Pre-existing Hemagglutinin Stalk Antibodies Correlate with Protection of Lower Respiratory Symptoms in Flu-Infected Transplant Patients

Teresa Aydillo, Alba Escalera, Shirin Strohmeier, Sadaf Aslam, Javier Sanchez-Cespedes, Juan Ayllon, Cristina Roca-Oporto, Pilar Perez-Romero, Miguel Montejo, Joan Gavalda, Patricia Munoz, Francisco Lopez-Medrano, Jordi Carratala, Florian Krammer, Adolfo García-Sastre, Elisa Cordero

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Hemagglutination-inhibitory antibodies are usually highly strain specific with little effect on infection with drifted or shifted strains. The significance of broadly cross-reactive non-HAI anti-influenza antibodies against conserved domains of virus glycoproteins, such as the hemagglutinin (HA) stalk, is of great interest. We characterize a cohort of 40 H1N1pmd09 influenza-infected patients and identify lower respiratory symptoms (LRSs) as a predictor for development of pneumonia. A binomial logistic regression of log10 pre-existing antibody values shows that the probability of LRS occurrence decreased with increased anti-HA full-length and stalk antibody ELISA titers. However, a multilevel logistic regression model adjusted by other potential serocorrelates demonstrates that only antibodies directed against the stalk of HA correlate with protection from lower respiratory infection, limiting disease progression. Our predictive model indicates that a threshold of protective immunity based on broadly cross-reactive HA stalk antibodies could be feasible.

Original languageEnglish
Article number100130
JournalCell Reports Medicine
Volume1
Issue number8
DOIs
StatePublished - 17 Nov 2020

Keywords

  • correlates of protection
  • influenza antibodies
  • transplant patients
  • viral pneumonia

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