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  1. Article ; Online: Enhanced stability of the SARS CoV-2 spike glycoprotein following modification of an alanine cavity in the protein core.

    Poumbourios, Pantelis / Langer, Christine / Boo, Irene / Zakir, Tasnim / Center, Rob J / Akerman, Anouschka / Milogiannakis, Vanessa / Aggarwal, Anupriya / Johnstone, Bronte A / Ha, Jungmin / Coulibaly, Fasséli / Turville, Stuart G / Drummer, Heidi E

    PLoS pathogens

    2023  Volume 19, Issue 5, Page(s) e1010981

    Abstract: The spike (S) glycoprotein of SARS CoV-2 is the target of neutralizing antibodies (NAbs) that are crucial for vaccine effectiveness. The S1 subunit binds ACE2 while the S2 subunit mediates virus-cell membrane fusion. S2 is a class I fusion glycoprotein ... ...

    Abstract The spike (S) glycoprotein of SARS CoV-2 is the target of neutralizing antibodies (NAbs) that are crucial for vaccine effectiveness. The S1 subunit binds ACE2 while the S2 subunit mediates virus-cell membrane fusion. S2 is a class I fusion glycoprotein subunit and contains a central coiled coil that acts as a scaffold for the conformational changes associated with fusion function. The coiled coil of S2 is unusual in that the 3-4 repeat of inward-facing positions are mostly occupied by polar residues that mediate few inter-helical contacts in the prefusion trimer. We examined how insertion of bulkier hydrophobic residues (Val, Leu, Ile, Phe) to fill a cavity next to Ala1016 and Ala1020 in the 3-4 repeat affects the stability and antigenicity of S trimers. Substitution of Ala1016 with bulkier hydrophobic residues in the context of a prefusion-stabilized S trimer, S2P-FHA, was associated with increased thermal stability. S glycoprotein membrane fusion function was retained with Ala1016/Ala1020 cavity-filling mutations associated with improved recombinant S2P-FHA thermostability, however 2 mutants, A1016L and A1016V/A1020I, lacked ability to mediate entry of S-HIV-1 pseudoparticles into 293-ACE2 cells. When assessed as immunogens, two thermostable S2P-FHA mutants derived from the ancestral isolate, A1016L (16L) and A1016V/A1020I (VI) elicited neutralizing antibody with 50%-inhibitory dilutions (ID50s) in the range 2,700-5,110 for ancestral and Delta-derived viruses, and 210-1,744 for Omicron BA.1. The antigens elicited antibody specificities directed to the receptor-binding domain (RBD), N-terminal domain (NTD), fusion peptide and stem region of S2. The VI mutation enabled the production of intrinsically stable Omicron BA.1 and Omicron BA.4/5 S2P-FHA-like ectodomain oligomers in the absence of an external trimerization motif (T4 foldon), thus representing an alternative approach for stabilizing oligomeric S glycoprotein vaccines.
    MeSH term(s) Humans ; Spike Glycoprotein, Coronavirus ; Severe Acute Respiratory Syndrome ; Angiotensin-Converting Enzyme 2 ; COVID-19 ; Antibodies, Neutralizing
    Chemical Substances spike protein, SARS-CoV-2 ; Spike Glycoprotein, Coronavirus ; Angiotensin-Converting Enzyme 2 (EC 3.4.17.23) ; Antibodies, Neutralizing
    Language English
    Publishing date 2023-05-18
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2205412-1
    ISSN 1553-7374 ; 1553-7374
    ISSN (online) 1553-7374
    ISSN 1553-7374
    DOI 10.1371/journal.ppat.1010981
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  2. Article ; Online: Novel siRNA therapeutics demonstrate multi-variant efficacy against SARS-CoV-2.

    Bowden-Reid, Ellen / Ledger, Scott / Zhang, Yuan / Di Giallonardo, Francesca / Aggarwal, Anupriya / Stella, Alberto Ospina / Akerman, Anouschka / Milogiannakis, Vanessa / Walker, Gregory / Rawlinson, William / Turville, Stuart / Kelleher, Anthony D / Ahlenstiel, Chantelle

    Antiviral research

    2023  Volume 217, Page(s) 105677

    Abstract: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a respiratory virus that causes COVID-19 disease, with an estimated global mortality of approximately 2%. While global response strategies, which are predominantly reliant on regular ... ...

