Are the presently licensed antibody treatments used to treat patients who have a higher risk of developing severe COVID-19 disease also effective against the viral variants that are currently in circulation? The Omicron sub-lineage BQ.1.1, which is currently spreading throughout the world, is resistant to all recognized antibody treatments, according to a recent study by researchers at the German Primate Center (DPZ)—the Leibniz Institute for Primate Research and Friedrich-Alexander University Erlangen-Nürnberg (The Lancet Infectious Diseases).
An immune response that results in the development of neutralizing antibodies that aid in protecting against (re)infection with SARS-CoV-2 or a severe course of the disease is produced by either an infection with the SARS coronavirus-2 (SARS-CoV-2) or a vaccination against COVID-19. By attaching to the viral spike protein, neutralizing antibodies offer defense and stop the virus from entering cells. However, some SARS-CoV-2 variations, particularly the Omicron form, avoid neutralizing antibodies and induce symptomatic infections even in vaccinated or recuperating individuals due to changes in the spike protein. This is known as immune evasion, and it poses a hazard to high-risk populations like the elderly and those whose immune systems have already been compromised, maybe as a result of disease or medicine. Even after receiving all of their vaccinations, they frequently fail to mount an immune response powerful enough to protect them from serious illness. Biotechnologically generated antibodies are given to high-risk patients as a preventative strategy or as an early therapy after SARS-CoV-2 infection has been confirmed. Different SARS-CoV-2 variants with spike protein mutations confer resistance to specific antibody treatments. Therefore, it is crucial to constantly check if therapeutic antibodies are still effective against viral strains that are currently in circulation.
The effectiveness of approved antibody therapies in inhibiting the currently circulating Omicron subvariants has been studied by a team of researchers from the Division of Molecular Immunology at the Friedrich-Alexander-University Erlangen-Nürnberg and the Infection Biology Unit at the German Primate Center—Leibniz Institute for Primate Research. The Omicron subvariant BQ.1.1, which is becoming more prevalent globally, has been discovered by the researchers to be resistant to every type of antibody treatment. “For our research, we combined various dilutions of the antibodies to be tested with non-propagating viral particles carrying the spike protein of chosen viral variations, and then we evaluated the quantity of antibody required to prevent infection of cell cultures.” Six of the twelve antibodies we evaluated individually and four antibody combinations have clinical use approval in Europe. Prerna Arora, the study’s principal author, notes Researchers discovered that neither individual antibodies nor antibody mixtures were able to neutralize the Omicron subvariant BQ.1.1. On the other hand, one authorized antibody and two authorized antibody mixtures were still able to neutralize the currently dominant Omicron subvariant BA.5. “We are particularly concerned about the Omicron subvariant BQ.1.1 being resistant to all current antibody treatments in high-risk patients.” Physicians should consider using alternative medications, such as paxil or molnupiravir, in addition to antibody treatments when treating infected high-risk patients, especially in areas where BQ.1.1 is common. “Markus Hoffmann, the study’s lead author, offers his thoughts on its findings.
The discovery that a new antibody therapy that is soon to be approved in the U.S. is already ineffective against the Omicron subvariant BQ.1.1 emphasizes the significance of creating new antibody treatments for COVID-19. “The need for new antibody therapeutics that are precisely targeted to viral variations that are already circulating and those that will emerge arises from the SARS-CoV-2 variants’ escalating development of antibody resistance.” “Targeting areas of the spike protein with a low risk of escape mutations would be ideal,” says Stefan Pöhlmann, director of the Infection Biology Unit at the German Primate Center—Leibniz Institute for Primate Research.
