The New Outlook of Monoclonal Antibodies in Neutralizing Target Cells in COVID-19

Authors

  • P Ashwathi Department of Pharmacy Practice, J.K.K. Nattraja College of Pharmacy, Kumarapalayam-638183, Tamil Nadu, India
  • N Venkateswaramurthy Department of Pharmacy Practice, J.K.K. Nattraja College of Pharmacy, Kumarapalayam-638183, Tamil Nadu, India
  • R Sambath Kumar Department of Pharmacy Practice, J.K.K. Nattraja College of Pharmacy, Kumarapalayam-638183, Tamil Nadu, India

Abstract

Background: The deadly arrival of novel coronavirus (COVID-19) in late December 2019, caused by the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has emerged worldwide causing a pandemic. The World Health Organization (WHO) has proved ineffectiveness against existing medications this influenced the prompt identification of Monoclonal antibodies (mAbs) which plays a vital role as the prophylactic application that helps in developing new interventions.

Objectives: To study the effect of mAbs in high-risk individuals in treating COVID-19.

Methodology: The recent studies related to the aim of the review were undertaken through a literature search to analyze the importance of mAbs in combating SARS-CoV-2.

Results:  In several countries even though vaccines have reached the Emergency Use Authorization (EUA) people still rely on traditional medications. Besides repurposed drugs, recently many mAbs targeting S-protein of SARS-CoV-2 have been signed up for clinical trials. Currently, no specific neutralizing mAbs have been reported for SARS-CoV-2 and it may take several years for such antibodies to be readily available. The development of mAbs for preventing the SARS-CoV 2 infection is challenged by the threat of antibody-dependent enhancement, antibody-resistant against SARS-CoV-2 variants, acute respiratory infections, clinical trials and risk assessment, and inexplicable. The clinical trial data proved that there is no life-threatening Adverse Drug Reactions (ADR) occurred during mAbs therapy for COVID-19 patients.

Conclusion: Establishing monoclonal antibodies will continue to be the best prophylactic application as it minimizes the risk of hospitalization in the high-risk individuals affected by SARS-CoV-2 infection.

Keywords: COVID-19, Monoclonal antibodies (mAbs), Emergency Use Authorization (EUA), Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2)

Keywords:

COVID-19, Monoclonal antibodies (mAbs), Emergency Use Authorization (EUA), Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2)

DOI

https://doi.org/10.22270/jddt.v11i5-S.5076

Author Biographies

P Ashwathi, Department of Pharmacy Practice, J.K.K. Nattraja College of Pharmacy, Kumarapalayam-638183, Tamil Nadu, India

Department of Pharmacy Practice, J.K.K. Nattraja College of Pharmacy, Kumarapalayam-638183, Tamil Nadu, India

N Venkateswaramurthy, Department of Pharmacy Practice, J.K.K. Nattraja College of Pharmacy, Kumarapalayam-638183, Tamil Nadu, India

Department of Pharmacy Practice, J.K.K. Nattraja College of Pharmacy, Kumarapalayam-638183, Tamil Nadu, India

R Sambath Kumar, Department of Pharmacy Practice, J.K.K. Nattraja College of Pharmacy, Kumarapalayam-638183, Tamil Nadu, India

Department of Pharmacy Practice, J.K.K. Nattraja College of Pharmacy, Kumarapalayam-638183, Tamil Nadu, India

References

Von Behring E, Kitasato S. On the realization of immunity in diphtheria and tetanus in animals. Dtsch Med Wochenschr. 1890; 16:1113-1114. https://doi.org/10.1055/s-0029-1207589

Waldmann TA, Strober W. Metabolism of immunoglobulins. Prog Allergy. 1969; 13:1-110. https://doi.org/10.1159/000385919

Llewelyn MB, Hawkins RE, Russell SJ, et al. Discovery of antibodies. BMJ. 1992; 305: 1269-1272. https://doi.org/10.1136/bmj.305.6864.1269

Behring EA, Kitasato S. Ueber das Zustandekommen der Diphtherie-immunitat und der Tetanus-immunitat bei Thieren. Dtsch. Med. Wochenschr. 1890; 28:1321-1332.