    Abstract Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a respiratory virus that causes COVID-19 disease, with an estimated global mortality of approximately 2%. While global response strategies, which are predominantly reliant on regular vaccinations, have shifted from zero COVID to living with COVID, there is a distinct lack of broad-spectrum direct acting antiviral therapies that maintain efficacy across evolving SARS-CoV-2 variants of concern. This is of most concern for immunocompromised and immunosuppressed individuals who lack robust immune responses following vaccination, and others at risk for severe COVID and long-COVID. RNA interference (RNAi) therapeutics induced by short interfering RNAs (siRNAs) offer a promising antiviral treatment option, with broad-spectrum antiviral capabilities unparalleled by current antiviral therapeutics and a high genetic barrier to antiviral escape. Here we describe novel siRNAs, targeting highly conserved regions of the SARS-CoV-1 and 2 genome of both human and animal species, with multi-variant antiviral potency against eight SARS-CoV-2 lineages - Ancestral VIC01, Alpha, Beta, Gamma, Delta, Zeta, Kappa and Omicron. Treatment with our siRNA resulted in significant protection against virus-mediated cell death in vitro, with >97% cell survival (P < 0.0001), and corresponding reductions of viral nucleocapsid RNA of up to 99.9% (P < 0.0001). When compared to antivirals; Sotrovimab and Remdesivir, the siRNAs demonstrated a more potent antiviral effect and similarly, when multiplexing siRNAs to target different viral regions simultaneously, an increased antiviral effect was observed compared to individual siRNA treatments (P < 0.0001). These results demonstrate the potential for a highly effective broad-spectrum direct acting antiviral against multiple SARS-CoV-2 variants, including variants resistant to antivirals and vaccine generated neutralizing antibodies.
    MeSH term(s) Animals ; Humans ; RNA, Small Interfering/genetics ; SARS-CoV-2/genetics ; Antiviral Agents/pharmacology ; Antiviral Agents/therapeutic use ; Post-Acute COVID-19 Syndrome ; COVID-19/therapy ; Hepatitis C, Chronic ; Antibodies, Neutralizing/therapeutic use ; Antibodies, Viral ; Spike Glycoprotein, Coronavirus
    Chemical Substances RNA, Small Interfering ; Antiviral Agents ; Antibodies, Neutralizing ; Antibodies, Viral ; Spike Glycoprotein, Coronavirus ; spike protein, SARS-CoV-2
    Language English
    Publishing date 2023-07-20
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 306628-9
    ISSN 1872-9096 ; 0166-3542
    ISSN (online) 1872-9096
    ISSN 0166-3542
    DOI 10.1016/j.antiviral.2023.105677
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  3. Article ; Online: Immunoglobulin repertoire restriction characterizes the serological responses of patients with predominantly antibody deficiency.

    Troelnikov, Alexander / Armour, Bridie / Putty, Trishni / Aggarwal, Anupriya / Akerman, Anouschka / Milogiannakis, Vanessa / Chataway, Tim / King, Jovanka / Turville, Stuart G / Gordon, Tom P / Wang, Jing Jing

    The Journal of allergy and clinical immunology

    2023  Volume 152, Issue 1, Page(s) 290–301.e7

    Abstract: Background: Predominantly antibody deficiency (PAD) is the most common category of inborn errors of immunity and is underpinned by impaired generation of appropriate antibody diversity and quantity. In the clinic, responses are interrogated by ... ...

