Detection and quantification of antibody to SARS CoV 2 receptor binding domain provides enhanced sensitivity, specificity and utility
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Published version
Author(s)
Type
Journal Article
Abstract
Accurate and sensitive detection of antibody to SARS-CoV-2 remains an essential component of the pandemic response. Measuring antibody that predicts neutralising activity and the vaccine response is an absolute requirement for laboratory-based confirmatory and reference activity. The viral receptor binding domain (RBD) constitutes the prime target antigen for neutralising antibody. A double antigen binding assay (DABA), providing the most sensitive format has been exploited in a novel hybrid manner employing a solid-phase S1 preferentially presenting RBD, coupled with a labelled RBD conjugate, used in a two-step sequential assay for detection and measurement of antibody to RBD (anti-RBD). This class and species neutral assay showed a specificity of 100% on 825 pre COVID-19 samples and a potential sensitivity of 99.6% on 276 recovery samples, predicting quantitatively the presence of neutralising antibody determined by pseudo-type neutralisation and by plaque reduction. Anti-RBD is also measurable in ferrets immunised with ChadOx1 nCoV-19 vaccine and in humans immunised with both AstraZeneca and Pfizer vaccines. This assay detects anti-RBD at presentation with illness, demonstrates its elevation with disease severity, its sequel to asymptomatic infection and its persistence after the loss of antibody to the nucleoprotein (anti-NP). It also provides serological confirmation of prior infection and offers a secure measure for seroprevalence and studies of vaccine immunisation in human and animal populations. The hybrid DABA also displays the attributes necessary for the detection and quantification of anti-RBD to be used in clinical practice. An absence of detectable anti-RBD by this assay predicates the need for passive immune prophylaxis in at-risk patients.
Date Acceptance
2022-01-20
Citation
Journal of Virological Methods, 302
ISSN
0166-0934
Publisher
Elsevier
Journal / Book Title
Journal of Virological Methods
Volume
302
Copyright Statement
Ā© 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
License URL
Sponsor
National Institute for Health Research
UK Research and Innovation
National Institute for Health Research
Imperial College Healthcare NHS Trust- BRC Funding
Wellcome Trust
National Institute for Health Research
UKRI MRC COVID-19 Rapid Response Call
UK Research and Innovation
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/35077719
PII: S0166-0934(22)00022-2
Grant Number
RP-2016-07-012
9815274 MC_PC_19025
HPRU-2012-10064
RDA02
214407/Z/18/Z
NIHR201385
MC_PC19025
1257927
Subjects
ELISA
Keywords: Sars-CoV-2
Receptor Binding Domain
antibodies
Publication Status
Published online
Article Number
114475
Date Publish Online
2022-01-22