Salivary anti‐RSV IgA antibodies and respiratory infections during the first year of life in atopic and non‐atopic infants

Banzhoff, Angelika; Dulleck, A.; Petzoldt, S.; Rieger, Christian

doi:10.1111/j.1399-3038.1994.tb00218.x

Cited by 9 publications

(7 citation statements)

References 22 publications

(22 reference statements)

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“… 36 Several groups have looked at correlation between changes in salivary IgA and respiratory infections in individuals and found that decreases in IgA correlated with an increase in infections. These findings have been reported in a wide variety of subjects including from elite athletes, 37 infants, 38 healthy children 39 , 40 , 41 and children with Down’s syndrome. 42 These findings suggest that individuals that are muco-negative for salivary IgA against SARS-CoV-2 may be at an elevated risk for infection and/or disease severity.…”

Section: Discussionsupporting

confidence: 57%

Salivary anti-SARS-CoV-2 IgA as an accessible biomarker of mucosal immunity against COVID-19

Varadhachary¹,

Chatterjee²,

Garza³

et al. 2020

Preprint

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Background: Mucosal immunity, including secretory IgA (sIgA), plays an important role in early defenses against respiratory pathogens. Salivary testing, the most convenient way to measure sIgA, has been used to characterize mucosal immune responses to many viral infections including SARS, MERS, influenza, HIV, and RSV. However, its role has not yet been characterized in the COVID-19 pandemic. Here, we report development and validation of a rapid immunoassay for measuring salivary IgA against the SARS-CoV-2 virus, and report quantitative results in both pre-COVID-19 and muco-converted subjects. Methods: We developed and refined a specific test for salivary IgA against SARS-CoV-2 on the Brevitest platform, a rapid immunoassay system designed for point-of-care use. A qualitative test was validated as per FDA guidelines with saliva obtained from subjects prior to the emergence of COVID-19, and from PCR-confirmed COVID-19 patients. We also generated a quantitative measure of anti-SARS-CoV-2 salivary IgA. Time taken for saliva self-collection was measured and its ease-of-use assessed. Results: We successfully validated a qualitative salivary assay for SARS-CoV-2 IgA antibodies, with positive and negative predictive values of 92% and 97%, respectively, and no observable cross-reactivity with any of seven potential confounders. Pre-COVID-19 saliva samples showed an 8-fold range of IgA concentrations, suggesting a broad continuum of natural antibody resistance against the novel virus, though at levels lower than that observed in COVID-19 PCR-confirmed subjects. Samples from muco-positive subjects also shown a ~9-fold variation in salivary IgA levels, with elevated salivary IgA observed beyond three months after onset of symptoms. We observed a correlation (r=0.4405) between salivary IgA levels and COVID-19 disease severity. In anecdotal observations, we observed individuals who exhibited antibodies early in the course of their disease, contemporaneously with a positive PCR test, as well as individuals who muco-converted despite no known direct exposure to a COVID-19 patient, no symptoms, and negative molecular and/or serum antibody tests. Salivary collection took 5-10 minutes, and was reported as being easy (mean of 1.1 on a scale of 1 to 10). Implications: Mucosal immunity, including secretory IgA, plays an important role in host defense against respiratory pathogens, and our early data suggest it may do so in COVID-19. Salivary IgA, an accessible marker of mucosal immunity, may be a useful indicator of several key parameters including individual and community immune response, disease severity, clinical risk, and herd immunity. The non-invasive nature and ease of saliva collection facilitates its potential use as a biomarker for ongoing patient assessment and management, as well as a community surveillance tool. By measuring mucosal immune responses directly and systemic immune responses indirectly, salivary IgA could be useful in developing and deploying a vaccine(s) against COVID-19. Quantitative IgA assessment could also potentially serve as a tool to segment the population into different risk categories and inform individual and collective decisions relating to appropriate activities and vaccine prioritization/delivery. These data reinforce the importance of further investigation into the role of mucosal immunity and IgA in host responses against COVID-19.

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Section: Discussionsupporting

confidence: 57%

Salivary anti-SARS-CoV-2 IgA as an accessible biomarker of mucosal immunity against COVID-19

Varadhachary¹,

Chatterjee²,

Garza³

et al. 2020

Preprint

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“…It has been proposed that low levels of salivary IgA are associated with the development of allergy [9]. Decreased total IgA has already been described in the saliva of children with atopy [23] as well as defective salivary IgA responses against the respiratory syncytial virus were found in symptomatic allergic infants [24]. In another previous study, nonatopic healthy individuals had increased Der p1-specific IgA production in serum, but not for specific IgE antibodies [4].…”

Section: Discussionmentioning

confidence: 99%

Serum and Salivary IgE, IgA, andIgG4Antibodies toDermatophagoides pteronyssinusand Its Major Allergens, Der p1 and Der p2, in Allergic and Nonallergic Children

Miranda

Silva

Fernandes

et al. 2011

Clinical and Developmental Immunology

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Allergic rhinitis (AR) is a public health problem with high prevalence worldwide. We evaluated levels of specific IgE, IgA, and IgG4 antibodies to the Dermatophagoides pteronyssinus (Dpt) house dust mite and to its major allergens (Der p1 and Der p2) in serum and saliva samples from allergic and nonallergic children. A total of 86 children were analyzed, from which 72 had AR and 14 were nonallergic healthy children. Serum IgE and serum/salivary IgG4 levels to Dpt, Der p1, and Der p2 were higher in allergic children whereas serum/salivary IgA levels to all allergens were higher in nonallergic children. IgE levels positively correlated with IgG4 and IgA to all allergens in allergic children, while IgA levels negatively correlated with IgG4 to Dpt and Der p1 in nonallergic children. In conclusion, mite-specific IgA antibodies predominate in the serum and saliva of nonallergic children whereas mite-specific IgE and IgG4 are prevalent in allergic children. The presence of specific IgA appears to have a key role for the healthy immune response to mucosal allergens. Also, specific IgA measurements in serum and/or saliva may be useful for monitoring activation of tolerance-inducing mechanisms during allergen specific immunotherapeutic procedures, especially sublingual immunotherapy.

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“…However, the majority of infants who develop severe RSV disease were born at term and are otherwise healthy. Among those, certain factors have been associated with severe disease: month of birth, age younger than 6 months, male sex, ethnicity [17], low socioeconomic status, crowded living conditions, number of siblings, indoor smoke pollution, day-care attendance [18], and a family history of asthma and atopy [19,20]. Many studies suggest that passively acquired maternal antibody confers protection against severe RSV disease [21,22], and incomplete transfer of maternally derived antibodies has been proposed as a contributing factor to the increased risk for RSV infection that is observed in preterm infants [9].…”

Section: Introductionmentioning

confidence: 99%

An epidemiological study of respiratory syncytial virus associated hospitalizations in Denmark

Stensballe

2002

Respir Res

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Salivary anti‐RSV IgA antibodies and respiratory infections during the first year of life in atopic and non‐atopic infants

Cited by 9 publications

References 22 publications

Salivary anti-SARS-CoV-2 IgA as an accessible biomarker of mucosal immunity against COVID-19

Salivary anti-SARS-CoV-2 IgA as an accessible biomarker of mucosal immunity against COVID-19

Serum and Salivary IgE, IgA, andIgG4Antibodies toDermatophagoides pteronyssinusand Its Major Allergens, Der p1 and Der p2, in Allergic and Nonallergic Children

An epidemiological study of respiratory syncytial virus associated hospitalizations in Denmark

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