antibody tests LIVE WEBINAR 16 JULY 2020 Dr. Jrg-M. Hollidt - - PowerPoint PPT Presentation

antibody tests
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antibody tests LIVE WEBINAR 16 JULY 2020 Dr. Jrg-M. Hollidt - - PowerPoint PPT Presentation

Comparative overview of currently available SARS-CoV-2 antibody tests LIVE WEBINAR 16 JULY 2020 Dr. Jrg-M. Hollidt Different targets & different results: Exemplary evaluation of screening data Overview of available SARS-CoV-2 antibody


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Comparative overview of currently available SARS-CoV-2 antibody tests

LIVE WEBINAR 16 JULY 2020

  • Dr. Jörg-M. Hollidt
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16.07.2020 | 2 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

Different targets & different results: Exemplary evaluation of screening data Overview of available SARS-CoV-2 antibody tests Precise consideration - theoretical & experience- based reflection on specificity and sensitivity New targets & combinations - the way leading to a reliable result!

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16.07.2020 | 3 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

The Mission

A precise assay needs precise samples. Targeted Procurement

  • f

Human Bio-Materials

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in.vent – Competences

16.07.2020 | 4 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

certified according to: DIN EN ISO 9001 & DIN EN ISO 13485

  • wn Donation Center in Hennigsdorf for donors and patients
  • wn manufacturing site for controls and calibrators
  • ICS: in.vent clinical services for IVD
  • wn IVD R & D Unit

ELISA, rapid tests, coated tubes: proof of principle / transfer to production

  • extensive experience in procuring, handling, processing,

storage and logistics of human Bio-Materials

  • in.vent produces controls and calibrators for IVD manufacturer
  • 50+ highly qualified employees
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Meeting the demands

16.07.2020 | 5 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

inquiry to in.vent samples are in our biorepository picking of samples and shipment to customer start of a procurement project yes no shipment of samples to customer in.vent procures:

  • Any kind of human Bio-Material
  • Large volumes and pools
  • Normal and disease state
  • Clinically defined samples
  • Cohorts and panels

in.vent produces:

  • Controls / Calibrators
  • Proficiency tests
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SARS-CoV-2

16.07.2020 | 6 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

  • Pathogen of the global COVID-19 outbreak 2019/2020
  • Enveloped positive single strand RNA virus: (+)ssRNA-virus
  • Belongs to the family Coronaviridae (crown-like appearance under electron microscope)

Spike protein (S) Envelope protein (E) Membrane protein (M) ssRNA Lipid bilayer Nucleocapsid protein (N) Structure of Coronavirus (09.07.2020)

Spike: Viral receptor protein for adhesion to the host cell Capsid: protein coat around genome

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16.07.2020 | 7 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

Infection cycle of SARS-CoV-2

  • 2/3 of 5´genome encodes polyproteins

which are cleaved into 16 non-structural proteins → forming replication complex

  • 3´end of genome encodes 4 structural

proteins: spike (S), envelope (E), matrix/membrane (M), nucleocapsid (N)

Attachment and fusion of SARS-CoV-2 with host cell by spike protein (source, 09.07.2020). angiotensin converting enzyme 2 receptor

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Variety of coronaviruses

16.07.2020 | 8 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

Highly pathogenic zoonotic viruses ➢ SARS-CoV: 2002, 8.098 infected people, 774 death ➢ MERS-CoV: 2012, 2.494 infected people, 858 death

Rinolophus sinicus (10.07.2020)

Low-pathogenic common coronaviruses ➢ HCoV-OC43 ➢ HCoV-HKU1 ➢ HCoV-NL63 ➢ HCoV-229E

infection rates of 40%-80%

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Sequence identity between corona viruses

16.07.2020 | 9 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

Primary amino acid sequence of the N protein from SARS-CoV (ORF9a, NP_828858.1) and SARS-CoV-2 (ORF9, BCA87368.1) (source, 14.07.2020).

Nucleocapsid protein

  • 90.5 % sequence identity between SARS-CoV-2 and SARS-CoV

(97.2 % sequence similarity)

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Sequence identity between corona viruses

16.07.2020 | 10 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

The spike protein of SARS-CoV-2 shares a high amino acid sequence identity with the other corona viruses.

Ribbon diagrams of SARS-CoV-2 S (A) and SARS-CoV S (D) ectodomain and demonstration of S1 (B, E) and S2 subunits (C, F) (source, 10.07.2020).

