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Are We Forgetting About IgA? A Re-examination of Coronavirus Disease 2019 Convalescent Plasma.

Title: Are We Forgetting About IgA? A Re-examination of Coronavirus Disease 2019 Convalescent Plasma.
Authors: Verkerke H; Center for Transfusion Medicine and Cellular Therapies, Emory University, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Saeedi BJ; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Boyer D; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Allen JW; Center for Transfusion Medicine and Cellular Therapies, Emory University, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Owens J; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Shin S; Center for Transfusion Medicine and Cellular Therapies, Emory University, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Horwath M; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Patel K; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Paul A; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Wu SC; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Wang J; Center for Transfusion Medicine and Cellular Therapies, Emory University, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Ho A; Center for Transfusion Medicine and Cellular Therapies, Emory University, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Maier CL; Center for Transfusion Medicine and Cellular Therapies, Emory University, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Zerra PE; Center for Transfusion Medicine and Cellular Therapies, Emory University, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Chonat S; Center for Transfusion Medicine and Cellular Therapies, Emory University, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Arthur CM; Center for Transfusion Medicine and Cellular Therapies, Emory University, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Roback JD; Center for Transfusion Medicine and Cellular Therapies, Emory University, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Neish AS; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Lough C; LifeSouth Community Blood Centers, Gainesville, Florida, USA.; Josephson CD; Center for Transfusion Medicine and Cellular Therapies, Emory University, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Stowell SR; Center for Transfusion Medicine and Cellular Therapies, Emory University, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Source: Transfusion [Transfusion] 2021 Jun; Vol. 61 (6), pp. 1740-1748. Date of Electronic Publication: 2021 May 26.
Publication Type: Case Reports; Journal Article
Language: English
Journal Info: Publisher: American Association Of Blood Banks Country of Publication: United States NLM ID: 0417360 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1537-2995 (Electronic) Linking ISSN: 00411132 NLM ISO Abbreviation: Transfusion Subsets: MEDLINE
Imprint Name(s): Original Publication: Arlington, Va. : American Association Of Blood Banks
MeSH Terms: Convalescence*; COVID-19/*immunology ; COVID-19/*therapy ; Immunoglobulin A/*blood ; SARS-CoV-2/*immunology; Antibodies, Viral/blood ; Down Syndrome/complications ; Down Syndrome/immunology ; Down Syndrome/therapy ; Heart Septal Defects/complications ; Heart Septal Defects/immunology ; Heart Septal Defects/therapy ; Immunity, Humoral/immunology ; Immunization, Passive/methods ; Immunoglobulin A/analysis ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Blood Donors ; Female ; Humans ; Infant ; Retrospective Studies ; Serologic Tests ; United States ; COVID-19 Serotherapy
Abstract: Background: While convalescent plasma (CP) may benefit patients with COVID-19, fundamental questions remain regarding its efficacy, including the components of CP that may contribute to its therapeutic effect. Most current serological evaluation of CP relies on examination of total immunoglobulin or IgG-specific anti-SARS-CoV-2 antibody levels. However, IgA antibodies, which also circulate and are secreted along the respiratory mucosa, represent a relatively uncharacterized component of CP.; Study Design and Methods: Residual samples from patients and CP donors were assessed for IgM, IgG, and IgA anti-SARS-CoV-2 antibody titers against the receptor-binding domain responsible for viral entry. Symptom onset was obtained by chart review.; Results: Increased IgA anti-SARS-CoV-2 antibody levels correlated with clinical improvement and viral clearance in an infant with COVID-19, prompting a broader examination of IgA levels among CP donors and hospitalized patients. Significant heterogeneity in IgA levels was observed among CP donors, which correlated weakly with IgG levels or the results of a commonly employed serological test. Unlike IgG and IgM, IgA levels were also more likely to be variable in hospitalized patients and this variability persisted in some patients >14 days following symptom onset. IgA levels were also less likely to be sustained than IgG levels following subsequent CP donation.; Conclusions: IgA levels can be very heterogenous among CP donors and hospitalized patients and do not necessarily correlate with commonly employed testing platforms. Examining isotype levels in CP and COVID-19 patients may allow for a tailored approach when seeking to fill specific gaps in humoral immunity.; (© 2021 AABB.)
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Grant Information: T32 GM008169 United States GM NIGMS NIH HHS; T32 HL066987 United States HL NHLBI NIH HHS
Contributed Indexing: Keywords: COVID-19; IgA; antibody isotype; convalescent plasma; serology
Substance Nomenclature: 0 (Antibodies, Viral); 0 (Immunoglobulin A); 0 (Immunoglobulin G); 0 (Immunoglobulin M)
SCR Disease Name: Atrioventricular Septal Defect
Entry Date(s): Date Created: 20210527 Date Completed: 20210630 Latest Revision: 20230727
Update Code: 20260130
PubMed Central ID: PMC8242454
DOI: 10.1111/trf.16435
PMID: 34041759
Database: MEDLINE

Case Reports; Journal Article