March 12, 2018Infectious Disease
According to an article published online in the New England Journal of Medicine (7 March 2018), monoclonal antibodies (mAbs) -- preparations of a specific type of antibody designed to bind to a single target, not only have shown promise in the fight against cancer and autoimmune diseases, they may also play a critical role in future battles against emerging infectious disease outbreaks.
Although mAbs were originally described in the 1970s, their value has become more widely recognized as processes have been developed to improve approaches to identify, select, optimize and manufacture them. These advances have allowed for improved safety and efficacy, and substantial efficiencies in identifying promising candidates. For example, mAbs now can be identified directly from individuals previously infected by or vaccinated against a specific pathogen. Moreover, modifications can be made to extend the life of a mAb and further improve its safety.
Because mAbs with optimized targeting and other characteristics can be developed, their activity can be precisely tailored to serve specific treatment and prevention purposes. For example, during the 2014-2016 Ebola outbreak, a small clinical trial <https://www.niaid.nih.gov/news-events/study-finds-ebola-treatment-zmapp-holds-promise-although-results-not-definitive> of the drug ZMapp, which contains three different mAbs, appeared to show a drop in mortality among infected volunteers who received the experimental therapeutic. Additionally, research in laboratory animals suggests that mAbs may play a role in protecting pregnant women in Zika-endemic areas and their fetuses from infection. Further, promising preclinical studies suggest that mAbs aimed at specific targets on the influenza virus could treat influenza disease and interrupt influenza transmission when used prophylactically in uninfected individuals.
The authors, however, caution that mAb-based therapies may be costly to develop and deploy, thus should be used judiciously. However, the authors are optimistic that development efforts will increase, as prices will likely fall in the future, and target optimization may offer effectiveness with smaller amounts of antibody. In addition, other novel approaches such as delivering antibodies through DNA or mRNA constructs, may be further developed. By prioritizing research for mAbs against infectious diseases, the authors assert, global health leaders can improve preparedness for treating and preventing emerging and re-emerging infectious diseases.