AUCTORES
Globalize your Research
Research Article
*Corresponding Author: Szymon Skoczen, Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, Wielicka 265, 30-663 Krakow, Poland.
Citation: Małgorzata Staruszkiewicz, Anna Pituch-Noworolska, Mohamad Skayne, Torsten Matthias, Aaron Lerner. (2022) Induction of IgA Antibodies Against S1 Protein of SARS-CoV-2 after mRNA Vaccine. J. Immunology and Inflammation Diseases Therapy. 5(3); Doi:10.31579/2637-8876/043
Copyright: © 2022 Szymon Skoczen. This is an open-access article distributed under the terms of The Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 19 August 2022 | Accepted: 01 September 2022 | Published: 08 September 2022
Keywords: specific IgA antibodies; SARS-CoV-2 S1 antigen; mRNA vaccine; serology; immune response
Background
IgA class antibodies produced during SARS-CoV-2 infection showed high neutralizing activity and effective defense of mucous membrane surface. In common use of vaccines against SARS-CoV-2 the production and circulation of specific antibodies in IgA class is important. This study shows specific IgA antibodies after mRNA vaccine against SARS-CoV-2.
Material and Methods
Study included 649 health care workers divided into: group without SARS-CoV-2 virus infection (440 individuals) and group after SARS-CoV-2 virus infection (209 individuals). The occurrence of specific anti S1 IgA antibodies was showed with immunoassay.
Results
The non-infected group showed a stepwise increase of IgA levels after first and second vaccination, followed by a significant drop 3-6 months post-vaccination. Not surprisingly, the post-infected group mounted higher titers, after first and second vaccination in all check points with decline later.
Conclusions
The combination of infection and vaccination gave better response and longer memory of specific IgA antibodies production what suggest longer presence of secretory IgA on mucous surface with protective activity.
dIgA -Dimeric IgA
FcαRI - FCreceptor
MALT - mucous associated lymphoid tissue,
pIgR - polymeric immunoglobulins receptor,
KIR - NK cells receptors,
DC - dendritic cells,
NET - neutrophil extracellular traps,
ADCC - antibodydependent cytotoxicity,
sIgA -secretory IgA,
IgAD - IgA deficiency,
RBD - receptor binding domain.
The basic role of immunoglobulins IgA present on mucous surfaces is protection against the attachment of pathogens coming from the environments e.g., food, air and fluids. IgA circulating in serum is produced in bone marrow, spleen and lymph nodes, mainly as monomeric form with short half-life (46 days). Human monomeric IgA contains two subclasses IgA1 and IgA2, distinguished by the length of the hinge region, numerous sequence differences in heavy chain constant regions and glycosylation patterns. The IgA2 is critical for mucosal defense, whereas IgA1 is important for serum IgA functions as suggested by the differential compartmental distribution. Both IgA subclasses show neutralizing and opsonizing pathogen activity in their localization. Mucous associated IgA2 subclass, is in dimeric form (dIgA), produced locally in mucous associated lymphoid tissue (MALT) with side-specific homing IgA plasma lasts. The third form of IgA is secretory IgA (sIgA) containing a secretory component added to produced IgA and cleaved during transcytosis through epithelial cells into the mucosal lumen. The IgA operates through binding to its matching Fc receptor (FcaRI) [1-4].
IgA functions and SARS-CoV-2 infection
After binding antigens with Fab binding sites, IgA neutralizes or blocks the activity of pathogens prevents their attachment to host epithelial cells. Moreover, IgA can neutralize toxins derived from pathogens, inhibiting development of symptoms associated with their detrimental activity. Fca RIbelonging toimmunoglobulins Fc receptors family is expressed on innate immune cells like neutrophils, eosinophils, monocytes, macrophages, Kupffer cells and some subsets of dendritic cells (DC). Binding of IgA to FcaRI activates FcaRI on different cells stimulates their functions e.g., phagocytosis, superoxide generation, release extracellular traps (NET) byneutrophils, antibody dependent cytotoxicity (ADCC) by NK cells, release of cytokine and chemokines and antigen presentation by DC[1,2,4]. The anti genspecific IgA was noted after immunization bacterial antigens and also with viral antigen e.g., polio virus, influenza. The anti-viral role of IgA was suggested after finding HIV-specific IgA in sera of HIV infection survivors [1]. Moreover, selective IgA deficient patients demonstrate higher of mucosal infection and higher incidence of autoimmune diseases [5,6].
