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      Rapid, simplified whole blood-based multiparameter assay to quantify and phenotype SARS-CoV-2 specific T cells

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          Abstract

          Rapid tests to evaluate SARS-CoV-2-specific T cell responses are urgently needed to decipher protective immunity and aid monitoring vaccine-induced immunity. Using a rapid whole blood assay requiring minimal amount of blood, we measured qualitatively and quantitatively SARS-CoV-2-specific CD4T cell responses in 31 healthcare workers, using flow cytometry. 100% of COVID-19 convalescent participants displayed a detectable SARS-CoV-2-specific CD4T cell response. SARS-CoV-2-responding cells were also detected in 40.9% of participants with no COVID-19-associated symptoms or who tested PCR negative. Phenotypic assessment indicated that, in COVID-19 convalescent participants, SARS-CoV-2 CD4 responses displayed an early differentiated memory phenotype with limited capacity to produce IFNɣ. Conversely, in participants with no reported symptoms, SARS-CoV-2 CD4 responses were enriched in late differentiated cells, co-expressing IFNɣ and TNFα and also Granzyme B. This proof-of-concept study presents a scalable alternative to PBMC-based assays to enumerate and phenotype SARS-CoV-2-responding T cells, thus representing a practical tool to monitor adaptive immunity due to natural infection or vaccine trials.

          Abstract

          In this proof-of-concept study, we show that SARS-CoV-2T cell responses are easily detectable using a rapid whole blood assay requiring minimal blood volume. Such assay represents a suitable tool to monitor adaptive immunity in vaccine trials.

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          Most cited references40

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          Imbalanced Host Response to SARS-CoV-2 Drives Development of COVID-19

          Summary Viral pandemics, such as the one caused by SARS-CoV-2, pose an imminent threat to humanity. Because of its recent emergence, there is a paucity of information regarding viral behavior and host response following SARS-CoV-2 infection. Here we offer an in-depth analysis of the transcriptional response to SARS-CoV-2 compared with other respiratory viruses. Cell and animal models of SARS-CoV-2 infection, in addition to transcriptional and serum profiling of COVID-19 patients, consistently revealed a unique and inappropriate inflammatory response. This response is defined by low levels of type I and III interferons juxtaposed to elevated chemokines and high expression of IL-6. We propose that reduced innate antiviral defenses coupled with exuberant inflammatory cytokine production are the defining and driving features of COVID-19.
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            Targets of T cell responses to SARS-CoV-2 coronavirus in humans with COVID-19 disease and unexposed individuals

            Summary Understanding adaptive immunity to SARS-CoV-2 is important for vaccine development, interpreting coronavirus disease 2019 (COVID-19) pathogenesis, and calibration of pandemic control measures. Using HLA class I and II predicted peptide ‘megapools’, circulating SARS-CoV-2−specific CD8+ and CD4+ T cells were identified in ∼70% and 100% of COVID-19 convalescent patients, respectively. CD4+ T cell responses to spike, the main target of most vaccine efforts, were robust and correlated with the magnitude of the anti-SARS-CoV-2 IgG and IgA titers. The M, spike and N proteins each accounted for 11-27% of the total CD4+ response, with additional responses commonly targeting nsp3, nsp4, ORF3a and ORF8, among others. For CD8+ T cells, spike and M were recognized, with at least eight SARS-CoV-2 ORFs targeted. Importantly, we detected SARS-CoV-2−reactive CD4+ T cells in ∼40-60% of unexposed individuals, suggesting cross-reactive T cell recognition between circulating ‘common cold’ coronaviruses and SARS-CoV-2.
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              SARS-CoV-2-specific T cell immunity in cases of COVID-19 and SARS, and uninfected controls

              Memory T cells induced by previous pathogens can shape susceptibility to, and the clinical severity of, subsequent infections1. Little is known about the presence in humans of pre-existing memory T cells that have the potential to recognize severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here we studied T cell responses against the structural (nucleocapsid (N) protein) and non-structural (NSP7 and NSP13 of ORF1) regions of SARS-CoV-2 in individuals convalescing from coronavirus disease 2019 (COVID-19) (n = 36). In all of these individuals, we found CD4 and CD8 T cells that recognized multiple regions of the N protein. Next, we showed that patients (n = 23) who recovered from SARS (the disease associated with SARS-CoV infection) possess long-lasting memory T cells that are reactive to the N protein of SARS-CoV 17 years after the outbreak of SARS in 2003; these T cells displayed robust cross-reactivity to the N protein of SARS-CoV-2. We also detected SARS-CoV-2-specific T cells in individuals with no history of SARS, COVID-19 or contact with individuals who had SARS and/or COVID-19 (n = 37). SARS-CoV-2-specific T cells in uninfected donors exhibited a different pattern of immunodominance, and frequently targeted NSP7 and NSP13 as well as the N protein. Epitope characterization of NSP7-specific T cells showed the recognition of protein fragments that are conserved among animal betacoronaviruses but have low homology to 'common cold' human-associated coronaviruses. Thus, infection with betacoronaviruses induces multi-specific and long-lasting T cell immunity against the structural N protein. Understanding how pre-existing N- and ORF1-specific T cells that are present in the general population affect the susceptibility to and pathogenesis of SARS-CoV-2 infection is important for the management of the current COVID-19 pandemic.
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                Author and article information

                Journal
                Eur Respir J
                Eur Respir J
                ERJ
                erj
                The European Respiratory Journal
                European Respiratory Society
                0903-1936
                1399-3003
                18 June 2021
                18 June 2021
                : 2100285
                Affiliations
                [1 ]Wellcome Centre for Infectious Disease Research in Africa and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, South Africa
                [2 ]Division of Immunology, Department of Pathology, University of Cape Town, Observatory, South Africa
                [3 ]International Centre for Genetic Engineering and Biotechnology (ICGEB) Cape Town, Observatory, South Africa
                [4 ]Division of Medical Biochemistry and Structural Biology, Department of Integrative Biomedical Sciences, University of Cape Town, Observatory, South Africa
                [5 ]Department of Medicine, University of Cape Town, Observatory, South Africa
                [6 ]Department of Infectious Diseases, Imperial College London, London, UK
                [7 ]Department of Immunology and Microbiology, The Scripps Research Institute, Jupiter, FL, USA
                [8 ]Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
                [9 ]The Francis Crick Institute, London, UK
                Author notes
                Corresponding author: Catherine Riou ( cr.riou@ 123456uct.ac.za )
                Author information
                https://orcid.org/0000-0002-9796-2040
                Article
                ERJ-00285-2021
                10.1183/13993003.00285-2021
                8215505
                34140294
                156700e6-3cf4-41bc-9291-42e80c2690e0
                Copyright ©The authors 2021.

                This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org

                History
                : 29 January 2021
                : 26 May 2021
                Funding
                Funded by: Rosetrees Trust , open-funder-registry 10.13039/501100000833;
                Award ID: 2020-0009
                Funded by: Medical Research Council , open-funder-registry 10.13039/501100000265;
                Award ID: FC0010218
                Funded by: NIH Clinical Center , open-funder-registry 10.13039/100000098;
                Award ID: R21AI148027
                Funded by: European and Developing Countries Clinical Trials Partnership , open-funder-registry 10.13039/501100001713;
                Award ID: TMA2017SF-1951-TB-SPEC
                Award ID: TMA2018SF-2446
                Funded by: Wellcome , open-funder-registry 10.13039/100010269;
                Award ID: 104803
                Award ID: 203135
                Categories
                Original Research Article

                Respiratory medicine
                Respiratory medicine

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