The Vanderbilt-AstraZeneca team is far from the only group trying to identify or engineer monoclonals against SARS-CoV-2. Unlike the many repurposed drugs now being tested in COVID-19 patients, including the modestly effective remdesivir, the immune proteins specifically target this virus. Whereas some groups hope to sieve a neutralizing antibody (a “neut”) from the blood of a survivor like Dr. X, others are trying to produce a neut in mice by injecting them with the spike protein. Still others aim to re-engineer an existing antibody or even create one directly from DNA sequences.
Many researchers are optimistic that antibodies will, relatively quickly, prove their worth as a preventive or remedy that buys the world time until a vaccine arrives—if it does. “We’ve got at least 50—and probably more we don’t know about—companies and academic labs that are all racing horses,” says immunologist Erica Ollmann Saphire of the La Jolla Institute for Immunology, who leads an effort to coordinate and evaluate these candidates. Regeneron Pharmaceuticals, which developed a cocktail of three monoclonal antibodies that worked against the Ebola virus—a notoriously difficult disease to treat—may be out of the gates first with a candidate monoclonal drug entering clinical trials as soon as next month.
Saphire says many questions remain. “We need a sense of the landscape: What are the most effective antibodies against this virus? If we need a cocktail of two, what is the most effective combination?” she asks. “And you might want a very different kind of antibody to prevent infection versus treating an established one.”
Monoclonal antibodies could potentially be used both for treatment and prevention of #COVID. @WHO happy to work with developers on facilitating trials & mechanisms for affordable access.
The race is on for antibodies that stop the new coronavirus https://t.co/2vNmdFVw3l— Soumya Swaminathan (@doctorsoumya) May 6, 2020