RT Journal Article
SR Electronic
T1 Biological Significance of Anti–SARS-CoV-2 Antibodies
JF Neurology - Neuroimmunology Neuroinflammation
JO Neurol Neuroimmunol Neuroinflamm
FD Lippincott Williams & Wilkins
SP e935
DO 10.1212/NXI.0000000000000935
VO 8
IS 2
A1 Navid Manouchehri
A1 Lawrence Steinman
A1 Olaf Stuve
YR 2021
UL http://nn.neurology.org/content/8/2/e935.abstract
AB Objective To discuss the pathogenic and diagnostic relevance of cellular and humoral immune responses against severe acute respiratory syndrome novel coronavirus (SARS-COV-2) and pertinent observations made in progressive multifocal leukoencephalopathy (PML).Methods Review of pertinent literature.Results There is at least 1 precedent for an antibody response against a viral pathogen that fails to provide host protection in the absence of immune-competent CD4+ T cells. PML is an infection of the CNS caused by JC virus (JCV), which commonly occurs during treatment with the therapeutic monoclonal antibody natalizumab. In this context, the humoral immune response fails to prevent JCV reactivation, and elevated anti-JCV serum indices are associated with a higher PML incidence. The more relevant immune-competent cells in host defense against JCV appear to be T cells. T cell–mediated responses are also detectable in convalescing patients with SARS-COV-2 irrespective of the humoral immune response.Conclusion Based on pathogenic lessons learned from PML under natalizumab therapy, we suggest the incorporation of functional assays that determine neutralizing properties of SARS-CoV-2–specific antibodies. In addition, we outline the potential role of T-cell detection assays in determining herd immunity in a given population or in studying therapeutic responses to vaccines.GMFR=geometric mean fold rise; GMT=geometric mean titer; Ig=immunoglobulin; IRIS=immune reconstitution inflammatory syndrome; JCV=JC virus; PML=progressive multifocal leukoencephalopathy