The protocol described here outlines a fast and effective method for measuring neutralizing antibodies against the SARS-CoV-2 spike protein by evaluating the ability of convalescent serum samples to inhibit infection by an enhanced green fluorescent protein-labeled vesicular stomatitis virus pseudotyped with spike glycoprotein.
As the COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to evolve, it has become evident that the presence of neutralizing antibodies against the virus may provide protection against future infection. Thus, as the creation and translation of effective COVID-19 vaccines continues at an unprecedented speed, the development of fast and effective methods to measure neutralizing antibodies against SARS-CoV-2 will become increasingly important to determine long-term protection against infection for both previously infected and immunized individuals. This paper describes a high-throughput protocol using vesicular stomatitis virus (VSV) pseudotyped with the SARS-CoV-2 spike protein to measure the presence of neutralizing antibodies in convalescent serum from patients who have recently recovered from COVID-19. The use of a replicating pseudotyped virus eliminates the necessity for a containment level 3 facility required for SARS-CoV-2 handling, making this protocol accessible to virtually any containment level 2 lab. The use of a 96-well format allows for many samples to be run at the same time with a short turnaround time of 24 h.
In December 2019, a novel coronavirus was identified, which we now know as SARS-CoV-2, the causative agent of coronavirus disease 2019 (COVID-19)1. SARS-CoV-2 is a betacoronavirus belonging to the Coronaviridae family. These enveloped viruses comprise a large positive-sense RNA genome and are responsible for respiratory and intestinal infections in both humans and animals2. As of May 2021 there have been more than 157 million reported cases of COVID-19 globally and more than 3.2 million deaths3. The development of an effective vaccine has become the primary goal of researchers around the globe with at least 77 preclinical vaccines under investigation and 90 currently undergoing clinical trials4.
Coronaviruses encode four structural proteins including the spike protein (S), nucleocapsid (N), envelope protein (E), and the membrane protein (M). Entry of SARS-CoV-2 requires interaction of the receptor-binding domain (RBD) of S with the host receptor, human angiotensin-converting enzyme 2 (hACE2), and subsequent membrane fusion following proteolytic cleavage by host cellular serine protease, transmembrane protease serine 2 (TMPRSS2)5,6,7,8,9,10. Humoral immunodominance of the S protein of SARS-CoV has been previously reported and has now been shown also for SARS-CoV-211,12,13. Indeed, neutralizing antibody responses against S have been detected in convalescent serum from SARS-CoV patients 24 months after infection14, highlighting their critical role in the long-term immune response. The S protein has been identified as a promising vaccine target and has thus become a key component of most vaccines under development15,16.
While the rapid detection of neutralizing antibodies is a critical aspect of vaccine development, it may also shed light on the rate of infection and sero-epidemiologic surveillance in impacted areas17. A replication-competent VSV pseudotyped with the SARS-CoV-2 S glycoprotein, in place of the wild-type VSV glycoprotein, to study SARS-CoV-2 infection in biosafety level 2 settings was kindly donated by Whelan and co-workers18. VSV expressing spike (VSV-S) will be utilized to determine the neutralizing antibody response against SARS-CoV-2 spike protein. As the VSV-S used here also expresses enhanced green fluorescent protein (eGFP), eGFP foci may be detected within 24 h to quantify infection, whereas plaque formation can take 48 to 72 h. Summarized here is a simple and effective protocol to determine the ability of convalescent patient serum to neutralize VSV-S-eGFP infection. This method may also be easily adapted to interrogate other potential therapeutics that aim to disrupt the host-viral interaction of SARS-CoV-2 S protein.
1. Plating cells (Day 1) for the production and quantification of SARS-CoV-2 pseudovirus
2. VSV-S-EGFP pseudovirus preparation
3. Titering the VSV-S-eGFP pseudovirus
4. Plating cells (Day 1) for the measurement of neutralization of SARS-CoV-2 pseudovirus by commercially available antibodies and convalescent patient serum
5. Antibody or serum dilutions and infections (Day 2)
NOTE: This protocol can be applied to measure the neutralization of VSV-S-eGFP by both commercially available antibodies and patient serum, as well as serum collected from animals for pre-clinical vaccine development studies. *Take note of the additional steps listed when handling patient/animal serum samples.
