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    • Non-Invasive Immune Monitoring to Predict COVID-19 Disease Course and Assess SARS-CoV-2 Vaccine Response
    Blog Clinical Research Insights Translational & Lab Insights
    Article

    Non-Invasive Immune Monitoring to Predict COVID-19 Disease Course and Assess SARS-CoV-2 Vaccine Response

    Written By Eva Raschke, PhD
    July 22, 2022 • 3 min. read

    Since the beginning of the SARS-CoV-2 pandemic, a key focus of research has been characterizing the human immune response in relation to the virus. Understanding how immune cell profiles change during acute infection or in response to vaccination may be key to predicting disease course or vaccine efficacy. Over the past decade, epigenetic-based cell counting has emerged as a complement or alternative to flow cytometry for immunophenotyping. This technique utilizes differences in the methylation status of specific gene loci to distinguish target immune cell types from other cell populations, and can be applied to fresh, frozen or paper-spotted dried blood and other bodily fluids or tissues.

    In a recent study, Precision for Medicine collaborated with investigators from the University General Hospital of Valencia in Spain and University Hospitals of the Ruhr-University Bochum in Germany to explore whether epigenetic immune cell counting could advance the efficiency and quality of diagnostic and immune monitoring related to COVID-19. This study leveraged immune cell type-specific epigenetic assays originally developed for use in therapeutic clinical research in oncology and autoimmune disease. Given the availability of 35 existing assays for a wide range of key immune cell populations that are relevant in COVID-19 and the low sample requirements, our objective was to explore the use of epigenetic measurements in a pandemic setting.

    Objectives for Non-Invasive Immune Monitoring

    To evaluate the utility of epigenetic immune cell counting using Precision’s proprietary Epiontis ID technology for predicting COVID-19 disease course and assessing SARS-CoV-2 vaccine response.

    Figure 1. Process of Epigenetic Cell Counting

    Predicting COVID-19 Disease Course

    Approach

    Epigenetic immunophenotyping was performed on whole blood collected from unvaccinated patients who were hospitalized for COVID-19. Various immune cell populations (CD3, CD4, CD8 and regulatory T cells; natural killer (NK) cells; and naïve and memory B cells) were quantified. Measurement results were compared to healthy controls and analyzed for utility in predicting COVID-19 disease course. Disease stage was assigned according to Robert-Koch-Institute classification and disease course was characterized as:

    • Poor prognosis – A change in disease stage from moderate to severe or critical or from severe to critical
    • Good prognosis – A change in disease stage from severe or critical to moderate or from critical to severe or moderate or stably moderate

    Epigenetic immunophenotyping was also performed on nasopharyngeal swab samples to evaluate whether these non-invasive sample types could be used for epigenetic immune monitoring.

    Results

    Epigenetic immunophenotyping of whole blood and nasopharyngeal swab samples showed significantly lower CD3 T cell counts and higher neutrophil counts in patients compared to controls. High CD3 T cell count and higher lymphocyte-to-neutrophil ratio (LNR) correlated positively with favorable clinical outcomes.

    Figure 2. CD3 T cells and Lymphocyte-to-Neutrophil Ratio as Strong Prognostic Markers for Disease Course

    Assessing SARS-CoV-2 Vaccine Response

    Approach

    Dried blood spots were collected from healthy subjects before and after SARS-CoV-2 booster vaccination to assess immune cell population changes associated with vaccine response. Post-vaccination samples were taken at 6 hours, 18 hours, 24 hours, 48 hours and 6 days after vaccination.

    Results

    Epigenetic immune cell counting was performed for CD3 T cells, CCR7+, CTLA4+, TIGIT+, B cells, memory B cells, and IgM+ B cells and showed:

    • T cell responses as early as 6 hours post vaccination
    • Decreases in CD3 T cells, CCR7+ cells, and TIGIT+ cells after vaccination, with the most significant reduction in TIGIT+ cells
    Figure 3. Decreases in Immune Cell Subsets After SARS-CoV-2 Vaccination

    Key Takeaways

    Epigenetic immunophenotyping allows lymphocyte quantification from a range of sample matrices, including nasopharyngeal swabs and DBS, which can be performed by untrained individuals in a point-of-care or home setting.

    The results demonstrated that epigenetic immunophenotyping has potential for predicting the disease course based on a patient’s level of CD3 T cells and neutrophils. Furthermore, epigenetic immunophenotyping allows for close monitoring of COVID-19 vaccination response with immune cell changes observable as early as 6 to 24 hours after vaccination.

    Download this poster to learn more about the application of epigenetic immunophenotyping to diagnostic and immune monitoring in COVID-19 >


    • Eva Raschke, PhD

      Eva Raschke, PhD serves as a subject matter expert for immune monitoring solutions at Precision for Medicine with a focus on the epigenetic immune monitoring technology Epiontis ID. She has supported the development, validation and clinical use of this technology platform in different roles since 2008. Eva obtained a Ph.D. in Molecular Biology from the Ludwig-Maximilians-University Munich.

    Precision for Medicine is part of the Precision Medicine Group, an integrated team of experts that extends Precision for Medicine’s therapeutic development capabilities beyond approval and into launch strategies, marketing communication, and payer insights. As one company, the Precision Medicine Group helps pharmaceutical and life-sciences clients conquer product development and commercialization challenges in a rapidly evolving environment.

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