    Abstract Background: Predominantly antibody deficiency (PAD) is the most common category of inborn errors of immunity and is underpinned by impaired generation of appropriate antibody diversity and quantity. In the clinic, responses are interrogated by assessment of vaccination responses, which is central to many PAD diagnoses. However, the composition of the generated antibody repertoire is concealed from traditional quantitative measures of serological responses. Leveraging modern mass spectrometry-based proteomics (MS-proteomics), it is possible to elaborate the molecular features of specific antibody repertoires, which may address current limitations of diagnostic vaccinology.
    Objectives: We sought to evaluate serum antibody responses in patients with PAD following vaccination with a neo-antigen (severe acute respiratory syndrome coronavirus-2 vaccination) using MS-proteomics.
    Methods: Following severe acute respiratory syndrome coronavirus-2 vaccination, serological responses in individuals with PAD and healthy controls (HCs) were assessed by anti-S1 subunit ELISA and neutralization assays. Purified anti-S1 subunit IgG and IgM was profiled by MS-proteomics for IGHV subfamily usage and somatic hypermutation analysis.
    Results: Twelve patients with PAD who were vaccine-responsive were recruited with 11 matched vaccinated HCs. Neutralization and end point anti-S1 titers were lower in PAD. All subjects with PAD demonstrated restricted anti-S1 IgG antibody repertoires, with usage of <5 IGHV subfamilies (median: 3; range 2-4), compared to ≥5 for the 11 HC subjects (P < .001). IGHV3-7 utilization was far less common in patients with PAD than in HCs (2 of 12 vs 10 of 11; P = .001). Amino acid substitutions due to somatic hypermutation per subfamily did not differ between groups. Anti-S1 IgM was present in 64% and 50% of HC and PAD cohorts, respectively, and did not differ significantly between HCs and patients with PAD.
    Conclusions: This study demonstrates the breadth of anti-S1 antibodies elicited by vaccination at the proteome level and identifies stereotypical restriction of IGHV utilization in the IgG repertoire in patients with PAD compared with HC subjects. Despite uniformly pauci-clonal antibody repertoires some patients with PAD generated potent serological responses, highlighting a possible limitation of traditional serological techniques. These findings suggest that IgG repertoire restriction is a key feature of antibody repertoires in PAD.
    MeSH term(s) Humans ; COVID-19 ; Amino Acid Substitution ; Biological Assay ; Primary Immunodeficiency Diseases ; Vaccination ; Immunoglobulin G ; Immunoglobulin M ; Antibodies, Viral
    Chemical Substances Immunoglobulin G ; Immunoglobulin M ; Antibodies, Viral
    Language English
    Publishing date 2023-03-23
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 121011-7
    ISSN 1097-6825 ; 1085-8725 ; 0091-6749
    ISSN (online) 1097-6825 ; 1085-8725
    ISSN 0091-6749
    DOI 10.1016/j.jaci.2023.02.033
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  4. Article ; Online: Improvement of immune dysregulation in individuals with long COVID at 24-months following SARS-CoV-2 infection.

    Phetsouphanh, Chansavath / Jacka, Brendan / Ballouz, Sara / Jackson, Katherine J L / Wilson, Daniel B / Manandhar, Bikash / Klemm, Vera / Tan, Hyon-Xhi / Wheatley, Adam / Aggarwal, Anupriya / Akerman, Anouschka / Milogiannakis, Vanessa / Starr, Mitchell / Cunningham, Phillip / Turville, Stuart G / Kent, Stephen J / Byrne, Anthony / Brew, Bruce J / Darley, David R /
    Dore, Gregory J / Kelleher, Anthony D / Matthews, Gail V

    Nature communications

    2024  Volume 15, Issue 1, Page(s) 3315

    Abstract: This study investigates the humoral and cellular immune responses and health-related quality of life measures in individuals with mild to moderate long COVID (LC) compared to age and gender matched recovered COVID-19 controls (MC) over 24 months. LC ... ...

    Abstract This study investigates the humoral and cellular immune responses and health-related quality of life measures in individuals with mild to moderate long COVID (LC) compared to age and gender matched recovered COVID-19 controls (MC) over 24 months. LC participants show elevated nucleocapsid IgG levels at 3 months, and higher neutralizing capacity up to 8 months post-infection. Increased spike-specific and nucleocapsid-specific CD4
    MeSH term(s) Humans ; Post-Acute COVID-19 Syndrome ; COVID-19 ; CD8-Positive T-Lymphocytes ; Quality of Life ; SARS-CoV-2 ; Antibodies, Viral
    Chemical Substances Antibodies, Viral
    Language English
    Publishing date 2024-04-17
    Publishing country England
    Document type Journal Article
    ZDB-ID 2553671-0
    ISSN 2041-1723 ; 2041-1723
    ISSN (online) 2041-1723
    ISSN 2041-1723
    DOI 10.1038/s41467-024-47720-8
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  5. Article ; Online: Humoral and cellular immunity to SARS-CoV-2 Ancestral and Omicron BA.5 variants following vaccination in myelofibrosis patients.

