Sensitive and Specific Detection of Low-Level Antibody Responses in Mild Middle East Respiratory Syndrome Coronavirus Infections
Nisreen M.A. Okba, V. Stalin Raj, Ivy Widjaja, Corine H. GeurtsvanKessel, Erwin de Bruin, Felicity D. Chandler, Wan Beom Park, Nam-Joong Kim, Elmoubasher A.B.A. Farag, Mohammed Al-Hajri, Berend-Jan Bosch, Myoung-don Oh, Marion P.G. Koopmans, Chantal B.E.M. Reusken, and Bart L. Haagmans
Author affiliations: Erasmus Medical Center, Rotterdam, the Netherlands (N.M.A. Okba, V.S. Raj, C.H. GeurtsvanKessel, E. de Bruin, F.D. Chandler, M.P.G. Koopmans, C.B.E.M. Reusken, B.L. Haagmans); Utrecht University, Utrecht, the Netherlands (I. Widjaja, B.-J. Bosch); Seoul National University College of Medicine, Seoul, South Korea (W.B. Park, N.-J. Kim, M.-D. Oh); Ministry of Public Health, Doha, Qatar (E.A.B.A. Farag, M. Al-Hajri)
Figure 5. Correlation between neutralizing and S1 antibody responses and comparison of different S1 platforms. A) PRNT90 neutralization titers and IgG titers obtained by in-house S1 ELISA among PCR-confirmed MERS-CoV patients and persons with camel contact. Spearman correlation r value and 2-tailed p-value are shown. Yellow shading indicates S1-reactive nonneutralizing antibodies. B) Receiver operator characteristic (ROC) curves comparing the specificity and sensitivity of different MERS-CoV S1–based platforms for the diagnosis of MERS-CoV infections among PCR-confirmed cases. AUC for iELISA (blue) is 1; for S1 microarray (red) is 0.9893; for rELISA (green) is 0.9481. Dotted lines show the cutoff for each assay. AUC, area under the curve; dpd, days postdiagnosis; PRNT90, 90% reduction in plaque reduction neutralization test.
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