Infectious virus shedding duration reflects secretory IgA antibody response latency after SARS-CoV-2 infection

• Published in: Proceedings of the National Academy of Sciences - PNAS Vol. 120; no. 52; p. e2314808120
• Main Authors: Miyamoto, Sho, Nishiyama, Takara, Ueno, Akira, Park, Hyeongki, Kanno, Takayuki, Nakamura, Naotoshi, Ozono, Seiya, Aihara, Kazuyuki, Takahashi, Kenichiro, Tsuchihashi, Yuuki, Ishikane, Masahiro, Arashiro, Takeshi, Saito, Shinji, Ainai, Akira, Hirata, Yuichiro, Iida, Shun, Katano, Harutaka, Tobiume, Minoru, Tokunaga, Kenzo, Fujimoto, Tsuguto, Suzuki, Michiyo, Nagashima, Maki, Nakagawa, Hidenori, Narita, Masashi, Kato, Yasuyuki, Igari, Hidetoshi, Fujita, Kaori, Kato, Tatsuo, Hiyama, Kazutoshi, Shindou, Keisuke, Adachi, Takuya, Fukushima, Kazuaki, Nakamura-Uchiyama, Fukumi, Hase, Ryota, Yoshimura, Yukihiro, Yamato, Masaya, Nozaki, Yasuhiro, Ohmagari, Norio, Suzuki, Motoi, Saito, Tomoya, Iwami, Shingo, Suzuki, Tadaki
• Format: Journal Article
• Language: English
• Published: United States National Academy of Sciences 26.12.2023
• Subjects: Antibodies; Antibodies, Viral; Antibody Formation; Antibody response; Coronaviruses; COVID-19; Epithelium; Humans; Immunoglobulin A; Immunoglobulin A, Secretory; Immunoglobulin G; Infections; Infectivity; Latency; Mucosal immunity; Pandemics; Reaction Time; Respiratory diseases; Respiratory tract; Ribonucleic acid; Risk management; RNA; RNA, Viral; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Viral diseases; Virus Shedding; Viruses; prior-infection; COVID-19 vaccine; infectious virus shedding duration; human-to-human transmission; mucosal secretory IgA
• ISSN: 0027-8424; 1091-6490; 1091-6490
• DOI: 10.1073/pnas.2314808120

Infectious virus shedding from individuals infected with severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is used to estimate human-to-human transmission risk. Control of SARS-CoV-2 transmission requires identifying the immune correlates that protect infectious virus shedding. Mucosal immunity prevents infection by SARS-CoV-2, which replicates in the respiratory epithelium and spreads rapidly to other hosts. However, whether mucosal immunity prevents the shedding of the infectious virus in SARS-CoV-2-infected individuals is unknown. We examined the relationship between viral RNA shedding dynamics, duration of infectious virus shedding, and mucosal antibody responses during SARS-CoV-2 infection. Anti-spike secretory IgA antibodies (S-IgA) reduced viral RNA load and infectivity more than anti-spike IgG/IgA antibodies in infected nasopharyngeal samples. Compared with the IgG/IgA response, the anti-spike S-IgA post-infection responses affected the viral RNA shedding dynamics and predicted the duration of infectious virus shedding regardless of the immune history. These findings highlight the importance of anti-spike S-IgA responses in individuals infected with SARS-CoV-2 for preventing infectious virus shedding and SARS-CoV-2 transmission. Developing medical countermeasures to shorten S-IgA response time may help control human-to-human transmission of SARS-CoV-2 infection and prevent future respiratory virus pandemics.