    Alcheikh, Ahmad / Perkins, Griffith B / Pucar, Phillippa A / Cecchin, Amelia / Chai, Cheng Sheng / Tunbridge, Matthew / Akerman, Anouschka / Aggarwal, Anupriya / Milogiannakis, Vanessa / Turville, Stuart / Allen, Sharon / Hissaria, Pravin / Banovic, Tatjana / Coates, P Toby / Ross, David M

    Blood cancer journal

    2023  Volume 13, Issue 1, Page(s) 50

    MeSH term(s) Humans ; SARS-CoV-2 ; Primary Myelofibrosis/genetics ; COVID-19/prevention & control ; Immunity, Cellular ; Vaccination
    Language English
    Publishing date 2023-04-10
    Publishing country United States
    Document type Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 2600560-8
    ISSN 2044-5385 ; 2044-5385
    ISSN (online) 2044-5385
    ISSN 2044-5385
    DOI 10.1038/s41408-023-00824-8
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  6. Article ; Online: Multiple COVID-19 vaccine doses in CLL and MBL improve immune responses with progressive and high seroconversion.

    Shen, Yandong / Freeman, Jane A / Holland, Juliette / Naidu, Kartik / Solterbeck, Ann / Van Bilsen, Nenna / Downe, Paul / Kerridge, Ian / Wallman, Lucinda / Akerman, Anouschka / Aggarwal, Anupriya / Milogiannakis, Vanessa / Martins Costa Gomes, Gabriela / Doyle, Chloe M / Sandgren, Kerrie J / Turville, Stuart / Cunningham, Anthony L / Mulligan, Stephen P

    Blood

    2022  Volume 140, Issue 25, Page(s) 2709–2721

    Abstract: Patients with chronic lymphocytic leukemia (CLL) or monoclonal B-lymphocytosis (MBL) have impaired response to COVID-19 vaccination. A total of 258 patients (215 with CLL and 43 with MBL) had antispike antibody levels evaluable for statistical analysis. ... ...

    Abstract Patients with chronic lymphocytic leukemia (CLL) or monoclonal B-lymphocytosis (MBL) have impaired response to COVID-19 vaccination. A total of 258 patients (215 with CLL and 43 with MBL) had antispike antibody levels evaluable for statistical analysis. The overall seroconversion rate in patients with CLL was 94.2% (antispike antibodies ≥50 AU/mL) and 100% in patients with MBL after multiple vaccine doses. After 3 doses (post-D3) in 167 patients with CLL, 73.7% were seropositive, 17.4% had antispike antibody levels between 50 and 999 AU/mL, and 56.3% had antispike antibody levels ≥1000 AU/mL, with a median rise from 144.6 to 1800.7 AU/mL. Of patients who were seronegative post-D2, 39.7% seroconverted post-D3. For those who then remained seronegative after their previous dose, seroconversion occurred in 40.6% post-D4, 46.2% post-D5, 16.7% post-D6, and 0% after D7 or D8. After seroconversion, most had a progressive increase in antispike antibody levels. Neutralization was associated with higher antispike antibody levels, more vaccine doses, and earlier severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants; neutralizing antibody against early clade D614G was detected in 65.3%, against Delta in 52.0%, and against Omicron in 36.5%. SARS-CoV-2-specific T-cell production of interferon γ and interleukin 2 occurred in 73.9% and 60.9%, respectively, of 23 patients tested. After multiple vaccine doses, by multivariate analysis, immunoglobulin M ≥0.53 g/L, immunoglobulin subclass G3 ≥0.22 g/L and absence of current CLL therapy were independent predictors of positive serological responses. Multiple sequential COVID-19 vaccination significantly increased seroconversion and antispike antibody levels in patients with CLL or MBL.
    MeSH term(s) Humans ; COVID-19 Vaccines ; Leukemia, Lymphocytic, Chronic, B-Cell/therapy ; Lymphocytosis ; Seroconversion ; COVID-19/prevention & control ; SARS-CoV-2 ; Immunoglobulin M ; Immunoglobulin G ; Immunity ; Antibodies, Viral
    Chemical Substances COVID-19 Vaccines ; Immunoglobulin M ; Immunoglobulin G ; Antibodies, Viral
    Language English
    Publishing date 2022-10-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80069-7
    ISSN 1528-0020 ; 0006-4971
    ISSN (online) 1528-0020
    ISSN 0006-4971
    DOI 10.1182/blood.2022017814
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  7. Article ; Online: COVID-19 vaccine failure in chronic lymphocytic leukaemia and monoclonal B-lymphocytosis; humoural and cellular immunity.