Hung IF, To KK, Lee Ck, et al. Convalescent plasma treatment reduced mortality in patients with severe pandemic influenza A (H1N1) 2009 virus infection. Clin. Infect. Dis. 2011; 52(4):447-456. https://doi.org/10.1093/cid/ciq106

Jenkins JM, Campos MS, Baillie JK, et al. The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review and exploratory meta-analysis. J. Infect. Dis.2015; 211(1):80-90. https://doi.org/10.1093/infdis/jiu396

Kim PS, Read SW, Fauci AS, et al. Therapy for early COVID-19: a critical need. JAMA. 2020; 324(21):2149-2150.. https://doi.org/10.1001/jama.2020.22813

Walls AC, Park YJ, Tortorici MA, et al. Structure, Function and Antigenicity of the SARS-COV-2 Spike Glycoprotein. Cell. 2020; 181(2):281-292. https://doi.org/10.1016/j.cell.2020.02.058

X SL, Moreno MT, Ramilo O, et al. Safety and pharmacokinetics of palivizumab therapy in children hospitalized with respiratory syncytial virus infection. Pediatr. Infect. Dis. J. 2004; 23(8):707-712. https://doi.org/10.1097/01.inf.0000133165.85909.08

Malley R, Romilo O, Gruber WC, et al. Reduction of respiratory syncytial virus (RSV) in tracheal aspirates in intubated infants by use of humanized monoclonal antibody to RSV F protein. J. Infect. Dis. 1998; 178(6):1555-1561. https://doi.org/10.1086/314523

Zhou P, Yang X, Wang X, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020; 579(7798):270-273. https://doi.org/10.1038/s41586-020-2012-7

Marston HD, Paules CI, Fauci AS. Monoclonal antibodies for emerging infectious diseases-borrowing from history. N Engl J Med. 2018; 378(16):1469-1472. https://doi.org/10.1056/NEJMp1802256

Tillett R, Sevinsky J, Hartley P, et al. Genomic evidence for reinfection with SARS-CoV-2: a case study. Lancet Infect Dis. 2020; 21(1):52-58. https://doi.org/10.1016/S1473-3099(20)30764-7

Pan H, Peto R, Henao-Restrepo A, et al. Repurposed antiviral drugs for Covid-19-interim WHO solidarity trial results. N. Engl. J. Med. 2020; 384: 497-511. https://doi.org/10.1056/NEJMoa2023184

Petrilli CM, Jones SA, Yang J, et al. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study. BMJ. 2020; 369:m1966. https://doi.org/10.1136/bmj.m1966

Chen P, Nirula A, Heller B, et al. SARS-CoV-2 neutralizing antibody LY-CoV555 in outpatients with Covid-19. N Engl J Med. 2021; 384:229-37. https://doi.org/10.1056/NEJMoa2029849

Weinreich DM, Sivapalasingam S, Norton T, et al. REGN-COV2, a neutralizing antibody cocktail, in outpatients with Covid-19. N Engl J Med. 2021; 384:238-51. https://doi.org/10.1056/NEJMoa2035002

Petrosillo N, Viceconte G, Ergonul O, et al. COVID-19, SARS and MERS: are they closely related? Clin. Microbiol. Infect. 2020; 26 (6):729-734. https://doi.org/10.1016/j.cmi.2020.03.026

Cutino‐Moguel C, Eades C, Rezvani K, et al. Immunotherapy for infectious diseases in haematological immunocompromised. Br. J. Haematol. 2017; 177(3):348-356. https://doi.org/10.1111/bjh.14595

Wang C, Li W, Drabek D, et al. A human monoclonal antibody blocking SARS-CoV-2 infection. Nat. Commun. 2020; 11(10):2251. https://doi.org/10.1038/s41467-020-16256-y

Marovich M, Mascola J, Cohen M. Monoclonal antibodies for prevention and treatment of COVID-19. JAMA. 2020 https://doi.org/10.1001/jama.2020.10245

(2):131-132. doi:https://doi.org/10.1001/jama. 2020.10245.

Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of 2019 novel coronavirus infection in China. N Engl J Med. 2020; 382(18):1708-1720. doi: https://doi.org/10.1056/NEJMoa2002032

Gorbalenya A, Andrey M. Anastasia A, et al. The species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat. Microbiol. 2020; 5:536-544. https://doi.org/10.1038/s41564-020-0695-z

Andersen KG, Rambaut A, Lipkin WI, et al. The proximal origin of SARS-CoV-2. Nat. Med. 2020; 26 (4):450-452. https://doi.org/10.1038/s41591-020-0820-9

Kan B, Wang M, Jing, H, et al. Molecular evolution analysis and geographic investigation of severe acute respiratory syndrome coronavirus-like virus in palm civets at an animal market and on farms. J. Virol. 2005; 79(18):11892-11900. https://doi.org/10.1128/JVI.79.18.11892-11900.2005

Young BE, Kalimuddin S, Loh J, et al. Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore. JAMA. 2020; 323(15):1488-1494. https://doi.org/10.1001/jama.2020.3204

