Serum and Mucosal Antibody-mediated Protection and Identification of Asymptomatic Respiratory Syncytial Virus Infection in Community-dwelling Older Adults in Europe

Overview

Journal Front Immunol

Specialty Allergy & Immunology

Date 2024 Nov 4

PMID 39493753

Authors

Deniz Oner

Charlotte Vernhes

Sunita Balla-Jhagjhoorsingh

Annick Moureau

Marjolein Crabbe

Bruno Salaun

Arangassery Rosemary Bastian

Kim Thys

Jonathan De Smedt

Salo N Ooft

Koos Korsten

Niels Adriaenssens

Samuel Coenen

Christopher C Butler

Theo J M Verheij

Simon B Drysdale

Joanne G Wildenbeest

Andrew J Pollard

Peter J M Openshaw

Louis Bont

Jeroen Aerssens

Affiliations

Soon will be listed here.

Abstract

Introduction: Respiratory syncytial virus (RSV) causes acute respiratory tract infection (ARTI) and reinfects adults throughout life, posing a risk for hospitalization in older adults (>60 years) with frailty and comorbidities.

Methods: To investigate serum and mucosal antibodies for protection against RSV infections, baseline serum samples were compared for RSV-pre- and -post-fusion (F) binding, and RSV-A2 neutralizing IgG antibodies between symptomatic RSV-ARTI ( = 30), non-RSV (RSV negative) ARTI ( = 386), and no ARTI ( = 338). Mucosal RSV-pre-F IgA and IgG levels, as well as serum RSV-G IgG antibodies, were analyzed to determine their association with protection from symptomatic RSV-ARTI in a subset study.

Results: Using a receiver operating characteristic (ROC) analysis, we established thresholds of 1.4- to 1.6-fold change (FC) for RSV-pre-F and -post-F, and RSV-A2 neutralizing IgG antibodies, respectively, enabling the identification of asymptomatic RSV cases with high sensitivity and specificity (>80% and >90%, respectively). As a result, serum RSV-pre-F, RSV-G IgG, and mucosal pre-F binding IgA antibodies showed correlations with protection against symptomatic RSV infection. RSV-pre-F IgG antibodies were correlated with protection from RSV infections irrespective of the symptoms.

Discussion: This study provides insights into antibody-mediated protection for symptomatic RSV infection in a community-dwelling older-adult population and establishes a threshold to identify asymptomatic RSV infection using a data-driven approach.

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