    Shen, Yandong / Freeman, Jane A / Holland, Juliette / Solterbeck, Ann / Naidu, Kartik / Soosapilla, Asha / Downe, Paul / Tang, Catherine / Kerridge, Ian / Wallman, Lucinda / Van Bilsen, Nenna / Milogiannakis, Vanessa / Akerman, Anouschka / Martins Costa Gomes, Gabriela / Sandgren, Kerrie / Cunningham, Anthony L / Turville, Stuart / Mulligan, Stephen P

    British journal of haematology

    2022  Volume 197, Issue 1, Page(s) 41–51

    Abstract: Chronic lymphocytic leukaemia (CLL) is associated with immunocompromise and high risk of severe COVID-19 disease and mortality. Monoclonal B-cell lymphocytosis (MBL) patients also have immune impairment. We evaluated humoural and cellular immune ... ...

    Abstract Chronic lymphocytic leukaemia (CLL) is associated with immunocompromise and high risk of severe COVID-19 disease and mortality. Monoclonal B-cell lymphocytosis (MBL) patients also have immune impairment. We evaluated humoural and cellular immune responses in 181 patients with CLL (160) and MBL (21) to correlate failed seroconversion [<50 AU/ml SARS-CoV-2 II IgG assay, antibody to spike protein; Abbott Diagnostics)] following each of two vaccine doses with clinical and laboratory parameters. Following first and second doses, 79.2% then 45% of CLL, and 50% then 9.5% of MBL patients respectively remained seronegative. There was significant association between post dose two antibody level with pre-vaccination reduced IgM (p < 0.0001), IgG2 (p < 0.035), and IgG3 (p < 0.046), and CLL therapy within 12 months (p < 0.001) in univariate analysis. By multivariate analysis, reduced IgM (p < 0.0002) and active therapy (p < 0.0002) retained significance. Anti-spike protein levels varied widely and were lower in CLL than MBL patients, and both lower than in normal donors. Neutralisation activity showed anti-spike levels <1000 AU/ml were usually negative for both an early viral clade and the contemporary Delta variant and 72.9% of CLL and 53.3% of MBL failed to reach levels ≥1000 AU/ml. In a representative sample, ~80% had normal T-cell responses. Failed seroconversion occurred in 36.6% of treatment-naïve patients, in 78.1% on therapy, and in 85.7% on ibrutinib.
    MeSH term(s) B-Lymphocytes ; COVID-19 ; COVID-19 Vaccines ; Humans ; Immunity, Cellular ; Leukemia, Lymphocytic, Chronic, B-Cell/complications ; Lymphocytosis/complications ; SARS-CoV-2
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2022-01-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 80077-6
    ISSN 1365-2141 ; 0007-1048
    ISSN (online) 1365-2141
    ISSN 0007-1048
    DOI 10.1111/bjh.18014
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  8. Article ; Online: Enhanced stability of the SARS CoV-2 spike glycoprotein trimer following modification of an alanine cavity in the protein core.

    Poumbourios, Pantelis / Langer, Christine / Boo, Irene / Zakir, Tasnin / Center, Rob J / Akerman, Anouschka / Milogiannakis, Vanessa / Aggarwal, Anupriya / Turville, Stuart G / Drummer, Heidi E

    bioRxiv

    Abstract: The spike (S) glycoprotein of SARS CoV-2 is the target of neutralizing antibodies (NAbs) that are crucial for vaccine effectiveness. The S1 subunit binds ACE2 while the S2 subunit mediates virus-cell membrane fusion. S2 is a class I fusion glycoprotein ... ...