Ceccarelli M, Berretta M, Rullo EV, et al. Editorial-Differences and similarities between Severe Acute Respiratory Syndrome (SARS)-CoronaVirus (CoV) and SARS-CoV-2. Would a rose by another name smell as sweet? Eur. Rev. Med. Pharmacol. Sci. 2020; 24(5): 2781-2783. doi: https://doi.org/10.26355/eurrev_202003_20551

Du L, He Y, Zhou Y, et al. The spike protein of SARS-CoV- a target for vaccine and therapeutic development. Nat. Rev. Microbiol. 2009; 7:226-236. https://doi.org/10.1038/nrmicro2090

Rota PA, Oberste MS, Monroe SS, et al. Characterization of a novel coronavirus associated with severe acute respiratory syndrome. Science. 2003; 300(5624):1394-1399. https://doi.org/10.1126/science.1085952

Tortorici MA, Veesler D. Structural insights into coronavirus entry. Adv. Virus Res. 2019; 105:93-116. https://doi.org/10.1016/bs.aivir.2019.08.002

Lu RM, Hwang YC, Liu IJ, et al. Development of therapeutic antibodies for the treatment of diseases. J. Biomed. Sci. 2020; 27(1):1-30. https://doi.org/10.1186/s12929-019-0592-z

Walker LM , Burton DR. Passive immunotherapy of viral infections: super-antibodies enter the fray. Nat. Rev. Immunol. 2018; 18(5):297-308. https://doi.org/10.1038/nri.2017.148

Jiang S, Du L, Shi Z, et al. An emerging coronavirus causing pneumonia outbreak in Wuhan, China: calling for developing therapeutic and prophylactic strategies. Emerg. Microbes Infect. 2020; 9(1):275-277. https://doi.org/10.1080/22221751.2020.1723441

Zhu Z, Chakraborti S, He Y, et al. Potent cross-reactive neutralization of SARS coronavirus isolates by human monoclonal antibodies. Proc. Natl. Acad. Sci. 2007; 104(29):12123-12128. https://doi.org/10.1073/pnas.0701000104

Zhou Y, Yang Y, Huang J, et al. Advances in MERS-CoV vaccines and therapeutics based on the receptor-binding domain. Viruses. 2019; 11(1):60. https://doi.org/10.3390/v11010060

Tian X, Li C, Huang A, et al. Potent binding of 2019 novel coronavirus spike protein by a SARS coronavirus-specific human monoclonal antibody. Emerg. Microbes Infect. 2020; 9 (1):382-385. https://doi.org/10.1080/22221751.2020.1729069

U.S. Food & Drug Administration. Coronavirus (COVID-19) update: FDA authorizes monoclonal antibodies for treatment of COVID-19. Available at: https://www.fda.gov/newsevents/press-announcements/coronavirus-covid-19-update-fda-authorizes-monoclonalantibodies-treatment-covid-19. Published November 21, 2020.

Regeneron Pharmaceuticals Inc. Fact sheet for health care providers: emergency use authorization (EUA) of casirivimab and imdevimab. Available at: Regeneron https:// www.regeneron.com/sites/default/files/treatmentcovid19-eua-fact-sheet-for-hcp.pdf. Updated June 2021.

Gupta A, Juarez E, Moya J, et al. Early Covid-19 Treatment With SARS-CoV-2 Neutralizing Antibody Sotrovimab. BMJ. May 28, 2021. https://doi.org/10.1101/2021.05.27.21257096

Saunders KO. Conceptual Approaches to Modulating Antibody Effector Functions and Circulation Half-Life. Front Immunol. 2019; 10:1296. https://doi.org/10.3389/fimmu.2019.01296

Bloch EM, Shoham S, Casadevall A, et al. Deployment of convalescent plasma for the prevention and treatment of COVID-19. J Clin Invest. 2020; 130(6):2757-2765. https://doi.org/10.1172/JCI138745

Wen J, Cheng Y, Ling R, et al. Antibody-dependent enhancement of coronavirus. Int J Infect Dis. 2020; 100:483-489. https://doi.org/10.1016/j.ijid.2020.09.015

Arvin AM, Fink K, Schmid MA, et al. A perspective on potential antibody-dependent enhancement of SARS-CoV-2. Nature. 2020; 584(7821):353-363. https://doi.org/10.1038/s41586-020-2538-8

Lee WS, Wheatley AK, Kent SJ, et al. Antibody-dependent enhancement and SARS-CoV-2 vaccines and therapies. Nat Microbiol. 2020; 75(7):1699-1709. https://doi.org/10.1038/s41564-020-00789-5

