Mubarak A, Alqoufail M, Almutairi S, Alrfaei B, Almotairi A, Aziz I, Almanaa TN, Abdel-Maksoud MA, Farrag MA, Aldreiwish AD, Awadalla ME, Alosaimi B, and Alturaiki W
Ayman Mubarak,1 Mahfoudh Alqoufail,1 Saeedah Almutairi,1 Bahauddeen Alrfaei,2 Abdulaziz Almotairi,3 Ibrahim Aziz,1 Taghreed N Almanaa,1 Mostafa A Abdel-Maksoud,1 Mohamed A Farrag,1 Allolo D Aldreiwish,4 Maaweya E Awadalla,5 Bandar Alosaimi,5 Wael Alturaiki4 1Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia; 2Stem Cells Unit, Department of Cellular Therapy, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Science, MNGHA, Riyadh, Saudi Arabia; 3College of Medicine, Almaarefa University, Riyadh, Saudi Arabia; 4Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia; 5Research Center, King Fahad Medical City, Riyadh Second Health Cluster, Riyadh, Saudi ArabiaCorrespondence: Wael Alturaiki, Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia, Email w.alturaiki@mu.edu.saPurpose: Thymic stromal lymphopoietin (TSLP) is a proinflammatory cytokine produced by epithelial cells that is involved in the activation of allergic disorders. To date, no study has examined TSLP induction during Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Herein, we aimed to study the effects of the recombinant spike protein of MERS-CoV on TSLP production. Additionally, the effects of recombinant human TSLP (rhTSLP) on B cell survival and antibody production were investigated.Patients and Methods: B cells were separated using the Human B Cell Enrichment Kit, and B cell survival was measured using the WST-1 Assay Kit. Enzyme-linked immunosorbent assay (ELISA) was used to measure TSLP levels in the sera of both MERS-CoV-infected (n=4; median age, 53 years) and healthy individuals (n=5; median age, 35 years).Results: We showed that the group of infected patients had significantly higher levels of TSLP than healthy controls (37.6 pg/mL vs 19.8 pg/mL, *p< 0.05). The levels of TSLP in A549 cells were remarkably increased after 48 h of stimulation with recombinant full-length spike protein (rSP) (32.2 pg/mL, p=0.01). B cell survival was greatly enhanced by rhTSLP alone or in combination with rSP (0.02 vs 0.046, and 0.045; **p< 0.01, respectively). Our data also showed a significant synergistic effect of rhTSLP and rSP on the augmented response of IgG antibodies against the spike protein of MERS-CoV compared with unstimulated cells (0.156 vs 0.22; *p< 0.05).Conclusion: TSLP production is induced in vivo after MERS-CoV infection and in vitro after treatment with the rSP of MERS-CoV, which has a significant effect on the survival of B cells. Our data suggest that TSLP can be used as a strong mucosal adjuvant for vaccine development against MERS-CoV infection. However, further investigation is required to study the functional role of TSLP in MERS-CoV infection.Keywords: MERS-CoV, TSLP, recombinants spike protein, B cells