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Saliva SARS-CoV-2 Antibody Prevalence in Children.
Microbiol Spectr. 2021 10 31; 9(2):e0073121.MS

Abstract

COVID-19 patients produce circulating and mucosal antibodies. In adults, specific saliva antibodies have been detected. Nonetheless, seroprevalence is routinely investigated, while little attention has been paid to mucosal antibodies. We therefore assessed SARS-CoV-2-specific antibody prevalence in serum and saliva in children in the Netherlands. We assessed SARS-CoV-2 antibody prevalence in serum and saliva of 517 children attending medical services in the Netherlands (irrespective of COVID-19 exposure) from April to October 2020. The prevalence of SARS-CoV-2 spike (S), receptor binding domain (RBD), and nucleocapsid (N)-specific IgG and IgA were evaluated with an exploratory Luminex assay in serum and saliva and with the Wantai SARS-CoV-2 RBD total antibody enzyme-linked immunosorbent assay in serum. Using the Wantai assay, the RBD-specific antibody prevalence in serum was 3.3% (95% confidence interval [CI]. 1.9 to 5.3%). With the Luminex assay, we detected heterogeneity between antibodies for S, RBD, and N antigens, as IgG and IgA prevalence ranged between 3.6 and 4.6% in serum and between 0 and 4.4% in saliva. The Luminex assay also revealed differences between serum and saliva, with SARS-CoV-2-specific IgG present in saliva but not in serum for 1.5 to 2.7% of all children. Using multiple antigen assays, the IgG prevalence for at least two out of three antigens (S, RBD, or N) in serum or saliva can be calculated as 3.8% (95% CI, 2.3 to 5.6%). Our study displays the heterogeneity of the SARS-CoV-2 antibody response in children and emphasizes the additional value of saliva antibody detection and the combined use of different antigens. IMPORTANCE Comprehending humoral immunity to SARS-CoV-2, including in children, is crucial for future public health and vaccine strategies. Others have suggested that mucosal antibody measurement could be an important and more convenient tool to evaluate humoral immunity compared to circulating antibodies. Nonetheless, seroprevalence is routinely investigated, while little attention has been paid to mucosal antibodies. We show the heterogeneity of SARS-CoV-2 antibodies, in terms of both antigen specificity and differences between circulating and mucosal antibodies, emphasizing the additional value of saliva antibody detection next to detection of antibodies in serum.

Authors+Show Affiliations

Department of Pediatric Infectious Diseases, Rheumatology, & Immunology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.Department of Medical Microbiology and Infection Prevention, Amsterdam Institute of Infection and Immunity, Amsterdam UMC, University of Amsterdamgrid.7177.6, Amsterdam, The Netherlands.Department of Pediatric Infectious Diseases, Rheumatology, & Immunology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.Department of Pediatrics, Flevoziekenhuis, Almere, The Netherlands.Department of Pediatrics, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands.Department of Pediatrics, Amstellandziekenhuis, Amstelveen, The Netherlands.Department of Pediatrics, Amstellandziekenhuis, Amstelveen, The Netherlands.Department of Pediatrics, Zaans Medisch Centrum, Zaandam, The Netherlands.Department of Medical Microbiology and Infection Prevention, Amsterdam Institute of Infection and Immunity, Amsterdam UMC, University of Amsterdamgrid.7177.6, Amsterdam, The Netherlands.Department of Medical Microbiology and Infection Prevention, Amsterdam Institute of Infection and Immunity, Amsterdam UMC, University of Amsterdamgrid.7177.6, Amsterdam, The Netherlands.Department of Medical Microbiology and Infection Prevention, Amsterdam Institute of Infection and Immunity, Amsterdam UMC, University of Amsterdamgrid.7177.6, Amsterdam, The Netherlands.Department of Medical Microbiology and Infection Prevention, Amsterdam Institute of Infection and Immunity, Amsterdam UMC, University of Amsterdamgrid.7177.6, Amsterdam, The Netherlands.Department of Experimental Immunohematology, Sanquin Research, Amsterdam, The Netherlands. Landsteiner Laboratory, Amsterdam UMC, University of Amsterdamgrid.7177.6, Amsterdam, The Netherlands.Department of Experimental Immunohematology, Sanquin Research, Amsterdam, The Netherlands. Landsteiner Laboratory, Amsterdam UMC, University of Amsterdamgrid.7177.6, Amsterdam, The Netherlands.Landsteiner Laboratory, Amsterdam UMC, University of Amsterdamgrid.7177.6, Amsterdam, The Netherlands. Department of Immunopathology, Sanquin Research, Amsterdam, The Netherlands.Department of Experimental Immunohematology, Sanquin Research, Amsterdam, The Netherlands. Landsteiner Laboratory, Amsterdam UMC, University of Amsterdamgrid.7177.6, Amsterdam, The Netherlands.Landsteiner Laboratory, Amsterdam UMC, University of Amsterdamgrid.7177.6, Amsterdam, The Netherlands. Department of Immunopathology, Sanquin Research, Amsterdam, The Netherlands.Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. Department of Pediatrics, Tergooi Hospital, Blaricum, The Netherlands.Department of Medical Microbiology and Infection Prevention, Amsterdam Institute of Infection and Immunity, Amsterdam UMC, University of Amsterdamgrid.7177.6, Amsterdam, The Netherlands.Department of Pediatric Infectious Diseases, Rheumatology, & Immunology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

