Patients develop subclinical to severe respiratory tract infections, with an overall 35.4% case fatality rate. Studies of host immune function, important for understanding responses that protect against subsequent exposure to MERS and for prevalence studies have focused on measurements of anti-virus antibody. MERS-CoV antibodies tend to be transient, making these studies difficult. CoV-specific T cell responses are generally long-lived but nothing is known about this aspect of the immune response in MERS patients. We identified MERS-CoV-specific CD4 and CD8 T cell responses in all MERS survivors, and demonstrated functionality by measuring cytokine expression after peptide stimulation. Neutralizing antibody titers correlated with CD4 T cell responses, but not with CD8 T cell responses. The magnitude of the antibody titer predicted its protective ability in an animal model of MERS. Patients with higher antibody titers and CD4 T cell responses had longer ICU stays, shed virus for a longer time and required ventilation. Patients with undetectable or very low MERS-CoV-specific antibody responses had measurable virus-specific CD8 T cell responses that were indistinguishable from those of the total pool of patients. No correlations were observed between age, disease severity, comorbidities and MERS-CoV-specific CD8 T cell responses.

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5
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2017
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Zhao, Jingxian; Alshukairi, Abeer N; Baharoon, Salim A et al. (2017) Recovery from the Middle East respiratory syndrome is associated with antibody and T-cell responses. Sci Immunol 2:
Houser, Katherine V; Gretebeck, Lisa; Ying, Tianlei et al. (2016) Prophylaxis With a Middle East Respiratory Syndrome Coronavirus (MERS-CoV)-Specific Human Monoclonal Antibody Protects Rabbits From MERS-CoV Infection. J Infect Dis 213:1557-61
Wang, Lingshu; Shi, Wei; Joyce, M Gordon et al. (2015) Evaluation of candidate vaccine approaches for MERS-CoV. Nat Commun 6:7712