Immunologic Testing for SARS-CoV-2 Infection from the Antigen Perspective.
Immunologic Testing for SARS-CoV-2 Infection from the Antigen Perspective.
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DOI：
10.1128/jcm.02160-20
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发表时间：
2021-04-20
影响因子：
9.4
通讯作者：
Li J
中科院分区：
文献类型：
--
作者：
Li D;Li J
2019冠状病毒病（COVID-19）由新型冠状病毒严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起，已作为严重流行病在全球蔓延。SARS-CoV-2感染刺激抗原特异性抗体反应。2019冠状病毒病（COVID-19）由新型冠状病毒严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起，已作为严重流行病在全球蔓延。SARS-CoV-2感染刺激抗原特异性抗体反应。针对SARS-CoV-2已开发了多种血清学检测方法。然而，哪些抗原最适合血清学检测仍然知之甚少。具体而言，哪些抗原对血清学检测的敏感性和特异性最高，哪些抗原与其他冠状病毒的交叉反应性最小，目前尚不清楚。此前的研究表明，刺突（S）蛋白的S1结构域在流行性冠状病毒和普通人冠状病毒之间具有极低的交叉反应性，而S蛋白的S2结构域和核衣壳蛋白（N蛋白）则表现出低水平的交叉反应性。因此，S1被认为比S蛋白的天然同源三聚体更具特异性，并且受体结合结构域作为检测患者抗体的抗原比天然N蛋白更敏感。此外，越来越多的研究使用多抗原蛋白阵列来筛查COVID-19康复期患者的血清。与每种单独的抗原相比，抗原组合表现出改善的性能。对于快速抗原检测，在病毒载量较高的疾病发病第一周，检测的灵敏度较高。高灵敏度和特异性的抗体免疫学诊断方法或直接检测临床样本中的病毒抗原的方法将有助于SARS-CoV-2感染的快速和准确诊断。
Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread globally as a severe pandemic. SARS-CoV-2 infection stimulates antigen-specific antibody responses. Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread globally as a severe pandemic. SARS-CoV-2 infection stimulates antigen-specific antibody responses. Multiple serologic tests have been developed for SARS-CoV-2. However, which antigens are most suitable for serological testing remains poorly understood. Specifically, which antigens have the highest sensitivity and specificity for serological testing and which have the least cross-reactivity with other coronaviruses are currently unknown. Previous studies have shown that the S1 domain of the spike (S) protein has very low cross-reactivity between epidemic coronaviruses and common human coronaviruses, whereas the S2 domain of the S protein and the nucleocapsid protein (N protein) show low-level cross-reactivity. Therefore, S1 is considered more specific than the native homotrimer of the S protein, and the receptor-binding domain as an antigen to test patient antibodies is more sensitive than the native N protein. In addition, an increasing number of studies have used multiantigen protein arrays to screen serum from convalescent patients with COVID-19. Antigen combinations demonstrated improved performance compared to each individual antigen. For rapid antigen detection, the sensitivity of the test is higher in the first week of onset of the disease with high viral loads. Highly sensitive and specific immunological diagnostic methods for antibodies or those that directly detect viral antigens in clinical samples would be beneficial for the rapid and accurate diagnosis of SARS-CoV-2 infection.