34523985

Citation

Keuning, Maya W., et al. "Saliva SARS-CoV-2 Antibody Prevalence in Children." Microbiology Spectrum, vol. 9, no. 2, 2021, pp. e0073121.
Keuning MW, Grobben M, de Groen AC, et al. Saliva SARS-CoV-2 Antibody Prevalence in Children. Microbiol Spectr. 2021;9(2):e0073121.
Keuning, M. W., Grobben, M., de Groen, A. C., Berman-de Jong, E. P., Bijlsma, M. W., Cohen, S., Felderhof, M., de Groof, F., Molanus, D., Oeij, N., Rijpert, M., van Eijk, H. W. M., Koen, G., van der Straten, K., Oomen, M., Visser, R., Linty, F., Steenhuis, M., Vidarsson, G., ... Pajkrt, D. (2021). Saliva SARS-CoV-2 Antibody Prevalence in Children. Microbiology Spectrum, 9(2), e0073121. https://doi.org/10.1128/Spectrum.00731-21
Keuning MW, et al. Saliva SARS-CoV-2 Antibody Prevalence in Children. Microbiol Spectr. 2021 10 31;9(2):e0073121. PubMed PMID: 34523985.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Saliva SARS-CoV-2 Antibody Prevalence in Children. AU - Keuning,Maya W, AU - Grobben,Marloes, AU - de Groen,Anne-Elise C, AU - Berman-de Jong,Eveline P, AU - Bijlsma,Merijn W, AU - Cohen,Sophie, AU - Felderhof,Mariet, AU - de Groof,Femke, AU - Molanus,Daniel, AU - Oeij,Nadia, AU - Rijpert,Maarten, AU - van Eijk,Hetty W M, AU - Koen,Gerrit, AU - van der Straten,Karlijn, AU - Oomen,Melissa, AU - Visser,Remco, AU - Linty,Federica, AU - Steenhuis,Maurice, AU - Vidarsson,Gestur, AU - Rispens,Theo, AU - Plötz,Frans B, AU - van Gils,Marit J, AU - Pajkrt,Dasja, Y1 - 2021/09/15/ PY - 2021/9/16/pubmed PY - 2021/11/17/medline PY - 2021/9/15/entrez KW - SARS-CoV-2 KW - antibodies KW - children KW - humoral immunity KW - prevalence KW - saliva SP - e0073121 EP - e0073121 JF - Microbiology spectrum JO - Microbiol Spectr VL - 9 IS - 2 N2 - COVID-19 patients produce circulating and mucosal antibodies. In adults, specific saliva antibodies have been detected. Nonetheless, seroprevalence is routinely investigated, while little attention has been paid to mucosal antibodies. We therefore assessed SARS-CoV-2-specific antibody prevalence in serum and saliva in children in the Netherlands. We assessed SARS-CoV-2 antibody prevalence in serum and saliva of 517 children attending medical services in the Netherlands (irrespective of COVID-19 exposure) from April to October 2020. The prevalence of SARS-CoV-2 spike (S), receptor binding domain (RBD), and nucleocapsid (N)-specific IgG and IgA were evaluated with an exploratory Luminex assay in serum and saliva and with the Wantai SARS-CoV-2 RBD total antibody enzyme-linked immunosorbent assay in serum. Using the Wantai assay, the RBD-specific antibody prevalence in serum was 3.3% (95% confidence interval [CI]. 1.9 to 5.3%). With the Luminex assay, we detected heterogeneity between antibodies for S, RBD, and N antigens, as IgG and IgA prevalence ranged between 3.6 and 4.6% in serum and between 0 and 4.4% in saliva. The Luminex assay also revealed differences between serum and saliva, with SARS-CoV-2-specific IgG present in saliva but not in serum for 1.5 to 2.7% of all children. Using multiple antigen assays, the IgG prevalence for at least two out of three antigens (S, RBD, or N) in serum or saliva can be calculated as 3.8% (95% CI, 2.3 to 5.6%). Our study displays the heterogeneity of the SARS-CoV-2 antibody response in children and emphasizes the additional value of saliva antibody detection and the combined use of different antigens. IMPORTANCE Comprehending humoral immunity to SARS-CoV-2, including in children, is crucial for future public health and vaccine strategies. Others have suggested that mucosal antibody measurement could be an important and more convenient tool to evaluate humoral immunity compared to circulating antibodies. Nonetheless, seroprevalence is routinely investigated, while little attention has been paid to mucosal antibodies. We show the heterogeneity of SARS-CoV-2 antibodies, in terms of both antigen specificity and differences between circulating and mucosal antibodies, emphasizing the additional value of saliva antibody detection next to detection of antibodies in serum. SN - 2165-0497 UR - https://www.unboundmedicine.com/medline/citation/34523985/Saliva_SARS_CoV_2_Antibody_Prevalence_in_Children_ L2 - https://doi.org/10.1128/Spectrum.00731-21 DB - PRIME DP - Unbound Medicine ER -