SARS-CoV-2 S蛋白和N蛋白特异性IgM和 IgG抗体动态变化研究  

Kinetics of IgM and IgG antibody specific to SARS-CoV-2 nucleocapsid and spike proteins

作　　者：赵令斋[1] 伍妙梨[2] 冯嘉敏 李凌华[3] 洪文昕[3] 丛峰[2] 张复春[3] ZHAO Ling-zhai;WU Miao-li;FENG Jia-min;LI Ling-hua;HONG Wen-xin;CONG Feng;ZHANG Fu-chun(Guangzhou Institute of Infectious Disease,Guangzhou Eighth People's Hospital,Guangzhou Medical University,Guangzhou,Guangdong 510060,China;不详)

机构地区：[1]广州医科大学附属市八医院传染病研究所,广东广州510060 [2]广东省实验动物监测所,广东广州510633 [3]广州医科大学附属市八医院感染科,广东广州510060

出　　处：《中国病毒病杂志》2021年第6期438-443,共6页Chinese Journal of Viral Diseases

基　　金：国家“十三五”艾滋病和病毒性肝炎等重大传染病防治科技重大专项(2018ZX10102-001);广州市科技计划项目(202008010011)。

摘　　要：目的观察新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患者核衣壳蛋白(nucleocapsid protein, N蛋白)和刺突蛋白(spike glycoprotein, S蛋白)的IgM和IgG抗体动态变化,了解机体对新型冠状病毒(severe gcute respiratory syndrome coronavirus 2,SARS-CoV-2)免疫反应情况,为抗体诊断试剂和疫苗的应用提供科学基础。方法应用N蛋白和S蛋白特异性IgM和IgG抗体免疫荧光层析法试剂盒检测2020年1月21日至2020年4月11日在广州医科大学附属市八医院住院的60例(其中48例轻症,12例重症)COVID-19患者发病9周内的290份系列血浆标本,操作步骤按照试剂盒说明书严格进行。结果 S蛋白抗体荧光定量值随病程呈明显的涨消过程(IgM:27.32~110.10 TU/ml;IgG:56.85~135.00 TU/ml), N蛋白抗体无明显波动,S蛋白抗体定量值在2~7周显著高于N蛋白;抗体阳性率在发病早期随病程逐渐上升,N蛋白IgM和IgG抗体从第1周的12.50%分别升至第4周的峰值51.72%和86.21%;S蛋白IgM和IgG抗体分别从第1周的25.00%和14.58%升至第4周的100.00%,之后开始下降;S蛋白IgM抗体阳性率在发病第2~8周高于N蛋白,IgG抗体阳性率在发病第2、3、4、6和7周高于N蛋白;重症患者第3周N蛋白IgG抗体阳性率(100.00%)高于轻症患者(59.52%)(χ^(2)=9.67,P=0.001 9);第2周S蛋白IgG抗体阳性率(80.00%)也高于轻症患者(46.58%)(χ^(2)=5.57,P=0.018 2)。结论 SARS-CoV-2 S蛋白比N蛋白诱导更高强度的抗体应答,抗体水平与病情严重程度有一定的相关性。Objective To study the kinetics of IgM and IgG antibodies based on nucleocapsid(N) and spike(S) protein of SARS-Co V2-in COVID-19 patients. Methods Immunofluorescent kits were used to detect N and S protein specific IgM and IgG antibodies from Jan.21 to Feb.11, 2020 for the 60 hospitalized COVID-19 patients(48 mild, 12 severe cases) with a total of 290 plasma samples collected 9 weeks after the onset of the disease. Results The level of antibodies specific for S protein varied significantly with the course of disease(Ig M from 27.32 to 110.10 TU/ml, IgG from 56.85 to 135.00 TU/ml), but not for N protein.Higher level of Ig M/Ig G antibodies specific to S protein was observed during the 2—7 week than that to N protein.The seropositive rate of antibodies gradually increased during the early stage of disease.IgM/IgG antibodies specific to N protein changed from 12.50% at the first week to peak level(51.72% and 86.21% respectively) at the 4 th week and those for S protein from 25.00% and 14.58% to 100.00%, and then declined.The seropositive rate of Ig M antibody specific to S protein was higher than that for N protein during 2—8 th week and that for Ig G antibody at 2, 3, 4, 6 and 7 th week.The seropositive rate of Ig G antibody specific to N protein in severe patients at the third week was higher than that in mild patients(100.00% vs 59.52%,χ^(2)=9.67, P=0.001 9), and the same as to Ig G antibody for S protein at the second week after disease onset(80.00% vs 46.58%, χ^(2)=5.57, P=0.018 2). Conclusions SARS-Co V2-S protein can induc stronger antibody response than N protein, and the antibody level was related to the severity of the disease.

关 键 词：新型冠状病毒肺炎 严重急性呼吸综合征冠状病毒-2 核衣壳蛋白 刺突蛋白 抗体 

分 类 号：R512.99[医药卫生—内科学]