Neutralizing monoclonal antibodies present new prospects to treat SARS-CoV-2 infections

Abstract

The coronavirus disease 2019 (COVID-19) has caused global public health and economic crises. Thus, new therapeutic strategies and effective vaccines are urgently needed to cope with this severe pandemic. The development of a broadly neutralizing antibody against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is one of the attractive treatment strategies for COVID-19. Currently, the receptor-binding domain (RBD) of the spike (S) protein is the main target of neutralizing antibodies when SARS-CoV-2 enters human cells through an interaction between the S protein and the angiotensin-converting enzyme 2 expressed on various human cells. A single monoclonal antibody (mAb) treatment is prone to selective pressure due to increased possibility of targeted epitope mutation, leading to viral escape. In addition, the antibody-dependent enhancement effect is a potential risk of enhancing the viral infection. These risks can be reduced using multiple mAbs that target nonoverlapping epitopes. Thus, a cocktail therapy combining two or more antibodies that recognize different regions of the viral surface may be the most effective therapeutic strategy.

Keywords

neutralizing antibody / antibody cocktail / SARS-CoV-2 / COVID-19 / therapeutic strategy

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Acknowledgements

This study was supported by the National Natural Science Foundation of China (No. 81970514), the Shanghai Municipal Key Clinical Specialty (No. shslczdzk01103), and the Shanghai Municipal Planning Commission of Science and Research Fund (No. 202040111).

Compliance with ethics guidelines

Rongtao Lai, Tianhui Zhou, Xiaogang Xiang, Jie Lu, Haiguang Xin, and Qing Xie declare that they have no conflict of interest. This manuscript does not involve a research protocol requiring approval by the relevant institutional review board or ethics committee.

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