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New study - SARS-CoV-2 immunity after infection or not?
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A study by Long et al., recently published in the renowned scientific journal "Nature" (https://doi.org/10.1038/s41591-020-0965-6), strongly emphasizes why it is necessary, during and after the corona pandemic, to use readily available and efficiently performed antibody tests such as enzyme-linked immunosorbent assays (ELISA).
In the study mentioned above, Chinese researchers around Long and Huang compared samples from the megacity Chongqing. They examined samples of 74 patients with and without symptoms. After an infection, the body generates an immune response to eliminate a pathogen. The immune system first produces IgM and IgA antibodies. Once the pathogen is recognized and fought, IgG antibodies are produced. IgG antibodies offer some protection against future SARS-CoV-2 infections and are detected in the blood as so-called antibody titers. These IgG antibodies form the memory of the immune system for many years. Vaccines work similarly by teaching the immune system to produce antibodies to protect against specific pathogens.
Quantitative antibody tests that target neutralizing antibodies are among the most important tools for clinicians to determine a titer that reflects the value of a protective immune response to infection. Thus, the titer required for an effective vaccine can easily be determined using our SRS-CoV-2 AESKULISAs.
Long et al. have investigated this fact by measuring IgM and IgG levels in patient samples using ELISA. Even though the sample of patients is small, the study shows no insignificant decrease in antibodies in the patient group with mild to mild symptoms. Only 62.2 percent of patients in the group without symptoms still had antibodies in their blood a few weeks after infection. In the group of symptomatic patients, 78.4 percent still had antibodies in their blood.
After approximately eight weeks, follow-up examinations showed that the antibody concentration in the blood of the symptom-free patients decreased by 81.1 percent. In the group of symptomatic patients, the decrease was only 62.2 percent. The group of Long and Huang also identified patients positive for SARS-CoV-2 by ELISA, who had previously been categorized as negative by RT-PCR. An examination of the samples for cytokines involved in the immune reaction, including G- and M-CSF, IL2, IL6, CCL2, IFN-γ, shows that patients with symptoms had a higher value of these proteins, which indicates a stronger immune response.
Even though the study mentioned above only involved a comparatively small sample, the results cast doubt on previous assumptions that strong symptoms represent a high risk of infection and that anyone who has survived an infection is immune to future infections.
At Imperial College London, Professor Altmann confirms the present study, stating that most infected people show only mild or no symptoms at all. The crucial question is whether they have sustained protective immunity. For him, it is an essential but also worrying point, that many patients in the study showed a significant drop in antibody concentration only 6-7 weeks after the disease's onset. Long et al. write that the decrease in IgG and neutralizing antibodies in early convalescence will influence the immune strategy and serological investigations.
That is precisely where AESKU sees the primary clinical utility of its quantitaive AEKULISA SARS-CoV-2 tests and offers six different kits for detection and monitoring of the immune status.
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Tracing the Virus - AESKULISA SARS-CoV-2 Antibody Tests
A secure future thanks to quantitative SARS-CoV-2 AESKULISA tests
In the current situation, it is hardly necessary to argue about the urgent need for an effective and robust vaccine to treat COVID-19, because our society and humanity itself are in a state of emergency. However, not only a vaccine is urgently needed, but the success of vaccination must also be verified using quantitative tests. Quantitative tests react to neutralizing antibodies, i.e., antibodies responding to a pathogen and breaking it down, make it possible to determine the success of an immune response and a vaccination in everyday practice.
For the determination of an immune reaction, the examination of immunoglobulins, so-called antibodies, has been established for years. Since protein structures on the surface of a pathogen (bacterium, virus) are specific, i.e., unique for individual structures, the immune system forms the appropriate antibody; it is possible to examine different antibodies for confirmation and infection. In the case of SARS-CoV-2 viruses, the nucleocapsid protein (N) and the spike protein (S1) are suitable.
AESKU offers six different immunoassays:
AESKULISA® SARS-CoV-2 NP IgM/ IgA / IgG*
AESKULISA® SARS-CoV-2 NP IgA*, IgG*, and IgM* tests are qualitative and quantitative immunoassays for the detection of human IgM, IgA, and IgG antibodies in serum or plasma directed against SARS-CoV-2 in highly conserved nucleocapsid protein (NP). The nucleocapsid protein is very reactive and stimulates a strong immune response. This potent immune response provides a very sensitive detection of antibodies, which allows a clear differentiation between positive and negative samples.
They are, therefore, ideal for IgM, IgG, and IgA detection for screening and diagnosis. Due to the high sensitivity and the strong conservation of the nucleocapsid protein in the coronavirus family, the risk of cross-reaction with antibodies against SARS-CoV-1 is increased. Since antibodies against the nucleocapsid protein have no neutralizing effect, they are not suitable for determining the immune status, the so-called antibody titer.
AESKU uses immunogenic nucleocapsid proteins of SARS-CoV-2 expressed in insect cells for the sensitive detection of IgM, IgA, and IgG antibodies.
AESKULISA®
Sensitivity
Specificity
SARS-CoV-2 NP IgA*
98.3 %
> 99 %
SARS-CoV-2 NP IgG*
95.2 %
> 99 %
Table 1: Sensitivity and specificity of AESKULISA® SARS-CoV-2 NP IgA
and IgG immunoassays were assessed by the analysis of 76 serum samples from healthy blood donors (2018) and 20 individuals with clinically confirmed COVID19 using the clinical findings as a reference.
