Comprehensive analysis of nasal IgA antibodies induced by intranasal administration of the SARS-CoV-2 spike protein

Reviewer #1 (Public Review):

Despite evidence suggesting the benefits of neutralizing mucosa-derived IgA in the upper airway in protection against the SARS-CoV-2 virus, all currently approved vaccines are administered intramuscularly, which mainly induces systemic IgG. Waki et al. aimed to characterize the benefits of intranasal vaccination at the molecular level by isolating B cell clones from nasal tissue. The authors found that Spike-specific plasma cells isolated from the spleen of vaccinated mice showed significant clonal overlap with Spike-specific plasma cells isolated from nasal tissue. Interestingly, they could not detect any spike-specific plasma cells in the bone marrow or Peyer's patches, indicating that these nose-derived cells did not necessarily home to and reside in these locations, although the Peyer's patch is not a typical plamsa cell niche - rather the lamina propria of the gut would have been a better place to look. Furthermore, they found that multimerization improves the antibody/antigen binding when the antibody is of low or intermediate affinity, but that high-affinity monomeric antibodies do not benefit from multimerization. Lastly, the authors used a competitive ELISA assay to show that multimerization could improve the neutralizing capacity of these antibodies.

The strength of this paper is the cloning of multiple IgA from the nasal mucosae (n=99) and the periphery (n=114) post-SARS-CoV-2 i.n. vaccination to examine the clonal relationship of this IgA with other sites, including the spleen. This analysis provides novel insights into the nature of the mucosal antibody response at the site where the host would encounter the virus, and whether this IgA response disseminates to other tissues.

There were also some weaknesses:

1. The finding that multimerization improves binding and neutralization is not surprising as this was observed before by Wang and Nussenzweig for anti-SARS-CoV-2 IgA (authors should cite Enhanced SARS-CoV-2 neutralization by dimeric IgA. Wang et al, Sci. Transl. Med 2021, 13:3abf1555). In addition, as far as I can tell we cannot ascertain the purity of fractions from the size exclusion chromatography thus I wasn't sure whether the input material used in Fig. 4 was a mixed population of dimer/trimer/tetramer?

2. The flow cytometric assessment of the IgA+ clones from the nasal mucosae was difficult to interpret (Fig. 1B). It was hard for me to tell what they were gating on and subsequently analysing without an IgA-negative population for reference.

3. While the i.n. study itself is large and challenging, it would have been interesting to compare an i.m. route and examine the breadth of SARS-CoV-2 variant S1 binding for IgGs as in Fig. 2A. Are the IgA responses derived from the mucosae of greater breadth than systemic IgG responses? Alternatively, and easier, authors could do some comparisons with well-characterized IgG mAb for affinity and cross-reactivity as a benchmark to compare with the IgAs they looked at.

Overall the authors did a good job of looking at a large range of systemic vs mucosal S1-specific antibodies in the context of an intra-nasal vaccination and this provides additional evidence for the utility of mucosal vaccination approaches for reducing person-to-person transmission.

Reviewer #2 (Public Review):

Summary:
This research demonstrates the breadth of IgA response as determined by isolating individual antigen-specific B cells and generating mAbs in mice following intranasal immunization of mice with SARS-CoV2 Spike protein. The findings show that some IgA mAb can neutralize the virus, but many do not. Notable immunization with Wuhan S protein generates a weak response to the omicron variant.

Strengths:
Detailed analysis characterizing individual B cells with the generation of mAbs demonstrates the response's breadth and diversity of IgA responses and the ability to generate systemic immune responses.

Weaknesses:
The data presentation needs clarity, and results show mAb ability to inhibit SARS-CoV2 in vitro. How IgA functions in vivo is uncertain.