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Sci Immunol. 2017 Aug 4;2(14). pii: eaan5393. doi: 10.1126/sciimmunol.aan5393. Epub 2017 Aug 4.

Recovery from the Middle East respiratory syndrome is associated with antibody and T-cell responses.

Author information

1
State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510182, China.
2
Department of Microbiology and Immunology, University of Iowa, Iowa City, IA 52242, USA.
3
King Faisal Specialist Hospital and Research Centre, Jeddah, Kingdom of Saudi Arabia. stanley-perlman@uiowa.edu zhaojincun@gird.cn aalshukairi@kfshrc.edu.sa.
4
King Saud bin Abdulaziz for Health Sciences University, Riyadh, Kingdom of Saudi Arabia.
5
King Faisal Specialist Hospital and Research Centre, Jeddah, Kingdom of Saudi Arabia.
6
King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.
7
King Fahd General Hospital, Jeddah, Kingdom of Saudi Arabia.
8
Al Nour Specialist Hospital, Makkah, Kingdom of Saudi Arabia.
9
Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
10
Department of Pathology, University of Iowa, Iowa City, IA 52242, USA.
11
Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA 52242, USA.
12
Department of Microbiology and Immunology, University of Iowa, Iowa City, IA 52242, USA. stanley-perlman@uiowa.edu zhaojincun@gird.cn aalshukairi@kfshrc.edu.sa.
13
State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510182, China. stanley-perlman@uiowa.edu zhaojincun@gird.cn aalshukairi@kfshrc.edu.sa.
14
Guangzhou Eighth People's Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, China.

Abstract

The Middle East respiratory syndrome coronavirus (MERS-CoV) causes a highly lethal pneumonia. MERS was recently identified as a candidate for vaccine development, but most efforts focus on antibody responses, which are often transient after CoV infections. CoV-specific T cells are generally long-lived, but the virus-specific T cell response has not been addressed in MERS patients. We obtained peripheral blood mononuclear cells and/or sera from 21 MERS survivors. We detected MERS-CoV-specific CD4+ and CD8+ T cell responses in all MERS survivors and demonstrated functionality by measuring cytokine expression after peptide stimulation. Neutralizing (PRNT50) antibody titers measured in vitro predicted serum protective ability in infected mice and correlated with CD4+ but not CD8+ T cell responses; patients with higher PRNT50 and CD4+ T cell responses had longer intensive care unit stays and prolonged virus shedding and required ventilation. Survivors with undetectable MERS-CoV-specific antibody responses mounted CD8+ T cell responses comparable with those of the whole cohort. There were no correlations between age, disease severity, comorbidities, and virus-specific CD8+ T cell responses. In conclusion, measurements of MERS-CoV-specific T cell responses may be useful for predicting prognosis, monitoring vaccine efficacy, and identifying MERS patients with mild disease in epidemiological studies and will complement virus-specific antibody measurements.

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