SARS-CoV-2−Reactive Mucosal B Cells in the Upper Respiratory Tract of Uninfected Individuals

PURPOSE OF THE STUDY: To investigate the role of the mucosal immune system of the upper respiratory tract in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by exploration of the presence of pre-existing mucosal SARS-CoV-2-reactive B cells in tonsillar tissue specimens. STUDY POPULATION: Tonsillar tissue from pediatric patients who underwent tonsillectomy at The Hospital for Sick Children in Toronto, Canada in 2015 to 2016, before the COVID-19 pandemic. METHODS: Using flow cytometry and fluorescently labeled tetramers to the SARS-CoV-2 Spike protein (S-protein), SARS-CoV-2-reactive B cells were isolated from tonsillar tissue. Monoclonal antibodies (mAbs) recognizing the SARS-CoV-2 S-protein were generated from these B-cells using single-cell real time-polymerase chain reaction and RNA sequencing. Human embryonic kidney derived cell lines expressing SARS-CoV-2 S protein were used for in vitro assays assessing the mAbs' SARS-CoV-2 recognition and Ag binding. RESULTS: Pre-existing SARS-CoV-2-reactive B cells were identified and isolated from prepandemic human tonsillar tissue. The mAbs generated from these B cells recognized the S-protein of the wild-type SARS-CoV-2 virus. Additionally, the mAbs originated from naïve B cells as well as Ag-experienced memory B cells, germinal center B cells, and plasma cells. These mAbs were able to partially block binding in vitro by consistently showing >20% inhibition of S-protein binding. The antibodies did not react to the S-proteins of endemic coronaviruses, human coronavirus-OC43 and human coronavirus-229E. The antibodies also demonstrated significantly reduced recognition of the SARS-CoV-2 B.1.1.7 and B1.315 variants. CONCLUSIONS: B cells contained in the lymphoid tissues of the upper respiratory tract can contain pre-existing SARS-CoV-2 reactive antibodies. Monoclonal antibodies generated by these B-cells demonstrated in vitro SARS-CoV-2 recognition and neutralizing potential. However, these mAbs had reduced binding to the Spike proteins of SARS-CoV-2 variants and did not recognize endemic coronaviruses. The existence of these antibodies may explain the variation in COVID-19 symptom severity since these pre-existing Abs may lead to rapid engagement of the SARS-CoV-2 pathogen as the mucosal surface of the respiratory tract is a main point of contact.