Sars cov 2 monoclonal antibodies

Several neutralizing monoclonal antibodies (mAbs) have been developed against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and are now being evaluated in clinical trials. Since the US Food and Drug Administration recently granted emergency use authorizations to neutralize mAbs in non-hospitalized patients with mild to moderate COVID-19, there is an urgent need to discuss the broader potential of these new therapies and develop strategies to implement and use them effectively in clinical practice, given the limited initial availability.

Here, we review the precedent for passive immunization and lessons learned from the use of antibody therapies for viral infections such as respiratory syncytial virus, Ebola virus, and SARS-CoV infections.

Then we focus on the deployment of convalescent plasma and neutralizing mAbs for the treatment of SARS-CoV-2. We reviewed specific clinical issues, including the justification for patient stratification, potential biomarkers, known risk factors, and time considerations for optimal clinical use.

To answer these questions, it is necessary to understand factors such as viral load kinetics and their correlation with clinical outcomes, endogenous antibody responses, pharmacokinetic properties of neutralizing mAbs, and the potential benefit of combining antibodies to defend against variants. emerging virals.

Introduction

Amid the current COVID-19 pandemic, a variety of prophylactic and therapeutic treatments are being developed or reused to combat COVID-19. Monoclonal antibodies (mAbs) that can bind and “neutralize” the virus in infected patients are a new class of antiviral intervention1,2.

Neutralizing mAbs are recombinant proteins that can be derived from the B cells of convalescent patients or humanized mice (Fig. 1). High-throughput screening of these B cells allows the identification of antibodies with the specificity and affinity necessary to bind to a virus and block virus entry, thus nullifying the pathology associated with productive infection.

These mAbs are called “neutralizers” and can ultimately be used as a type of passive immunotherapy (detailed below) to minimize virulence. In this review, we highlight the relative value that neutralizing mAbs can provide to patients and clinicians, and move on to examine the role of these agents in the spectrum of potential treatments for COVID-19.

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