InSARS-CoV 2 infection the question of neutralizing activity of specific IgA was important due to protective role of IgA on surface mucous membranes. In experimental model of monoclonal antibodies IgA and IgG class expressed in transgenic mice, the neutralization activity of IgA was higher than IgG against authentic SARS-CoV-2 virus. This tendency was present all tested forms of IgA – monomeric, dimeric or secretory IgA [7].
Ina recent clinical study of 64 healthcare workers infected with SARS-CoV-2, monomeric IgA antibodies, specific for S1 spike protein, were assayed in serum, in tears, nasal fluid and saliva, representing mucosal secretory IgA (sIgA). Ahigh level of serum IgA was noted in patients with severe course of SARS-CoV-2 infection, rapidly increasing after symptom's onset [8]. Notable, IgA specific for S1 protein in serum patients with severe course of SARS-CoV-2 infection, rapidly increasing after symptom's onset [8]. Notable, IgA specific for S1 protein in serum patients with mild course was in low level and decreased within one month. Analyses of sIgA mucosal secretions showed specific sIgA antibodies in asymptomatic individuals or with mild course of disease what suggested the local mucous reaction in the absence of systemic IgA production seen as circulating serum antibodies. Disease severity, gender, rather than age, played an important role in antibody levels. However, there was no relation in time and level, between systemic and local mucosal IgA responses [3,7].
Like in many other viral infections, antibodies to SARS-CoV-2 antigens are produced in all immunoglobulins’ classes. Increase of IgA antibodies level in serum strongly correlated with increase of IgG level in sera of 101 SARS-CoV-2 adult patients (76 PCR positive and 25 pandemic survivors). The correlation between IgG and IgA antibodies levels suggested the used of IgA ELISA test as a confirmation of seropositivity during viral infection. Further more, the high level of IgA antibodies was helpful to detect SARS-CoV-2 infection in patients with low level of IgG anti S1 protein antibodies [9].
Neutralization of virus is critical for inhibition of virus replication and spreading. Adjusting the amount of IgA to IgG, the potency of neutralization was higher in antibodies of IgA then IgG. The high neutralization activity was shown for circulating monomeric IgA in serum and for secretory IgA purified from bronchial lavage and saliva at different periods of symptomatic SARS-CoV 2 infection. The assay of sIgA neutralization activity showed high potency in late stage of disease, up to 6 weeks after onset of symptoms. Comparison of equivalent amount of IgA subtypes and IgG suggested a highest neutralization activity of sIgA, lower activity of monomeric IgA and IgG [3,5,10,11]. Earlyoccurrence of mucosal sIgA with high neutralization activity represents an important first line of defense against viruses including the SARS-CoV-2. Effectiveness of this compartmental activity is crucial for virus entry into cells, replication and development of clinical symptoms. Vaccines against SARS-CoV-2 are inducing cellular and humoral response to viral proteins with production of specific antibodies, mainly IgG class [10,12]. Inthe present study S1 protein IgA specific antibodies were tested aiming to explore their post mRNA vaccine activity, in relation to prior symptomatic or non-infected SARS-CoV-2 individuals.
Patients
Thehealthcare workers of the University Children Hospital in Krakow, Poland were included in the present study of IgA antibodies production to SARS-CoV-2 S1 spike protein, after vaccinations. Blood samples were withdrawn from the personal who recieved BioNtech-Pfizer BNT162b2 vaccine in two scheduled doses.
