Investigating the role autoantibodies play among Native Hawaiians and other Pacific Islanders in increased severity of COVID-19

Hardisty, Sabrina
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Background: In Hawaii, the Native Hawaiian and other Pacific Islander (NHPI) communities have reported the highest rates of COVID-19. NHPI populations experience higher rates of autoimmune diseases such as type 1 diabetes, systemic lupus erythematosus, and rheumatoid arthritis, which are linked to increased production of autoantibodies, antibodies that target self-antigens and interfere with the typical immune response. Further, increased autoantibody production has been associated with increased disease severity in COVID-19. Objective: To investigate the relationship between autoantibodies and SARS-CoV-2 infection among NHPI Hypothesis: NHPI have an increased tendency to produce autoantibodies upon SARS-CoV-2 infection due to their greater predisposition to develop autoimmunity as compared to non-NHPI. Methods: Using Luminex-based assay, we evaluated a panel of 20 autoantibodies associated with autoimmune diseases in 152 blood samples collected from naturally infected (NI) and/or vaccinated (VX) NHPI (n=58) and non-NHPI (n=94), and negative controls (NEG), (n=14). Results: Several autoantibodies were detected in subjects who were NI with SARS-CoV-2. There were no differences in the autoantibody levels between NHPI and non-NHPI. Interestingly, SARS-CoV-2 naive VX individuals, both NHPI and non-NHPI, had a reduced tendency to produce autoantibodies, and this was even lower than control subjects (NEG). Conclusions: The data did not support our initial hypothesis that NHPI produced higher levels of autoantibodies compared to non-NHPI after COVID-19 infection. However, the reduced levels of autoantibodies detected in both NHPI and non-NHPI vaccinated individuals against COVID-19 suggest that vaccination dampens the production of autoantibodies. Individuals who have been previously infected with SARS-CoV-2, however, do not see these same benefits after subsequent vaccination. Natural infection with SARS-COV-2 appears to increase autoantibody production in all ethnicities. Therefore, NHPI, who are predisposed to developing autoimmune diseases, pose an even greater benefit from COVID-19 vaccination.
Autoantibodies, Pacific Islanders, COVID-19 (Disease), Hawaiians
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