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COVID-19

Monoclonal Antibodies — the Mercenary Army that Might be able to Fight Covid-19

The Coronavirus — Photo Courtesy of Wikimedia Commons

This is a good thing. We need to throw everything at this disease, and see what works.

And there are quite a few types of these vaccines, each with their own powers and drawbacks.

  • We are exploring Nucleic-acid vaccines, which are cutting edge but haven’t had a precedent of successfully fighting off any other disease.
  • We are exploring treatment through the BCG Tuberculosis Vaccine, which proponents believe provides some off-target protection against Covid-19. This is currently being studied in Australia and the Netherlands, but note that many scientists are skeptical of this treatment.
  • Of course, we are also exploring the standard methodologies of making a vaccine through weakened or inactivated viruses. We’ve made vaccines in this way for centuries, but have not yet found a way to treat Covid-19 through this path.

And then there are protein-based vaccines, Trojan-horse vaccines, and more.

Man holding syringe and vaccine — Photo Courtesy of Dimitri Houtteman and Unsplash
There are over 90 vaccines for Covid-19 in development as of 7–1–20 — And if just one works, it will all be worth it

Again, this is all great; if just one vaccine works, be it from an old methodology or a cutting edge technology, it will be worth it.

But while we’re searching for these vaccines, as well as cures, we may also have an alternative treatment, one born of existing technology and knowledge

It’s not training our bodies’ own army, but rather importing an external temporary army, an army of mercenaries.

And these mercenaries are called monoclonal antibodies.

Monoclonal antibodies — mercenary agents that (may) pack a punch

What is treatment with monoclonal antibodies?

In short, it is one form of injecting foreign antibodies to a disease into a recipient’s system, either to confer a temporary immunity, or to treat an already-infected patient.

Infographic of how monoclonal antibodies might help both uninfected and infected people
An infographic showing how treatment through monoclonal antibodies could work, in theory at least

Though there is not yet sufficient data proving this treatment’s efficacy for Covid-19, treatment through monoclonal antibodies has been successfully employed against other diseases and syndromes.

For example, treatment of Ebola patients with introduced monoclonal antibodies brought their survival rates up to 90%.

The Ebola virus — photo courtesy of the CDC and Unsplash
The Ebola Virus

And monoclonal antibodies can be produced in great quantities.

Monoclonal antibodies can be produced at scale

Many pipettes — Photo courtesy of Louis Reed and Unsplash

You can, of course, import another recovered patient’s antibodies en masse through convalescent plasma, which takes their Covid-19 antibodies and every other antibody. This method is not that scalable, and so far the data also indicates that it is not effective for treating Covid-19.

Growing antibodies in clone cells, either in a lab or a living specimen, is a bit more scalable.

If the clone cells produce all the recovering or recovered cells’ antibodies, they would make polyclonal antibodies.

If the clone cells produce just one type of antibody, perhaps the one type of antibody that you need, they would make monoclonal antibodies.

You might call such antibodies mercenaries because they are effectively foreign agents introduced to fight on an otherwise ill-prepared immune system’s behalf.

You might call them an alternative treatment, because they are not a vaccine, nor are they technically a cure.

But whatever you call it, such treatment has its upside, and it also has its share of advocates.

The data on this mercenary approach of monoclonal antibodies is not yet conclusive, but the concept has its proponents

The Coronavirus — photo courtesy of Fusion Medical Animation and Unsplash
The Coronavirus

Yale Immunobiology Professor Akiko Iwasaki suggested on Noah Feldman’s Podcast that treatment through monoclonal antibodies may be effective, and additionally―we may already have a leg up the technique. According to Dr. Iwasaki:

You hear on TV lots of commercials that use the monoclonal antibody for let’s say psoriasis or arthritis, and so many, many companies now have great capacity and expertise to generate a very effective monoclonal antibody against a variety of things, including viruses and bacteria, so I think that leveraging the existing capacity as well expertise of the pharma and biotechnology that we can quickly generate and hopefully distribute safe and effective monoclonal antibodies.

Make no mistake, Iwasaki wants to explore treatment of Covid-19 monoclonal antibodies within the context of exploring everything else as well, but she believes this technique of sidestepping the standard processes of immunization may have its benefits:

[Protection through monoclonal antibodies] can last up to months, maybe up to 6 months or even longer … And not only that, but some monoclonal antibodies have a vaccine effect, meaning that once the monoclonal antibody binds to the surface of the virus, that can sort of educate the immune response to generate more of these antibodies against the virus by sort of vaccinating a person that way.

Monoclonal antibodies not only confer transient protection but potentially can vaccinate you against the virus when the virus enters the body of that person.

So this treatment may provide a temporary immunity, and that immunity might even become a permanent one.

That’s a maybe, at least.

And where we are as of now, a maybe is worth exploring.

The Flu Vaccine — Photo courtesy of the CDC and Unsplash
Monoclonal antibodies are not vaccines, but there is a chance they could help the body develop its own immunity

So in short, monoclonal antibodies might not be the silver bullet―but they still have quite a bit of upside

Monoclonal antibodies may be employed as a temporary prophylaxis, or at least an immune-boost for essential health care workers in an infected setting.

Since this technique sidesteps the immune processes, its prophylactic properties would be effective immediately.

And we’ve done this before. Like Dr. Iwasaki said, producing and testing monoclonal antibodies is not some unproven technology. Pharmaceutical companies and the world of Biotech have been making monoclonal antibodies at scale for years, to treat everything from cancer to arthritis.

If monoclonal antibodies prove effective (and that is a big if), the world may already have the infrastructure to deliver them.

There are substantial challenges of course, and this alternative treatment should be held up to the same scrutiny as every other treatment:

  • Does it deliver the antibodies to the right place, i.e. the lungs?
  • If the antibodies arrive in the right place, are they effective?
  • Could this treatment be dangerous?

We always have to pay attention to that last one, considering there was a Dengue Fever vaccine that was shown to worsen outcomes in patients that have not yet had the disease.

But though monoclonal antibodies are not a true vaccine, and might not even be considered a cure either, they must be explored.

The world is currently in a war now, and we need all the help we can get, even from alternative treatments―even from mercenary antibodies.

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