    Abstract The spike (S) glycoprotein of SARS CoV-2 is the target of neutralizing antibodies (NAbs) that are crucial for vaccine effectiveness. The S1 subunit binds ACE2 while the S2 subunit mediates virus-cell membrane fusion. S2 is a class I fusion glycoprotein and contains a central coiled coil that acts as a scaffold for the conformational changes associated with fusion function. The coiled coil of S2 is unusual in that the 3-4 repeat of inward-facing positions are mostly occupied by polar residues that mediate few inter-helical contacts in the prefusion trimer. We examined how insertion of bulkier hydrophobic residues (Val, Leu, Ile, Phe) to fill a cavity formed by Ala1016 and Ala1020 that form part of the 3-4 repeat affects the stability and antigenicity of S trimers. Substitution of Ala1016 with bulkier hydrophobic residues in the context of a prefusion-stabilized S trimer, S2P-FHA, was associated with increased thermal stability. The trimer stabilizing effects of filling the Ala1016/Ala1020 cavity was linked to improved S glycoprotein membrane fusion function. When assessed as immunogens, two thermostable S2P-FHA mutants derived from the ancestral isolate, A1016L (16L) and A1016V/A1020I (VI) elicited very high titers of neutralizing antibodies to ancestral and Delta-derived viruses (1/2,700-1/5,110), while neutralization titer was somewhat reduced with Omicron BA.1 (1/210-1,1744). The antigens elicited antibody specificities that could compete with ACE2-Fc for binding to the receptor-binding motif (RBM) and NAbs directed to key neutralization epitopes within the receptor-binding domain (RBD), N-terminal domain (NTD) and stem region of S2. The VI mutation enabled the production of intrinsically stable Omicron BA.1 and Omicron BA.4/5 S ectodomain trimers in the absence of an external trimerization motif (T4 foldon). The VI mutation represents a method for producing an intrinsically stable trimeric S ectodomain glycoprotein vaccine in the absence of a foreign trimerization tag.
    Keywords covid19
    Language English
    Publishing date 2022-11-08
    Publisher Cold Spring Harbor Laboratory
    Document type Article ; Online
    DOI 10.1101/2022.11.08.515567
    Database COVID19

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  9. Article ; Online: TMPRSS2 activation of Omicron lineage Spike glycoproteins is regulated by TMPRSS2 cleavage of ACE2

    Aggarwal, Anupriya / Fichter, Christina / Milogiannakis, Vanessa / Akerman, Anouschka / Ison, Timothy / Ruiz Silva, Mariana / Esneau, Camille / Bartlett, Nathan / Burrell, Louise / Patel, Sheila / Churchill, Melissa / Angelovich, Thomas / Parry, Rhys / Sng, Julian D / Neely, Greg / Moreno, Cesar / Loo, Lipin / Kelleher, Anthony D / Brilot-Turville, Fabienne /
    Khromykh, Alexander / Turville, Stuart G.

    bioRxiv

    Abstract: Continued high levels spread of SARS-CoV-2 globally enabled accumulation of changes within the Spike glycoprotein, leading to resistance to neutralising antibodies and concomitant changes to entry requirements that increased viral transmission fitness. ... ...

    Abstract Continued high levels spread of SARS-CoV-2 globally enabled accumulation of changes within the Spike glycoprotein, leading to resistance to neutralising antibodies and concomitant changes to entry requirements that increased viral transmission fitness. Herein, we demonstrate a significant change in ACE2 and TMPRSS2 use by primary SARS-CoV-2 isolates that occurred upon arrival of Omicron lineages. Mechanistically we show this shift to be a function of two distinct ACE2 pools based on cleavage or non-cleavage of ACE2 by TMPRSS2 activity. In engineered cells overexpressing ACE2 and TMPRSS2, ACE2 was cleaved by TMPRSS2 and this led to either augmentation or progressive attenuation of pre-Omicron and Omicron lineages, respectfully. In contrast, TMPRSS2 resistant ACE2 restored infectivity across all Omicron lineages through enabling ACE2 binding that facilitated TMPRSS2 spike activation. Therefore, our data support the tropism shift of Omicron lineages to be a function of evolution towards the use of uncleaved pools of ACE2 with the latter consistent with its role as a chaperone for many tissue specific amino acid transport proteins.
    Keywords covid19
    Language English
    Publishing date 2023-09-22
    Publisher Cold Spring Harbor Laboratory
    Document type Article ; Online
    DOI 10.1101/2023.09.22.558930
    Database COVID19

