Monoclonal antibodies as a preventive for COVID-19

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A recent article in the journal 'Science' titled "Monoclonal antibodies can prevent COVID-19 -- but successful vaccines complicate its future", caught my eye. So what is a monoclonal antibody? These are antibodies that are produced in the laboratory by cloning white blood cells. This synthetic antibody substitutes the function of an antibody that our body cannot produce/ produces in low quantities in response to a particular antigen. For this reason it has been used to cure various diseases by targeting the specific disease-causing antigens. This idea of monoclonal antibodies was introduced by well-known immunologist Paul Ehrlich as a "magic bullet". The most common use of these monoclonal antibodies is for the treatment of cancer where antibodies against the cancer antigen, aid the immune system to fight cancer.



                                                                                                                     Source: wellcome.org

Recently, Eli Lilly - a pharmaceutical company we students are familiar with for having produced the first genetically engineered synthetic insulin - has produced a monoclonal antibody which has shown positive results for use as a preventive for COVID-19. A study in nursing home facilities in the USA has shown that people can be protected from developing COVID-19, especially for those who have compromised immune systems. 

The study by Eli Lilly involved 965 people who are either residents or workers in Nursing homes in the USA. These people were administered either with a single infusion of the antibody or a placebo. It was observed that there was an 80% reduction in chances of falling sick with COVID-19 among the residents and about 60% among the workers. There were only four death among the residents and all four of them belonged to the group of people who received a placebo.

This drug has also been allowed for Emergency Use Administration (EUA) by the FDA for patients who show symptoms in the early stages and for those who are at a high risk of developing acute symptoms of COVID-19. As of now it is only being used as a drug for treatment and not as a preventive. The FDA is yet to approve the use of monoclonal antibodies as a preventive.

There are a few disadvantages to a monoclonal antibody as a drug for treatment/prevention: 
  • Firstly it is quite expensive to synthesize and will hence be more costly than a vaccine
  • Secondly, though it shows rapid improvement in patient conditions, its effect is not likely to be long-term unlike a vaccine that takes time for antibody production in the body, but whose effects will be long-term
  • Thirdly, the drug requires infusion into the body and hence needs to be administered in a hospital in the early stages of the infection

A good question posed is: what is the use of monoclonal antibodies, if vaccines are a better alternative? Well, for one monoclonal antibodies help not only in treatment but also in prevention. It is a wonderful option for elderly people, who are the most affected by COVID-19 since they are weak and immunocompromised.

One lingering doubt in the minds of the scientists and people is: why did the antibody have more effect on the elder residents when compared to that of the workers. This is under study now.

Personally, I enjoyed the process of writing this blog post, even if I am just conveying information that's already out there. I feel this method of treatment/prevention against COVID-19 is a great fallback option to have. With new strains of COVID-19 arising, any form of treatment should not be discounted and may come handy in uncertain times! 


Sources
  • https://www.sciencemag.org/news/2021/01/monoclonal-antibodies-can-prevent-covid-19-successful-vaccines-complicate-their-future
  • https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/monoclonal-antibody/art-20047808
  • https://en.wikipedia.org/wiki/Monoclonal_antibody#:~:text=A%20monoclonal%20antibody%20(mAb%20or,is%20recognized%20by%20the%20antibody).
  • https://www.nytimes.com/2021/01/21/health/coronavirus-eli-lilly.html
  • https://www.gavi.org/vaccineswork/what-are-monoclonal-antibodies-and-can-they-treat-covid-19#:~:text=Out%20of%20more%20than%20100,virus%20that%20causes%20Covid%2D19.

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