Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 221, Issue 4, Pages 636-646Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiz608
Keywords
RSV; mucosal immunity; antibody; immune response; HCT; antibody affinity; epitope; repertoire; infection; virus
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Funding
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health [AAI17015]
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Background. Respiratory syncytial virus (RSV) infection causes significant morbidity in hematopoietic cell transplant (HCT) recipients. However, antibody responses that correlate with recovery from RSV disease are not fully understood. Methods. In this study, antibody repertoire in paired serum and nasal wash samples from acutely RSV-A-infected HCT recipients who recovered early (<14 days of RSV shedding) were compared with late-recovered patients (>= 14 days of shedding) using gene fragment phage display libraries and surface plasmon resonance. Results. Anti-F serum responses were similar between these 2 groups for antibody repertoires, neutralization titers, anti-F binding antibodies (prefusion and postfusion proteins), antibody avidity, and binding to specific antigenic sites. In contrast, nasal washes from early-recovered individuals demonstrated higher binding to F peptide containing p27. While the serum RSV G antibody repertoires in the 2 groups were similar, the strongest difference between early-recovered and late-recovered patients was observed in the titers of nasal wash antibodies, especially binding to the central conserved domain. Most importantly, a significantly higher antibody affinity to RSV G was observed in nasal washes from early-recovered individuals compared with late-recovered HCT recipients. Conclusions. These findings highlight the importance of mucosal antibodies in resolution of RSV-A infection in the upper respiratory tract.
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