  • SARS-CoV-2 and SARS-CoV Spike protein:

76 % sequence identity

  • S2 subunit: 88 % sequence idnetity

→ Sequence and conformational conservation suggests cross-reactivity of neutralizing Antibodies

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Dependence of post translational modifications

16.07.2020 | 11 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

Glycosylation of SARS-CoV-2 Spike protein influences:

  • Folding
  • Viral pathogenesis
  • Priming by host proteases
  • Antibody recognition

Glycosylation of SARS-CoV-2 pike S protein (source, 10.07.2020).

SARS-CoV-2 S comprise 22 N-linked glycosylations per protomer → at least 17 occupied

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Antigens of SARS-CoV-2

16.07.2020 | 12 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

Several antigenes of SARS-CoV-2 are available:

  • Nucleocapsid protein
  • Spike protein
  • Full-length S1 subunit
  • S1 N-terminal domain
  • Receprot binding domain
  • Fulll-length S2 subunit
  • Ectodomain (EDC)
  • Envelope protein
  • Membrane protein
  • Non structural protein (NSP) 1, 2, 5, 7, 8,

9, 10, 13, 14, 15

  • […]

Search entries: „SARS-CoV-2“; „protein“

  • 282 hits at BIOZOL Diagnostics
  • 241 hits at antibodies-online

Differing in label, application, purity, modifications, origin of expression, reactivity […]

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Seroconversion/ Immunstatus

16.07.2020 | 13 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

SARS-CoV-2 is different:

  • SARS-CoV-1:

➢ IgG detectable for 4-5 month ➢ Decreasing 2-3 years after seroconversion

  • MERS-CoV:

➢ Neutralizing Abs persisted up to 34 month after recovery

Estimated Variation over time in diagnostic tests for detection of SARS-CoV-2 (source, 10.07.2020)

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16.07.2020 | 14 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

Diagnostics

Company Ab class Antigen certification Abbott Diagnostics IgG N CE-IVD

  • A. Menarini Diagnostics

IgG, IgM No information CE-IVD Bestbion dx GmbH IgG, IgM, IgA No information CE-IVD Bio-Rad Laboratories GmbH IgG, IgM, IgA N CE-IVD DiaSorin Deutschland GmbH IgG S1, S2 CE-IVD FDA-EUA* EUROIMMUN Medizinische Labordiagnostika AG IgG, IgA; IgG, IgM S1; N (diagnostic relevant epitops) CE-IVD FDA-EUA* GA Generic Assays GmbH IgG, IgM; IgG+ Combind N+S N, S1, S2 CE-IVD Medac GmbH Diagnostika IgG, IgM N, S CE-IVD MIKROGEN GmbH IgG, IgA N CE-IVD Ortho Clinical Diagnostics Total Ig, IgG S1 CE-IVD FDA-EUA* Roche Diagnostics Deutschland GmbH IgG, IgM N CE-IVD, FDA-EUA* Institut Virion/Serion GmbH IgG, IgM, IgA Ectodomain N, Ectodomain CE-IVD VIROTECH Diagnostics GmbH IgG, IgM, IgA N CE-IVD Aidian Germany GmbH IgG, IgM CE-IVD Company Ab class Antigen certification Assure Tech IgG, IgM N, S1 CE-IVD Augurix IgG, IgM N, S1 CE-IVD CeGaT IgG S1 CE-IVD IBL International IgG, IgM, IgA Full-length N CE-IVD Bio-Rad Total Ig N CE-IVD FDA-EUA* Autobio IgG, IgM S FDA-EUA* Babson Diagnostics IgG S FDA-EUA* Biohit Healthcare IgG, IgM N FDA-EUA* Cellex, Inc. IgG, IgM N, S FDA-EUA* Emory Medical Laboratories IgG RBD FDA-EUA* Hangzhou Biotest Biotech IgG, IgM RBD FDA-EUA* Hangzhou Laihe Biotech IgG, IgM S FDA-EUA* Healgen IgG, IgM S1 FDA-EUA* InBios IgG S FDA-EUA* Mount Sinai Hospital IgG RBD FDA-EUA* Siemens Healthcare Diagnostics Total Ig RBD FDA-EUA* Vibrant America Clinical Labs IgG, IgM S1, RBD, S2, N FDA-EUA* Wadsworth Center, NY State Department of Health Total Ig Full-length N (from SARS-CoV-1) FDA-EUA* *FDA-EUA: Emergency Use Authorization by FDA

Sources unless otherwise deposited: U.S. Food & Drug Administration; Trillium Diagnostik (14.07.2020)

[…]

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Diagnostics

16.07.2020 | 15 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

331 regulatory authorized diagnostic tests → 164 serological assays (total 230)