Robbiani DF, Gaebler C, Muecksch F, et al. Convergent antibody responses to SARS-CoV-2 in convalescent individuals. Nature. 2020; 584:437-442. https://doi.org/10.1101/2020.05.13.092619

Baum A, Fulton BO, Wloga E, et al. Antibody cocktail to SARS-CoV-2 spike protein prevents rapid mutational escape seen with individual antibodies. Science. 2020; 369(6506):1014-1018. https://doi.org/10.1126/science.abd0831

Ning L, Abagna HB, Jiang Q, et al. Development and application of therapeutic antibodies against COVID-19. Int. J. Biol. Sci. 2021; 17(6):1486-1496. https://doi.org/10.7150/ijbs.59149

Roche JA & Roche R, et al. A hypothesized role for dysregulated bradykinin signaling in COVID-19 respiratory complications. FASEB J. 2020; 34(6):7265-7269. https://doi.org/10.1096/fj.202000967

He G, Massarella J, Ward P, et al. Clinical pharmacokinetics of the prodrug oseltamivir and its active metabolite Ro 64-0802. Clin. Pharmacokinet. 1999; 37(6):471-484. https://doi.org/10.2165/00003088-199937060-00003

Guillon A, Pardessus J, Lhommet P, et al. Exploring the fate of inhaled monoclonal antibody in the lung parenchyma by microdialysis. PMC. 2019; 11(2):297-304. https://doi.org/10.1080/19420862.2018.1556081

Brainard J. Scientists are drowning in COVID-19 papers. Can new tools keep them afloat? Science. 2020. https://doi.org/10.1126/science.abc7839

Yang L, Liu W, Yu X, et al. COVID-19 antibody therapeutics tracker: a global online database of antibody therapeutics for the prevention and treatment of COVID-19. Antib Ther. 2020; 3(3):205-12. https://doi.org/10.1093/abt/tbaa020

Graham BS. Rapid COVID-19 vaccine development. Science. 2020; 368(6494):945-946. https://doi.org/10.1126/science.abb8923

Sparrow E, Friede M, Sheikh M, et al. Therapeutic antibodies for infectious diseases. Bull World Health Organ. 2017; 95 (3): 235-237. https://doi.org/10.2471/BLT.16.178061

World Health Organization. Guidelines on evaluation of monoclonal antibodies as similar biotherapeutic products (SBPs). Available at: https://www.who.int/biologicals/expert_committee/mAb_SBP_GLECBS_review_adoption-2016.10.26-11.7post_ECBS-Clean_Version. pdf.2016 (accessed 2 February 2021).

Gottlieb RL, Nirula A, Chen P, et al. Effect of bamlanivimab as monotherapy or in combination with etesevimab on viral load in patients with mild to moderate COVID-19: a randomized clinical trial. JAMA. 2021; 325(7):632-644. https://doi.org/10.1001/jama.2021.0202

Regeneron Pharmaceuticals Inc. RECOVERY Trial Data Monitoring Committee recommends continuing evaluation of REGN-COV2 in all hospitalized patients. Available at: Regeneron https://investor.regeneron.com/newsreleases/news-release-details/recovery-trial-datamonitoring-committee-recommends-continuing (2020).

Wang C, Horby PW, Hayden FG et al. A novel coronavirus outbreak of global health concern. Lancet.2020; 395:470-473. https://doi.org/10.1016/S0140-6736(20)30185-9

Zhu N, Zhang D, Tan W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N. Engl. J. Med. 2020; 382:727-733. https://doi.org/10.1056/NEJMoa2001017

Published

2021-10-15
Statistics
Abstract Display: 522
PDF Downloads: 554
PDF Downloads: 38

How to Cite

1.
Ashwathi P, Venkateswaramurthy N, Sambath Kumar R. The New Outlook of Monoclonal Antibodies in Neutralizing Target Cells in COVID-19. J. Drug Delivery Ther. [Internet]. 2021 Oct. 15 [cited 2025 Nov. 23];11(5-S):138-42. Available from: https://jddtonline.info/index.php/jddt/article/view/5076

How to Cite

1.
Ashwathi P, Venkateswaramurthy N, Sambath Kumar R. The New Outlook of Monoclonal Antibodies in Neutralizing Target Cells in COVID-19. J. Drug Delivery Ther. [Internet]. 2021 Oct. 15 [cited 2025 Nov. 23];11(5-S):138-42. Available from: https://jddtonline.info/index.php/jddt/article/view/5076

Most read articles by the same author(s)

> >>