6. Imaging and quantification (Day 3)
This protocol outlines a rapid and effective method for detecting neutralizing antibodies against SARS-CoV-2 S protein via inhibition of VSV-S-eGFP pseudovirus infection (quantifiable by loss of eGFP foci detected). A schematic representation of the protocol is depicted in Figure 1. It is recommended that a commercially available antibody be used as a positive control each time the assay is run to ensure the consistency of the assay. Here, we demonstrate a dilution curve using a commercially available neutralizing IgG antibody against SARS-CoV-2 Spike RBD compared to an IgG control (see the Table of Materials for details about both antibodies; Figure 2).
Convalescent patient samples were collected approximately three months post SARS-CoV-2 infection, and pseudovirus neutralization was determined using the method described above (Figure 3). Importantly, minimal background inhibition was observed using healthy donor serum. Furthermore, of note, this assay distinguishes between patients with high symptom severity versus those with milder disease based on the need for hospitalization. In line with other reports, we have observed within our small cohort that hospitalized patients tend to demonstrate increased neutralizing capacity than those who did not require hospitalization19,20. While this may not always be the case for hospitalized versus non-hospitalized patient samples, the ability of the assay to differentiate varying degrees of neutralization is an asset. There may also be cases in which the neutralizing ability of the patient serum is much higher than those demonstrated here. If necessary, the starting dilution of patient serum may be adjusted, or additional dilution steps may be carried out on an additional plate.
Figure 1: Protocol outline demonstrating neutralization of VSV-S-eGFP by convalescent serum. Abbreviations: VSV = vesicular stomatitis virus; eGFP = enhanced green fluorescent protein; COVID-19 = coronavirus disease. Please click here to view a larger version of this figure.
Figure 2: A commercially available neutralizing antibody against SARS-CoV-2 has been used as an example of a positive control alongside IgG as a negative control. The ability of neutralizing antibodies to inhibit viral infection will vary; refer to the information available for the specific antibody purchased to determine which concentration to begin the dilution curve (samples were run in triplicate, error bars represent ± SD). (A) Percent inhibition has been calculated based on the number of eGFP foci detected via (B) fluorescent imaging. Abbreviations: SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2; IgG = immunoglobulin; SD = standard deviation; eGFP = enhanced green fluorescent protein; RBD = receptor-binding domain. Please click here to view a larger version of this figure.
Figure 3: The ability of convalescent serum from patients to neutralize VSV-S-eGFP varies depending on the severity of symptoms. Patient serum samples were collected approximately 3 months post-SARS-CoV-2 infection, and control samples were collected from uninfected patients (samples were run in triplicate, error bars represent ± SD). (A) Percent inhibition has been calculated based on the number of eGFP foci detected via (B) fluorescent imaging. Abbreviations: SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2; SD = standard deviation; eGFP = enhanced green fluorescent protein. Please click here to view a larger version of this figure.
The method described here may be adapted to suit varying lab environments and resources as needed. Importantly, the main limitation of this protocol is the necessity for a containment level 2 space and tissue culture hood. The application of a replicating RNA virus pseudotyped with the SARS-CoV-2 spike, such as VSV-S-eGFP, is a formidable alternative to the SARS-CoV-2 virus, which requires a containment level 3 working area, but may remain a limitation for some groups. All other steps described here are quite flexible and may be performed in nearly any containment level 2 lab. For example, the use of a fluorescent imager with an automated counting feature is not necessary. The 96-well format used here means that only approximately 4 fields of view are required to image nearly the entire well using the lowest objective available (2x).
A manual fluorescent microscope may be used to image multiple fields of each well, and ImageJ (free software) can then be used to quantify eGFP foci. Additionally, we have chosen to use the 96-well format to use the lowest volume of serum possible as well as keeping consumable usage to a minimum. If a fluorescent microscope is unavailable, this protocol may be scaled up to a 6- or 12-well format to detect plaque formation after crystal violet fixation and staining (similar to the viral titer protocol described above). The most critical consideration to keep in mind when performing this protocol is the temperature sensitivity of VSV-S-eGFP. When working with VSV-S-eGFP, always aliquot the virus into small volumes to avoid multiple freeze-thaw cycles, and keep the virus on ice whenever possible. Additionally, robust fluorescent signal may be detected after 24 h; however, we have acquired similar results after imaging at 20 to 28 h post infection.