Thecohort included 46 men and 636 women (682 all together). The age of the volunteers was 20-40 years old (386), 50-60 yearsold (233), 70-80 yearsold (9). Sample were collected according protocol showed in Figure 1.
Staffself-reported data on SARS-CoV-2 exposure history, PCR results, signs and symptoms of COVID-19, comorbidities, treatment used, vaccination complications and vaccine tolerance were recorded based on individual questionnaire. Ethical approval was obtained from the Jagiellonian University Medical College Ethics Committee No KBE 1072.6120.61.2021.
Clinical symptoms of SARS-CoV-2 infection of the participating volunteers are shown in Table 1. In the covid-19 infected group (219), the PCR test was performed in 132 (60,2%) with positive results in 128 cases and negative results in 14 cases. In the non-infected group (463), the PCR test was performed in 102 (22,0 %) ofthe participants and all results were negative. All samples were also checked for presence of anti NP antibodies (IgM and IgG) to identify volunteers with SARS-CoV-2, however, only the IgA results are perently reported.
Staffwere grouped into those with evidence o prior infection i.e., the positive and borderline anti-spike or anti-nucleocapsid antibody test (AESKULISA®) or positive PCR prior to the first dose of the vaccine. Additionaly, positive anti-nucleocapsid antibody test after the second dose of the vaccine, were included. Indications for PCR smearswere: contact with virus (patients (mainly children), family, social contacts) or presence of slight orunspecific symptoms suggesting possible SARS- CoV-2 infection. The second non-infected group included volunteers without antibodies to NP, part of them with negative PCR smear results and without any history of possibile contact with SARS-CoV-2 virus. (Figure 1)
Blood samples were collected from the participants according to the following our worked out schedule: 1-3 daysbefore the administration of the first vaccination for several participants – check point 03 weeks (19 - 22 days) after the administration of the first vaccination – check point 1 Within 14 - 22 days and > 22 days after the administration of second vaccination – check point 2.
Figure 1: Study Desing
Morethan 6 months (170 – 214 days) after the administration of the second vaccination – check point 3. Majority of samples were collected before the end of 6 months, only 15 samples were added later [12].
The time period between the first and the second dose of vaccine was about 3 weeks. The staff immunization program started at the end of December 2020, initially with the Pfizer-BioNTech BNT162b2 vaccine, and since March 2021, part of the staff was vaccinated with AstraZeneca ChAdOx1nCoV-1. Only serum samples of volunteers vaccinated with the Pfizer vaccine were analyzed for IgA antibody titer.
Laboratory assays
Theserological analyses were performed in the facilities of AESKU.Diagnostics GmbH & Co. KG in Wendelsheim, Germany, using the AESKULISA® SARS-CoV-2 S1 IgA immunoassay accordingto the manufacturer instructions. The present study is a part of of an extended project on the serological response to the mRNA-based vaccine where antibody isotypes like anti-IgG S1, IgM S1, IgG NP, IgM NP were analyzed. Only the IgA antibodies results are presently reported as a main aim of this paper.
GraphPad Prism version 6.01 was used for statistical analyses. Kruskal-Wallis test was conducted to identify any significant changes in categorical variables over time and between groups. Non-parametric Mann-Whitney (Wilcoxon) test was used to compare quantitative data over time or between groups, respectively.
