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Correlates of protection (CoPs) against the highly contagious respiratory disease whooping cough, caused by  Bordetella pertussis , remain elusive. Characterizing the antibody response to this pathogen is essential towards identifying potential CoPs. Here, we evaluate levels, avidity and functionality of  B .  pertussis- specific-antibodies from paired plasma samples derived from symptomatic and recovered pertussis patients, as well as controls. Natural infection is expected to induce protective immunity. IgG levels and avidity to nine  B .  pertussis  antigens were determined using a novel multiplex panel. Furthermore, opsonophagocytosis of a  B .  pertussis  clinical isolate by neutrophils was measured. Findings indicate that following infection,  B .  pertussis- specific antibody levels of (ex-) pertussis patients waned, while the avidity of antibodies directed against the majority of studied antigens increased. Opsonophagocytosis indices decreased upon recovery, but remained higher than controls. Random forest analysis of all the data revealed that 28% of the opsonophagocytosis index variances could be explained by filamentous hemagglutinin- followed by pertussis toxin-specific antibodies. We propose to further explore which other  B .  pertussis- specific antibodies can better predict opsonophagocytosis. Moreover, other  B .  pertussis- specific antibody functions as well as the possible integration of these functions in combination with other immune cell properties should be evaluated towards the identification of CoPs against pertussis.

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Detection of opsonizing antibodies directed against a recently circulating Bordetella pertussis strain in paired plasma samples from symptomatic and recovered pertussis patients