AESKULISA® SARS-CoV-2 S1 IgM/ IgA / IgG
AESKULISA® SARS-CoV-2 S1 IgA, IgG, and IgM tests are qualitative and quantitative immunoassays for the detection of human IgM, IgA, and IgG antibodies in serum or plasma directed against SARS-CoV-2 by the highly specific spike protein (S1). The spike protein has the advantage over the nucleocapsid protein that is highly specific for the SARS-CoV-2 virus.
Resulting in a much lower risk of cross-reactions with antibodies against other members of the coronavirus family. IgG antibodies react against the receptor-binding domain (RBD) on the spike proteins. They are considered to be neutralizing and, therefore, suitable for monitoring the antibody titer of patients.
* submitted for Emergency Use Authorization (EUA) in USA | IFU AESKULISA SARS-CoV-2 NP IgG US | IFU AESKULISA SARS-CoV-2 NP IgM US
Test Kit Components
- Aluminium-sealed and coated MTP with breakable cavities
- 4 Calibrators (A – D), Calibrator B = cut off Calibrator
- Positive and Negative Control
- Sample Dilution Buffer (5x conc.; for IgM detection incl. Rf Absorbent)
- Wash Buffer (50x conc.)
- Conjugate (anti-human IgG / IgA / IgM conjugated to POD)
- Substrate (TMB) and „Stop Solution“
- Quality Control Certificate and Instruction Manual
MEDLAB 2020 - AESKU.GROUP highlights from the premier global laboratory and diagnostics conference in DubaiThanks to all the visitors, partners, and friends who visited us during the 2020 MEDLAB conference. AESKU had our full line of innovative automation platforms on display. We were highlighting our ability to be a complete laboratory solutions provider, helping us expand our business into many new countries. Read more...
AESKU.GROUP Completes Acquisition of MBL Bion
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AACC 2019: Setting a Higher standard
It was a successful year for AESKU at this AACC. We announced the 400th placement of our HELIOS All-in-One IFA device, and officially introduced three products - the HELIOS HTC, AESQC IFA, and our own HERA automation management software. Read more...
Tuesday April 10th, 2018, was the official start date for the HELIOS system at the Vicente Corral Moscoso Regional Hospital in the city of Cuenca, Ecuador.
This public-sector hospital has been named ‘number one in service’ in its region.
Its clinical lab performs high-complexity routine, emergency and outpatient testing 24 hours a day, 7 days a week while serving as a reference location for a network of six area labs and the Teofilo Davila de Machala, Isidro Ayora de Loja, and Jose Carrasco Arteaga of the IESS – Cuenca Hospitals. Read more...
Best Review Paper Award goes to…
Prof. Aaron Lerner, Dr. Sandra Neidhöfer and Dr. Torsten Matthias received the Best Review Paper Award 2018 from the journal Microorganism with “The Gut Microbiome Feelings of the Brain: A Perspective for Non-Microbiologists Microorganisms”. Read more...
ICAP Compliant IFA QC now available from AESKU
AESKU is introducing a new Immunofluorescence Assay (IFA) Quality Control product line – AESQC IFA – that complies with International Consensus on Antinuclear Antibody Patterns (ICAP) nomenclature.
QCs in IFA are not only important as part of assay quality management, but now as IFA readers are becoming standard devices in laboratories, assuring their ability to read patterns in a standardized manner has also become important.
The AESQC IFA product line allows laboratories to compare IFA reader performance to a set of controls validated and standardized to the ICAP nomenclature. Read more...
Complete IFA Automation with HELIOS is a ‘Dream Come True’ for SSM Health
Wesley Badley, Clinical Laboratory Supervisor at St. Anthony’s Hospital in Oklahoma City, Oklahoma, had an IFA problem. His lab performs ANA testing for the hospital, off-site SSM facilities and affiliated rheumatologists.
“The main reason we were looking at the HELIOS was our sheer volume,” said Badley. “We couldn’t afford in our facility to sit around and have one full FTE be dedicated to doing manual IFA, ANA; it just wasn’t feasible. Also, just finding qualified technicians is a very hard thing to do in our area. Having people there that can read ANAs and read those patterns was hard.” Read more...
AESQC.com Web Portal, a Quality Control Resource, now Available from AESKU
AESKU announces the launch of AESQC.com, an online Quality Control resource providing lot-specific information, including pattern images, to help laboratories improve their Immunofluorescence Assay quality. Read more...
2nd Latin American Workshop, 2018
From 24th to 27th of September 2018, AESKU organized the second Latin America workshop in Cancun (Mexico).
We were delighted with the overall response and welcomed 26 participants from Colombia, Panama, Cuba, Costa Rica, Ecuador, Mexico, Peru, Bolivia, El Salvador, Paraguay, Spain and Brazil.
Since 2014, the Stifterverband acknowledges research companies that embrace their special responsibility for state and society with the "Innovative through Research" seal. Now Aesku.Diagnostics has received the award for its research competence and innovative abilities. Read more...
ICAP Compatible IFA Quality Controls Now Available from AESKU
AESKU announces a new ICAP compatible Immunofluorescence Assay (IFA) Quality Control (QC) product line and supporting Quality Assurance tool, AESQC.com, to help laboratories identify, correct, and prevent analytical failure prior to releasing results. Read more...
) in the interactive HELIOS picture to activate detailed information regarding the serveral HELIOS features.