Antibody avidity and neutralizing response against SARS-CoV-2 Omicron
variant after infection or vaccination
Abstract
Background. The recently emerged SARS-CoV-2 Omicron variant
exhibits several mutations on the spike protein, enabling it to escape
the immunity elicited by natural infection or vaccines. Avidity is the
strength of binding between an antibody and its specific epitope. The
SARS-CoV-2 spike protein binds to its cellular receptor with high
affinity, and is the primary target of neutralizing antibodies.
Therefore, protective antibodies should show high avidity. This study
aimed at investigating the avidity of receptor-binding domain (RBD)
binding antibodies and their neutralizing activity against the Omicron
variant in COVID-19 patients and vaccinees. Methods. Samples
collected from COVID-19 patients and from subjects who received
homologous or heterologous vaccination were tested for the avidity of
RBD-binding IgG and neutralizing antibodies against the wild-type
SARS-CoV-2 virus and the Omicron variant. Results. In patients,
RBD-binding IgG titres against the wild-type virus increased with time,
but remained low. High neutralizing titres against the wild-type virus
were not matched by high avidity or neutralizing activity against the
Omicron variant. Vaccinees showed higher avidity than patients. Two
vaccine doses elicited the production of neutralizing antibodies, but
low avidity for the wild-type virus; antibody levels against the Omicron
variant were even lower. Conversely, 3 doses of vaccine elicited high
avidity and high neutralizing antibodies against both the wild-type
virus and the Omicron variant. Conclusions. Repeated
vaccination increases antibody avidity against the spike protein of the
Omicron variant, suggesting that antibodies with high avidity and high
neutralizing potential increase cross-protection against variants that
carry several mutations on the RBD.