T-cell proliferation assay for the detection of SARS-CoV-2-specific T-cells

Both infection with and vaccination against SARS-CoV-2 trigger a complex B-cell and T-cell response. Methods for the analysis of the B-cell response are now well established. However, reliable methods for measuring the T cell response are less well established and their usefulness in clinical settings still needs to be proven. Here, we have developed and validated a T-cell proliferation assay based on 3H thymidine incorporation. The assay is using SARS-CoV-2 derived peptide pools that cover the spike (S), the nucleocapsid (N) and the membrane (M) protein for stimulation. We have compared this novel SARS-CoV-2 lymphocyte transformation test (SARS-CoV-2 LTT) to an established ELISA assay detecting Immunoglobulin G (IgG) antibodies to the S1 subunit of the SARSCoV-2 spike protein. The study was carried out using blood samples from both vaccinated and infected health care workers as well as from a non-infected control group. Our novel SARS-CoV-2 LTT shows excellent discrimination of infected and/or vaccinated individuals versus unexposed controls, with the ROC analysis showing an area under the curve (AUC) of > 0.95. No false positives were recorded as all unexposed controls had a negative LTT result. When using peptide pools not only representing the S protein (found in all currently approved vaccines) but also the N and M proteins (not contained in the vast majority of vaccines), the novel SARS-CoV-2 LTT can also discriminate T-cell responses resulting from vaccination against those induced by infection.

Automated summary

Both infection with and vaccination against SARS-CoV-2 can trigger a complex B-cell and T-cell response. Reliable methods for analyzing the B-cell response are well established, but methods for measuring the T-cell response still need to be proven in clinical settings. In this study, a T-cell proliferation assay based on 3H thymidine incorporation was developed and validated. The assay uses SARS-CoV-2 derived peptide pools to stimulate T-cell responses. The novel SARS-CoV-2 lymphocyte transformation test (SARS-CoV-2 LTT) showed excellent discrimination of infected and/or vaccinated individuals versus unexposed controls, with an area under the curve (AUC) of >0.95 in ROC analysis. Furthermore, the assay can also differentiate T-cell responses resulting from vaccination against those induced by infection by using peptide pools representing not only the S protein but also the N and M proteins.