Severe #COVID19 resulting from Original Antigenic Sin??

May be a contributor. Makes sense

Superb paper evaluating cross-reactivity between donor B cells targeting SARS-CoV-2 and other seasonal Coronas.

This figure (2) is really depicts it well...

1/

medrxiv.org/content/10.110…
This figure depicts one persons different B cells (x axis) across 3 different weeks in time, and how they react to SARS2 spike (y axis - broad categories) and how the secreted antibodies from those B cells reacts with other seasonal coronaviruses (y axis - smaller categories)

2/
What is remarkable is the change over time from day 9 to day 16 in the binding of antibodies to the seasonal coronavirus OC43 by B cells elicited by exposure to the SARS-CoV-2 Spike ectodomain (S ecto).

3/
At day 9 of COVID19 infection, this person had a bunch of B cells, primarily targeting SARS-CoV-2 and not so much OC43. However, as the infection wore on, an abundance of B cells came out of the Woodward to bind OC43 as well.

4/
While these could simply be cross reactive B cells raised against Secto of SARS2, they may indicate “back boosting” of B cells previously raised against OC43....

This backboosting is consistent with an idea of “original antigenic sin”

5/
Original Antigen Sin or OAS is a phenomena where a response to a new pathogen is distracted by previous immune memories to related known pathogens

This distraction can boost memory against the previous virus, at the expense of a diminished response to the new pathogen

6/
The back boosted B cells may not be particularly helpful to fight off the new pathogen (sometimes they could be (ie protective cross reactivity) but sometimes not and if it reduces the ability to develop proper immunity to the new pathogen, we suggest it is original antigenic sin
This terrific new preprint I’m discussing here ☝️is by first author Brenda Westerhuis, and senior authors @MarionKoopmans and Gijsbert P. van Nierop among numerous others!
*woodwork :)
Severe SARS-CoV-2 may be associated with original antigenic sin, as discussed in the paper. But doubtful is the only or even major contributing factor. Nevertheless understanding OAS is crucial for vaccine design, therapy & further refining understanding of this and other viruses
Plus would be delighted to hear from any of the authors on their take on the contribution of OAS to the severity. Necessary but not sufficient perhaps? Simply extra but not necessary for severe SARS2?

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More from @michaelmina_lab

16 Oct
NEW! research shows rapid antigen tests can work in a real world setting - with asymptomatic and symptomatic people. The rapid "paper-strip" antigen test called the BinaxNOW detected >90% of people with high viral loads who are likely to be infectious
nytimes.com/2020/10/15/hea…

1/
I've written about the BinaxNOW from @abbottnews before and why these types of tests can be 'game changers' for our ability to combat this virus


2/
As expected... the BinaxNOW did NOT detect all PCR positive people... only ~60%

BUT DID detect >90% of those with high/contagious virus load. THESE ARE THE PPL THAT MATTER most when trying to cut off transmission chains.

3/
Read 20 tweets
14 Oct
Rapid test data!

@MarionKoopmans and team evaluate rapid “paper-strip” Ag tests against likely contagious virus samples

Here @AbbottNews PanBio and SD Biosensor rapid tests perform very well to detect infectious virus

But, not all tests are equal

medrxiv.org/content/10.110…
1/ Image
The authors evaluated a number of different tests against PCR positive and culture positive specimens. (Culture positive is generally appreciated as representing likely transmissible virus).

They find a large disparity across different tests...

2/
Against culturable virus, they find that the Abbott PanBio Test and the SD Biosensor (Neither available in the US right now) perform very well. An additional 3 tests were evaluated 2, also looked quoted good but the rapigen performed quite poorly.

3/
Read 4 tweets
14 Oct
New research! Starring... Ct values!

We endeavored to ask:

Can we create a brand new metric to know if #COVID19 is increasing/decreasing without staring at case counts & fractions positive - both greatly obscured by test practices.

Yes! w/ Ct values!

medrxiv.org/content/10.110…
In this incredible Tweet thread 👆 @jameshay218 describes the new work - we hope will lay new groundwork for public health authorities to track this/future viruses & if control strategies are working

Work also w co 1st author Lee Kennedy-Shaffer, @mlipsitch & @SanjatKanjilal
One piece that is so cool about this method is we do NOT need a time series of case data to create a trajectory (those little bars on @nytimes website or google that we’ve all stared at for the past 9 months to see trend up vs down in cases). We can do it from a single day!

3/
Read 7 tweets
13 Oct
Important

This virus is not happening in a vacuum where no information existed previously

On Immunity, On testing, On serology, On transmission, On masks, On treatments...

We must stop this narrative that we know nothing of this virus until we learn it anew - again.

1/
The constant drum beat of “we do not know that yet” is tiring.

We KNOW SO MUCH! about SARS-CoV-2 and COVID-19. We knew it before this virus was ever discovered!

We’ve watched since January with study after study reaffirming out expectations of this virus in SO MANY WAYS.

2/
In many we ways we got lucky on this front.

Take HIV for ex. HIV was a new virus for which we generally did have to rewrite the text book

But this virus is different from HIV in that it is behaving in almost all ways per the “textbook”.

3/
Read 19 tweets
13 Oct
So important in this pandemic to NOT let RARE events make the headlines & grab our attention

@NPR - this should NOT be a headline unless you’re going to have daily headlines that say “Millions NOT reinfected today with COVID19”

People are scare enough

npr.org/sections/coron…
Re-exposures are essential to build our immune system. This is not in question. They are like training.

But like anything, when enough people get a re-exposure, there are going to be rare cases here and there that go awry and someone gets more sick the second time.

2/
But this is rare and should NOT be interpreted as people will not build protective immunity and that vaccines will not work.

The take away from this piece should be “In a rare event, a person in the US gets a severe second infection with SARS-CoV-2”

One other point

3/
Read 7 tweets
12 Oct
Trump tested negative on @AbbottNews BinaxNOW test. His MDs are using for evidence of no longer contagious

I don’t disagree - but like use of tests to stop transmission - this is just one piece. Frankly, in this context, it’s being used out of context...

1/
The most important point of deployable rapid tests are that they can be used by many people, frequently!

But should not be used as confirmatory testing of -ve PCRs. This doesn’t make sense and WH use for this confuses how these tests are most appropriately used.

2/
These tests should be to screen ppl (frequently) for +ve results to identify people likely needing to be isolated

In this case @POTUS has had numerous PCR tests and is the president! He can get a viral culture test if he wants to go out w confidence he is not contagious

3/
Read 5 tweets

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