Inthe non-infected group, serum IgA level, before vaccination (time 0) was low (0.9 U/ml). As expected, IgA antibodies leve was higher in the group after prior infection (mean value 6,5 U/ml) with maximal individual value 28.1 U/ml (Table 2). The number of individuals tested before vaccination in those two groups was low (13 in the naïve, 17 infected participants, respectively) because the program of vaccination was introduced earlier than the present study. The response in IgA antibodies to first dose of vaccine was higher in the infected group, when compared to the response in the non-infected group (mean value - 28,0 U/mland 11,6 U/ml respectively, p0.0001). Following the second vaccine, the level of specific IgA titers increased markedly in the noninfected group. In contrary, increase noted in participants after SARS-CoV-2 infection was small (28,0 U/ml – 35.8 U/ml) (Table 2, Figure.2). Analysis of individual induction of IgA antibodies production after vaccines showed the highest value of 262,4 U/ml, noted in non-infected group
The analysis of decline of IgA specific antibodies level showed a significant decrease in the non-infected group (mean value 5,9 U/ml - below the limit of cut off), (p 0.0001) (Table 2, Figure.2 and 3). Interestingly, in the infected group, level of specific IgA antibodies decreased also, but the mean value was 13,0 U/ml, significantly above the level of IgA specific antibodies in the non-infected group. It should be stressed that in both groups, the decrease of IgA antibodies level tested after two vaccinations and after 6 months was statistically significant (p 0.0001) with still higher level in group after infection. The statistical analysis of IgA level after first and second vaccine dose within the non-infected group showed a significant increase (p 0.01) between these two check points. In the group of participants, after SARS-CoV-2 infection, the difference between mean value of response to first and second dose of vaccine did not reach a statistical significance. The difference in IgA level between initial level and response to first vaccine in both groups was high, but due to discrepancy of participants numbers, the statistical analysis wasn’t performed (Figure.2 and 3).
Figure 2: Antibodies IgA class produced Post Vaccination according to prior infection of SARS-Cov-2
Figure 3: Antibodies IgA class produced Post Vaccination according to prior infection of SARS-Cov-2. Summary of the data set – the minimum, first quadrlle, median, third quadrlle and the maximum.The median is represented by the line in box
The comparison of gG specific antibodies level and IgA showed similar tendency with gentle differences. After first dose of vaccine increase of IgA level was relatively higher in non-infected group as compare to IgG response. In people after contact with SARS-CoV-2 virus, there was no increase of IgG level after second dose of vaccine with deep decrease 6 months later (Table 2, Figure.4).
Figure 4: Antibodies IgG class produced post vaccination according to prior infection of SARS- Cov-2
The further analysis of decrease of specific antibodies level with time (selected periods in days) showed no difference between infected and non-infected in IgG antibodies decline in comparison to IgA, when level of specific gA antibodies in people after infection was declining slowly with higher level at the end of observation time (Figure. 5).
Figure 5: Changes of antibodies levels produced post vaccination after the second dose
1. The production and lasting of specific IgA antibodies to SARS-CoV-2 S1 protein is better after prior contact with virus and mRNA vaccine than after vaccine only.
2. mRNA vaccine is inducing IgA producing memory B cells for longer time as compare to IgG, what is associated with better protection of mucous membranes against SARS-CoV-2.
The effect of two consecutive mRNA vaccinations against SARS-CoV-2 on specific IgA antibodies production was shown in people with or without infection of SARS-CoV-2. There was increase of IgA antibodies level after first followed with second dose of vaccine with decline in 6 months period thereafter. This pattern is know from studies of IgG antibodies production after mRNA vaccine. However, there are some differences between response in IgG immunoglobulin and IgA immunoglobulin as well as between people with or without virus infection. The results of our study showed better and longer production of specific IgA antibodies to SARS-CoV-2 antigen after infection even mild, supported with vaccination thereafter. These results are comparable to other observations, despite of different time between vaccination and assay of specific antibodies occurrence [14,15]. The possible explanation of differences between variety of antigens presented by virus during infection in opposite to one antigen selected for vaccine. The time and dynamic of IgA antibodies decrease in serum was shown as different from IgG level, what might be associated with half time of IgA circulation in serum or different regulation of production [9,13].