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  10. Article ; Online: Immune profiling of COVID-19 vaccine responses in people with multiple sclerosis on B cell-depleting therapy

    Perkins, Griffith B. / Hope, Christopher M. / Chai, Cheng Sheng / Tunbridge, Matthew J. / Sterling, Sebastian / Webb, Kevin / Yap, Joey / Yeow, Arthur Eng Lip / Masavuli, Makutiro G. / Kireta, Svjetlana / Zuiani, James D. / Akerman, Anouschka / Aggarwal, Anupriya / Milogiannakis, Vanessa / Roberts, Matthew B. / Wilson, William / Hurtado, Plinio R. / Turville, Stuart / Grubor-Bauk, Branka /
    Barry, Simon C. / Coates, P. Toby / Ravindran, Janakan / Hissaria, Pravin

    medRxiv

    Abstract: Background and Objective: People with multiple sclerosis (pwMS) receiving B cell-depleting therapies have impaired antibody responses to vaccination. In a proportion of individuals, repeat vaccination against COVID-19 leads to seroconversion. We sought ... ...

    Abstract Background and Objective: People with multiple sclerosis (pwMS) receiving B cell-depleting therapies have impaired antibody responses to vaccination. In a proportion of individuals, repeat vaccination against COVID-19 leads to seroconversion. We sought to describe the immune phenotype of pwMS on ocrelizumab, and identify clinical and immunological determinants of an effective vaccine response. Methods: This was a single-centre, prospective cohort study. Peripheral blood samples were collected from pwMS receiving ocrelizumab (n = 38) pre and post administration of a third dose of mRNA COVID-19 vaccine. Immunogenicity was measured by T cell IFNg; ELISpot, antibody titres, and live virus neutralisation. Humoral immunity was benchmarked against pwMS receiving natalizumab (n = 15), and against a correlate of real-world protection (50% reduction in incidence of infection) from SARS-CoV-2 ancestral and omicron BA.5 variants. The peripheral immune phenotype was comprehensively assessed by flow cytometry, and potential clinical and phenotypic determinants of response to vaccination identified. Results: Immune cell populations relevant to disease and vaccine response were altered in pwMS receiving ocrelizumab versus natalizumab treatment, including depleted CD20-expressing B cell, T cell and NK cell populations, and elevated CD27+CD38+ T cell and NK8 cell frequencies. Following a third vaccine dose, 51% of pwMS on ocrelizumab were seropositive for SARS-CoV-2 receptor-binding-domain IgG, and 25% and 14% met the threshold for effective neutralisation of live SARS-CoV-2 ancestral and omicron BA.5 virus, respectively. B cell frequency at the time of vaccination, but not time since ocrelizumab infusion, was positively correlated with antibody response, while a strong negative correlation was observed between CD56bright NK cell frequency and antibody response in the ocrelizumab group. In this exploratory cohort, CD3-CD20+ B cells (% of lymphocytes; OR=3.92) and CD56bright NK cells (% of NK cells; OR=0.94) were predictive of an effective neutralising antibody response in second dose non-responders (AUC: 0.98). Discussion: Ocrelizumab treatment was associated with an altered immune phenotype, including recently described T cell and NK populations with potential roles in disease pathogenesis. However, seroconversion was severely impaired by ocrelizumab, and less than half of those who seroconverted following a third vaccine dose demonstrated effective immunity against SARS-CoV-2 ancestral or omicron BA.5. B cell frequency was associated with an effective antibody response, while immunomodulatory CD56bright NK cells were identified as a potential negative determinant of response in those with inadequate B cell numbers. Immune phenotype rather than time since ocrelizumab infusion may help to stratify individuals for prophylaxis.
    Keywords covid19
    Language English
    Publishing date 2023-12-05
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2023.12.04.23299409
    Database COVID19

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