There are several methods available to detect the presence of antibodies against SARS-CoV-2, including the gold-standard enzyme-linked immunosorbent assay (ELISA) assay, which quantifies the total amount of antibodies against S21,22. Here, we have outlined a fast and reliable method to specifically detect neutralizing antibodies against the immunodominant SARS-CoV-2 spike protein in convalescent serum from patients. We have improved the classical plaque-reduction neutralization test (PRNT) by successfully adapting to a 96-well format, which allows for the detection of neutralizing antibodies in a large number of samples within 24 h by automated quantification of pseudovirus infection, allowing for quick turnaround of final data reports. In addition to detecting neutralizing antibodies within serum, this method can be adapted to perform high-throughput screening of other therapeutic strategies, which aim to directly inhibit the SARS-CoV-2 spike protein interaction with hACE2, such as monoclonal antibodies, recombinant soluble hACE2, or protease inhibitors, to impede viral entry23. With the emergence of several SARS-CoV-2 spike protein variants, it is also important to note that this method may be applied to determine if similar neutralization levels occur following infection with different variants of the virus24.
Other examples of available methods to detect antibodies against SARS-CoV-2 include ELISAs, lentivirus-based assays, and commercial kits to evaluate the neutralizing capacity of serum samples. While the commonly used IgM- or IgG-binding ELISAs are an effective method to determine the presence of antibody concentration to track previous infection or immunization, they are unable to distinguish the binding antibodies’ neutralizing capacity25. Pseudotyped lentivirus-based neutralization assays have an improved safety profile, by using non-replicative viral particles as opposed to replicating VSV-S-eGFP; however, this creates a barrier in terms of testing capacity as lentiviral titers tend to be much lower26,27. There are several commercially available kits that measure the ability of antibodies to block infection via competitive inhibition of the SARS-CoV-2 spike protein (RBD specifically) binding with the hACE2 receptor following incubation with convalescent serum (e.g., CUSABIO, GenScript, Abnova). While many of these kits have reputable sensitivity and specificity, they also tend to be relatively expensive and therefore not ideal for a large volume of samples. The protocol provided here is fast, reliable, and inexpensive. This high-throughput method may be used to test many samples, achieving a robust readout within 24 h.
The authors have nothing to disclose.
We would like to thank the Whelan lab for generously providing the VSV-S-eGFP virus used in this protocol (described in Case et al. 2020). We also thank Drs. Bill Cameron and Juthaporn Cowan (and team) for collecting the patient blood samples (REB protocol ID 20200371-01H). The authors disclose receipt of the following financial support for the research, authorship, and/or publication of this article: This work was funded by the generous support from the Ottawa Hospital Foundation and a grant from the Canadian Institutes of Health Research (#448323) and a Fast Grant from the Thistledown foundation for COVID-19 Science to C.S.I. T.R.J. is funded by an Ontario Graduate Scholarship and cluster Mitacs fellowship. JP is funded by a cluster Mitacs fellowship. T.A. is funded by a CIHR Banting Fellowship. We would also like to thank all the individuals who participated and donated their blood samples for this study.
0.25% trypsin-EDTA (Gibco) | Fisher scientific | LS25200114 | |
ArrayScan VTI HCS | Thermo Fisher Scientific | Automated fluorescent imager | |
carboxymethyl cellulose | Sigma | C5678 | |
Dulbecco's modified Eagle's medium (Gibco) | Fisher scientific | 10-013-CV | |
Dulbecco's modified Eagle's medium (Powder) (Gibco) | Thermo Fisher Scientific | 12-800-017 | |
Dulbecco’s Phosphate-Buffered Saline (DPBS) | Fisher scientific | 21-031-CV | |
HEPES | Fisher scientific | BP-310-500 | |
IgG Isotype Control (mouse) | Thermo Fisher Scientific | 31903 | |
Penicillin/streptomycin | Thermo Fisher Scientific | 15070063 | |
SARS-CoV-2 (2019-nCoV) Spike Neutralizing Antibody, Mouse Mab | SinoBiological | 40592-MM57 | |
Vero E6 cells | ATCC | CRL-1586 |