The schedules of vaccination are based on serial assays of occurrence, high level and following decrease of antibodies level in serum after infection and/or vaccines. Data are associated mainly to production and lasting of antibodies to anti-S1 spike protein and/or anti RBD antigen (receptor binding domain). The study of 26 healthcare workers infected with SARS-CoV-2 showed systemic decrease of IgA neutralizing antibodies within 3 months after onset of SARS-CoV-2 symptoms. Similar pattern of anti S1 spike protein antibodies decrease was noted against the RBD antigen. Compared to IgA antibodies, the level of IgG antibodies, in similar periods of observation, showed more stable level in IgA antibodies circulating in serum as monomeric [14]. The presence of monomeric IgA antibodies was thought as representative for all forms of IgA including dimeric form associated with mucous membranes. It was shown is study of secretory IgA occurrence in typical compartments e.g. breast milk during lactation as marker of mucous presence in breast ducts [8,13,14]. Vaccines containing mRNA induce cellular host expression of S1 spike protein followed with adaptive immune response, including production of specific antibodies and occurrence of specific memory T and B cells [15]. The study of specific T lymphocytes showed strong response of CD4+ subpopulation contributed to RBD- binding IgG and antibodies titer. These cells showed increased expression of CD40L (ligand) important for signaling and activating B cells. Vaccines provide long-term protection via generation of memory B cells leading to stimulation of long-lived plasma cells producing specific antibodies. The presence of memory B cells producing specific antibodies in IgG (IgG1, IgG2) class to S full length protein and RBD was shown as wells as production of IgM specific antibodies. There are no data about IgA specific antibodies and memory B cells contributed to this type of antibodies [15]. relation to level before vaccination [16,17]. The time of specific antibodies production in both antibodies' isotypes (IgG and IgA) after vaccine, is important for protection against re-infection and represents state of immune system ready for immediate reaction. Within mechanisms involved in protection against re-infections memory T and B cells are playing basic role supporting long-time protective activity of immune system [10,14,18].
The IgA specific antibodies are usually thought as one type, however, different role and activity is presented by subtypes – IgA1 and IgA2. The analysis of IgA antibodies in subclassesIgA1 and IgA2 after vaccination in 27 subjects without contact of SARS-CoV-2 and 19 patients after infection, showed increased level after first vaccine in IgA1 class in both studied groups. IgA2 antibodies titer was below cut - off in subjects without SARS-CoV-2 infection in contrast to increase of IgA2 antibodies in patients after infection [19]. Themain role of sIgA is protection of mucous membrane surface, however, it is largely understudied in the context of the SARS-CoV-2 using mucous membrane for entering through ACE2 receptor [20,21]. Thereis different prevalence of SARS-CoV-2 infections associated with expression of ACE2 receptor – in adult people the nasopharynx and the respiratory tracts were extensively explored, in opposite to children when the intestinal route represent a major port of entry for the virus [22,23,25]. IgAmucosal response is effective in virus neutralization, correlating with disease severity, even in absence of systemic IgA specific antibodies production [3, 23,24,26]. However, the role of IgA is important but not only one in response to SARS-CoV-2 infection, as patients with selected IgA deficiency (IgAD) are not prone to more frequent infection or more severe course of disease [27].
Our study of IgA and IgG specific antibodies production showed better response to vaccine after contact with SARS-CoV-2 virus and longer lasting reasonable level of IgA specific antibodies more than 6 months after second dose of mRNA vaccine. However, there are some limitations to the present study. It includes only IgA monomer, leaving the question about neutralizing capacity of dimeric IgA and secretory IgA on the mucosal surfaces.
The profile of antibodies production in response to vaccines showed systematic increase after consecutive dose of vaccine in majority of people without contact with virus. In people after infection (symptomatic or asymptomatic) this first contact is inducing response, in consequence of this, the first dose of vaccine is working as booster showing highest possible response. Thetendency to low or no increased of antibodies
We thank all sample donors for their valuable contribution and willingness to participate in this study. The clinical staff for collecting the samples especially Mrs. Anna Lalik. Dr. Sandra Neidhöfer and Dr. Andreas Schmiedl for their valuable laboratory work, Mrs. Diana Bläßer, Mrs. Jasmin Hollmann and Mrs. Silvia Brunner for technical assistance and Mr. Kenneth Scott for proofreading the manuscript.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