138 26 66

Total serological assays

CE mark (approval to sell in Europe) FDA-Emergency Use Authorization FDA do not distribute

Serological diagnostics overview (source; 14.07.2020)

6 14 11

IgG IgG, IgM total Ig

12 11 8

Spike protein Nucleocapsid protein N, S combined

31 authorized serological assays

3x S1, 1x S1, S2 4x whole S 4x RBD

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Characteristics of selected tests

16.07.2020 | 16 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

Company AG Principle Cut-off Sensitivity Specificity Interferences Diasorin source Roche source IBL source GA Generic Assays S1, S2 NP NP S1, S2, NP Magnetic beads coated with S1/S2 Double- antigen- sandwich, CLIA ELISA ELISA < 12 AU/mL negative; ≥ 15 AU/mL positive COI ≥ 1 = reactive 10 NovaTec Units (NTU) 1 Binding Index (BI) 97.9 % (48 samples taken > 15 days) 99.5 % (185 samples of 103 PCR positive patients; ≥14days) 9-11 days 40 % (N=10) ≥12days 100 % (N=9) >10 days 97.2 % IgG; 94.4 % IgM (N=36) 98.5 % (1000 blood donors) 99.8 % (6.305 lab. Routine; 4.148 blood donors 99.24 % (133 blood donors) 100 % (1000 blood donors,

  • lab. routine)

No cross reactivity: HuCoV OC43, NL63, 229E, MERS-CoV (1-2 samples) No cross reactivity: HuCoV OC43, HKU1, 229E

< 15 % signal changes: Albumin, Bilirubin, Cholesterol, Hg, Triglycerides (3 samples); no cross-reactivity: 14 paramters No crossreactions: HSV, EBV, CMV, HCV, HIV, HBsAg, Syphilis, Hg, Bilirubin, Triglyceride, Serum proteins, RF , etc.

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Dependence of sampling day

16.07.2020 | 17 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

Days post syndrome onset N samples N positive N equivocal N negative Sensitivity (eqv excluded)

0 – 5 13 1 12 8 % 6 – 8 10 4 6 40 % 9 – 11 10 4 6 40 % ≥ 12 9 9 100 % Sensitivity improves when samples are collected later after the infection onset.

IBL SARS-CoV-2 (COVID-19) IgG ELISA; antigen: full-length Nucleocapsid protein (source, 14.07.2020)

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16.07.2020 | 18 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

in.vent results

Roche vs. IBL - IgG

6 samples (plasma)

Roche vs. IBL - IgM

6 samples (plasma)

IBL positive IBL negative Roche positive Roche negative

2 4 4 2 2 2 2

IBL positive IBL negative Roche positive Roche negative

2 4 2 2 4 4 PCR positive

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16.07.2020 | 19 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

in.vent results

Company IBL ELISA EDI EISA In-House ELISA Antigene Nucleocapsid Nucleocapsid Nucleocapsid Spike S1 Spike S2 Antibody class IgG IgM IgA IgG IgM IgG IgM IgA IgG IgM IgA IgG IgM IgA N positive 10 4 5 3 1 10 12 13 12 7 2 3 9 2 N negative 35 41 40 42 44 35 33 32 33 38 43 42 36 43 % positive 20% 8% 10% 6% 2% 22% 27% 29% 27% 16% 4% 7% 20% 4%

IBL vs. EDI vs. In-House – 45 plasma samples Inconsistent results between samples

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16.07.2020 | 20 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

in conclusion

Diversity Immune response Clinical use Clinical developement of the disease Protection Time Harmonisation / standardisation Predicitve value

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16.07.2020 | 21 in.vent Diagnostica GmbH | Dr. J.-M. Hollidt | SARS-CoV-2 antibody tests

in.vent vs. Corona

We support your research & development!

Positive control for clinical characterization of an assay Analysis for different antigens and interfering substances Validation of an assay by determining specifity Large-volume donations from recovered SARS-CoV-2 patients for manufacturers and suppliers of control material SARS-CoV-2 Positive Specimens SARS-CoV-2 Distinction Panel

(including different viruses like CMV, EBV and more)

Analytical Specificity Panel for SARS-COV-2 SARS-CoV-2 Serum or Plasma Bulk

(characterized for SARS-CoV-2 IgG, IgM) find more in.vent SARS-CoV-2 Products at: www.inventdiagnostica.de samples are available 24/7 at: www.centralbiohub.com Contact: Ms. Julia Ettlinger will be happy to assist you: j.ettlinger@inventdiagnostica.de +49 (0) 3302 55 199-250

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Thanks for your attention!

Take care of yourself and stay healthy!