COVID-19 symptoms vary in intensity from mild to severe; although current strains of the virus tend to cause less severe signs and symptoms overall. New research from Emory University offers more precise prediction of severity by measuring autoantibodies found in nasal cavities – leading to tailored and personalized treatment plans tailored specifically for high risk individuals such as taking Paxlovid within one week of symptoms showing up in order to mitigate an extreme response.
Science Translational Medicine published the findings from this groundbreaking research project that followed nearly 200 COVID-19 patients ranging in severity from mild to severe for almost two years, tracking antibodies both blood- and nasal-borne for nearly two years, finding that 70% or more with mild/moderate COVID-19 developed certain autoantibodies – normally indicative of disease – in their nasal airways that was actually linked with decreased symptoms, better antiviral immunity, and quicker healing times.
These findings indicate that autoantibodies present in the nasal mucosa may play a protective role and help regulate immune function to limit excessive inflammation and combat viruses more efficiently.
Autoantibodies have traditionally been linked with pathology and poor prognosis, leading to more inflammation that would indicate more severe disease. But our findings with COVID-19 show something unique; nasal autoantibodies appeared soon after infection targeting an important proinflammatory molecule produced by patient cells; these autoantibodies may prevent excessive inflammation as people recovered while simultaneously serving to keep things balanced in the body.”
Eliver Ghosn, senior author on this paper and faculty member at both Emory Vaccine Center and Lowance Center for Human Immunology is responsible.
Studies conducted on COVID-19 patients have previously suggested that autoantibodies present in their blood can predispose them to life-threatening disease; however, such research often overlooks infection sites like the nose. A new study shows how immune responses mounted against viruses differ depending on where infection occurred – in short: nasal autoantibodies provide protection while blood autoantibodies signal severe infection.
“The key to solving this puzzle was looking directly at the site of infection – in this instance, nasal secretions,” according to Ghosn. While autoantibodies in blood samples had been linked with poor prognosis and recovery was likely unlikely; producing them quickly after infection meant an effective recovery timeframe and prompt return.
FlowBEAT: An efficient diagnostic tool
Ghosn lab developed the biotechnology tool FlowBEAT in order to enable more precise measurement of antibodies produced locally at sites of infection in nasal cavities and biological samples, and to quantify various kinds of antibodies produced there – this could eventually provide insight into testing other respiratory viruses like flu or RSV.
“Historically, technology for measuring antibodies had low sensitivity and efficiency because its scope was limited to measuring one or a few antibodies at once,” notes Ghosn. With FlowBEAT’s combination test for all human antibody types against multiple viral and host antigens in one tube – making a much more sensitive, efficient, scalable way of testing autoantibodies present that also predict the severity of symptoms a reality.”
Next, researchers aim to discover whether this remarkable mechanism for controlling COVID-19 infection in the nose also plays a part in other respiratory illnesses like flu or RSV.
“If nasal autoantibody response proves to be a widespread mechanism for protecting us against viral infections, this discovery could represent a breakthrough in understanding protective immunity.” Ghosn suggests. We would then interpret autoantibodies through an entirely novel lens; hopefully sparking off new lines of research or providing improved therapeutic options against common respiratory illnesses.
Ghosn Lab researchers are now in collaboration with Emory’s patent office to develop a predictive diagnostic tool utilizing “leftover” samples from standard nasal swabs commonly used as diagnostic tests for COVID-19.
“Currently, our approach to infection analysis entails either anticipating risk before an outbreak occurs or reviewing its course long after recovery has taken place,” according to PhD candidate Ben Babcock of Ghosn Lab’s GLAST program. But imagine a world in which physicians and patients could capture immune response real time right in clinic – an on-demand test offering real time data would allow faster, smarter treatment decisions by both sides.”
This study was part of an expansive collaboration among Emory Ghosn Lab and Sulggi Lee and Nadia Roan from Gladstone Institutes (UCSF and Gladstone), as well as Drs F.Eun-Hyung Lee, Inaki Sanz, Rabin Tirouvanziam from Emory laboratories respectively.
Journal Reference:Babcock, B. R. and colleagues (2024). Transient anti-interferon autoantibodies associated with recovery from COVID-19 infection – Science Translational Medicine doi.org/10.1126/scitranslmed.adq1789
