SARS-CoV-2 항체 검사의 임상적 유용성
Clinical Usefulness of SARS-CoV-2 Antibody Test
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초록
COVID-19 항체 검사(SARS-CoV-2 antibody test)는 COVID-19 감염 또는 백신접종 후 혈액 내에COVID-19 바이러스(SARS-CoV-2)에 대한 항체가 형성되었는지를 확인하는 검사로, 감염 후 1-2주부터 검출되기 시작하여 감염된 환자의 90% 이상에서 항체가 생성된다. 항체의 지속기간은 개인별, 항체 종류별로 차이가 있는데 IgG의 경우 최소 수개월 이상이고, 항체와 면역능과의 관련성에 대해서는 연구가 진행 중이다. 검사법으로는 효소면역검사법(enzyme-linked immunosorbentassay, ELISA), 화학발광면역측정법(chemiluminescence immunoassay, CIA), 면역크로마토그래피법(immunochromatographic assay), 중화항체검사법 등이 개발되어 사용되고 있으며, 시약에 사용되는 재조합 항원의 종류와 2차 항체의 종류에 따라 검출되는 표적(target) 항체가 다르다. COVID-19항체 검사로 현재 국내외 수많은 종류의 상품화된 제품이 개발되어 있으며, 시약의 재조합항원으로 S (spike) 단백, N (nucleocapsid) 단백, S 단백 중 S1이나 RBD (receptor binding domain) 부분, 혼합항원의 형태가 사용되고 있고, 이들 시약 항원과 반응하는 환자 혈액 내의 IgG, IgM, IgA, 또는 totalimmunoglobulin 항체를 검출한다. 본 리뷰에서 SARS-CoV-2 항체 검사의 종류 및 성능, 국내외 발표된 COVID-19 항체 검사 가이드라인을 조사하였다.
Abstract
SARS-CoV-2 antibody assay is a test that checks whether an antibody against the SARSCoV-2 virus has been formed in the blood after SARS-CoV-2 infection or vaccination. SARSCoV-2 antibody is detected 1–2 weeks after infection, and antibodies are produced inmore than 90% of infected patients. The duration for the formation of antibodies differs byindividual and by type of antibody. In the case of IgG, it is at least several months or longer,and the relationship between antibodies and immunity is being studied. As test methods,enzyme-linked immunosorbent assay (ELISA), chemiluminescence immunoassay (CIA),immunochromatographic assay, and neutralizing antibody assay have been developedand used. The target antibody to be detected differs depending on the type of recombinantantigen and the type of secondary antibody in reagents. Many kinds of commercializedSARS-CoV-2 antibody assays are currently being developed, and the S (spike) protein, N(nucleocapsid) protein, S1 or RBD (receptor binding domain) part of the S protein, and amixture of these antigens are used as recombinant antigens of reagents. IgG, IgM, IgA, or totalimmunoglobulin antibodies in patients’ blood that react with these reagent antigens aredetected. In this review, the types and performance of SARS-CoV-2 antibody tests and theguidelines for COVID-19 antibody tests published domestically and abroad were investigated.
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