1. Humoral Correlates of Protection Against Influenza A/H3N2 Virus Infection.
- Author
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Hoy G, Stadlbauer D, Balmaseda A, Kuan G, López R, Carreno Quiroz JM, Ojeda S, Sánchez N, Yellin T, Plazaola M, Frutos A, Krammer F, and Gordon A
- Subjects
- Humans, Adult, Male, Adolescent, Female, Child, Young Adult, Middle Aged, Child, Preschool, Nicaragua, Infant, Neuraminidase immunology, Aged, Family Characteristics, Enzyme-Linked Immunosorbent Assay, Immunity, Humoral, Influenza Vaccines immunology, Influenza Vaccines administration & dosage, Influenza, Human prevention & control, Influenza, Human immunology, Influenza A Virus, H3N2 Subtype immunology, Antibodies, Viral blood, Antibodies, Viral immunology, Hemagglutination Inhibition Tests, Hemagglutinin Glycoproteins, Influenza Virus immunology
- Abstract
Background: Influenza virus remains a threat to human health, but gaps remain in our knowledge of the humoral correlates of protection against influenza virus A/H3N2, limiting our ability to generate effective, broadly protective vaccines. The role of antibodies against the hemagglutinin (HA) stalk, a highly conserved but immunologically subdominant region, has not been established for influenza virus A/H3N2., Methods: Household transmission studies were conducted in Managua, Nicaragua, across 3 influenza seasons. Household contacts were tested for influenza virus infection using reverse-transcription polymerase chain reaction. We compared preexisting antibody levels against full-length HA, HA stalk, and neuraminidase (NA) measured by enzyme-linked immunosorbent assay, along with hemagglutination inhibition assay titers, between infected and uninfected participants., Results: A total of 899 individuals participated in household activation, with 329 infections occurring. A 4-fold increase in initial HA stalk titers was independently associated with an 18% decrease in the risk of infection (adjusted odds ratio [aOR], 0.82 [95% confidence interval {CI}, .68-.98]; P = .04). In adults, anti-HA stalk antibodies were independently associated with protection (aOR, 0.72 [95% CI, .54-.95]; P = .02). However, in 0- to 14-year-olds, anti-NA antibodies (aOR, 0.67 [95% CI, .53-.85]; P < .01) were associated with protection against infection, but anti-HA stalk antibodies were not., Conclusions: The HA stalk is an independent correlate of protection against A/H3N2 infection, though this association is age dependent. Our results support the continued exploration of the HA stalk as a target for broadly protective influenza vaccines but suggest that the relative benefits may depend on age and influenza virus exposure history., Competing Interests: Potential conflicts of interest. The Icahn School of Medicine at Mount Sinai has filed patent applications relating to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological assays, Newcastle disease virus–based SARS-CoV-2 vaccines, influenza virus vaccines, and influenza virus therapeutics that list F. K. as co-inventor. Some of this intellectual property has been licensed and F. K. receives royalty payments from it. Mount Sinai has spun out a company, Kantaro, to market serological tests for SARS-CoV-2 and another company, Castlevax, to develop SARS-CoV-2 vaccines; F. K. is co-founder and scientific advisory board member of Castlevax. F. K. has consulted for Merck, Curevac, Seqirus, and Pfizer and is currently consulting for 3rd Rock Ventures, GSK, Gritstone, and Avimex. The Krammer laboratory is also collaborating with Dynavax on influenza vaccine development. A. G. has served on a respiratory syncytial virus vaccine advisory board for Janssen. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
- Published
- 2024
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