nucleocapsid-specific antibody function in Covid-19 Convalescent plasma therapy

Summary COVID-19 convalescent plasma (CCP), a passive polyclonal antibody therapeutic, has exhibited mixed results in the treatment of COVID-19. Given that the therapeutic effect of CCP may extend beyond the ability of SARS-CoV-2-specific antibody binding and neutralization to influence the evolution of the endogenous antibody response, we took a systematic and comprehensive approach to analyze SARS-CoV-2 functional antibody profiles of participants in a randomized controlled trial of CCP treatment of individuals hospitalized with COVID-19 pneumonia where CCP was associated with both decreased mortality and improved clinical severity. Using systems serology, we found that the clinical benefit of CCP is related to a shift towards reduced inflammatory Spike (S) responses and enhanced Nucleocapsid (N) humoral responses. We found CCP had the greatest clinical benefit in participants with low pre-existing anti-SARS-CoV-2 antibody function, rather than S or N antibody levels or participant demographic features. Further, CCP induced immunomodulatory changes to recipient humoral profiles persisted for at least two months, marked by the selective evolution of anti-inflammatory Fc-glycan profiles and persistently expanded nucleocapsid-specific humoral immunity following CCP therapy. Together, our findings identify a novel mechanism of action of CCP, suggest optimal patient characteristics for CCP treatment, identify long-last immunomodulatory effects of CCP, and provide guidance for development of novel N-focused antibody therapeutics for severe COVID-19 hyperinflammation..

Medienart:

Preprint

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

bioRxiv.org - (2022) vom: 25. Feb. Zur Gesamtaufnahme - year:2022

Sprache:

Englisch

Beteiligte Personen:

Herman, Jonathan D. [VerfasserIn]
Wang, Chuangqi [VerfasserIn]
Burke, John Stephen [VerfasserIn]
Zur, Yonatan [VerfasserIn]
Compere, Hacheming [VerfasserIn]
Kang, Jaewon [VerfasserIn]
Macvicar, Ryan [VerfasserIn]
Shin, Sally [VerfasserIn]
Frank, Ian [VerfasserIn]
Siegel, Don [VerfasserIn]
Tebas, Pablo [VerfasserIn]
Choi, Grace H. [VerfasserIn]
Shaw, Pamela A. [VerfasserIn]
Yoon, Hyunah [VerfasserIn]
Pirofski, Liise-anne [VerfasserIn]
Juelg, Boris [VerfasserIn]
Bar, Katharine J. [VerfasserIn]
Lauffenburger, Douglas [VerfasserIn]
Alter, Galit [VerfasserIn]

Links:

Volltext [kostenfrei]

doi:

10.1101/2022.02.19.22271230

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

XBI035316373