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The Enzyme-Linked Immunosorbent Assay is a versatile technique, which can be used for several applications. It has enormously contributed to the study of infectious diseases. This review highlights how this methodology supported the science conducted in COVID-19 pandemics, allowing scientists to better understand the immune response against SARS-CoV-2. ELISA can be modified to assess the functionality of antibodies, as avidity and neutralization, respectively by the standardization of avidity-ELISA and surrogate-neutralization methods. Cellular immunity can also be studied using this assay. Products secreted by cells, like proteins and cytokines, can be studied by ELISA or its derivative Enzyme-linked immunospot (ELISpot) assay. ELISA and ELISA-based methods aided the area of immunology against infectious diseases and is still relevant, for example, as a promising approach to study the differences between natural and vaccine-induced immune responses against SARS-CoV-2. [ABSTRACT FROM AUTHOR]

The avidity index (AI) measures the binding strength between the antibody and the antigen, reflecting the affinity maturation. It can be measured by a modified ELISA, adding a chaotropic agent to disrupt the antigen x antibody interaction. However, details of the protocols used affect the final results. We compared the AI of mice sera after a three-dose immunization with meningococcal antigens using different adjuvants. The AI was assessed using potassium thiocyanate (KSCN) and urea as chaotropic agents, incubated at 4 °C, room temperature (RT) and 37 °C. KSCN presented statistically different results when the incubation was set at 4 °C vs RT and 4 °C vs 37 °C, thus, the mean AI obtained were lower. For Urea, 4 °C vs 37 °C presented relevant differences. Using whole-cells suspensions or OMVs as coating antigen provided similar results in some protocols. Thus, the affinity maturation was assessed after each immunization dose and adjuvant use (aluminium hydroxide and dimethyldioctadecylammonium bromide) supported affinity maturation. It is important to study the AI as a functional parameter of humoral response, and both KSCN and Urea are suitable chaotropic agents, however, the protocols should be standardized considering the nature of the antigen, the chaotropic activity and overall laboratory conditions. Adjuvants are important tools to improve antibody avidity following immunization. • Incubation of KSCN or Urea at 4 °C or 37 °C • Correlation of OMVs and WCs were better using KSCN 4 °C/RT or Urea 37 °C. • Affinity maturation curves were similar with different protocols. • Adjuvants improved avidity after immunization in middle-aged mice. [ABSTRACT FROM AUTHOR]