Structurally and functionally distinct early antibody responses predict COVID-19 disease trajectory and mRNA vaccine response

Chakraborty et al. (BioRxiv) doi: 10.1101/2021.05.25.445649

Keywords

  • COVID-19

  • IgG

  • Inflammation

 

Main Findings

Mild COVID-19 patients who experienced a worsening disease trajectory were characterised by the absence of an early robust neutralising IgG response with elevations in both afucosylated anti-spike IgG and the CD16a receptor on myeloid cells, which contribute to the inflammatory phenotype. 

Limitations

  • IgG post-translational modifications are also associated with specific patient characteristics including sex, age, demographic features

  • The mouse model is not a model of COVID-19 pathogenesis

  • The authors did not discuss the impact of afucosylation on IgG confirmation and the potential link with their non-neutralising activity

  • The authors did not discuss the potential benefit to use selective blockades of CD16a

Significance/Novelty

  • They demonstrated the functional link between afucosylated IgG and induction of lung inflammation in an in vivo model. 

  • Elevated concentrations of afucosylated IgG could be included in a panel of predictive factors of worsening COVID-19.

Credit

Reviewed by Stephanie Longet as part of the cross-institutional journal club of the Immunology Institute of the Icahn School of Medicine, Mount Sinai, the Kennedy Institute of Rheumatology and the Oxford Centre for Immuno-Oncology  (OXCIO) (University of Oxford, GB) and Karolinska Institute’s Center for Infectious Medicine (CIM) & Center for Molecular Medicine (CMM).