Single Monoclonal Antibodies Should Not Be Used for COVID-19 Therapy: A Call for Antiviral Stewardship.

IF 7.3 1区医学 Q1 IMMUNOLOGY Clinical Infectious Diseases Pub Date : 2024-12-17 DOI:10.1093/cid/ciae408

Arturo Casadevall, Daniele Focosi, Liise-Anne Pirofski, Shmuel Shoham

引用次数: 0

Abstract

The COVID-19 pandemic witnessed the greatest deployment of monoclonal antibody (mAb) therapies for an infectious disease, but all were defeated by SARS-CoV-2 evolution. As new mAbs are developed, the infectious disease community needs stewardship practices to reduce emergence of resistance.

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COVID-19治疗不应使用单一单克隆抗体：呼吁加强抗病毒管理。

在 COVID-19 大流行中，使用单克隆抗体（mAbs）治疗传染病的规模是历史上最大的。事实证明，针对 SARS-CoV-2 尖峰蛋白的 mAbs 是安全的，最初对 COVID-19 治疗有效，但由于 SARS-CoV-2 的持续演变，每种 mAbs 都被打败，导致它们被撤回。这对于免疫力低下的人来说是一个挫折，因为他们无法对 SARS-CoV-2 产生有效的抗体反应，也往往无法清除病毒。现在已经开发出新的 mAb，用于免疫抑制人群的暴露前预防（PreEP）。在此，我们认为，虽然将 mAb 用于 PreEP 是合理的，但不应将单一 mAb 用于 COVID-19 治疗。与病毒接种体较小的 PreEP 相比，COVID-19 免疫抑制患者的病毒负荷较大，可能蕴藏着 mAb-escape 变异体，单药 mAb 治疗可迅速选择出耐药性。选择 mAb-escape 变异体对患者、社会和 mAb 治疗本身的可行性都有潜在风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Infectious Diseases 医学-传染病学

CiteScore

25.00

自引率

2.50%

发文量

900

审稿时长

3 months

期刊介绍： Clinical Infectious Diseases (CID) is dedicated to publishing original research, reviews, guidelines, and perspectives with the potential to reshape clinical practice, providing clinicians with valuable insights for patient care. CID comprehensively addresses the clinical presentation, diagnosis, treatment, and prevention of a wide spectrum of infectious diseases. The journal places a high priority on the assessment of current and innovative treatments, microbiology, immunology, and policies, ensuring relevance to patient care in its commitment to advancing the field of infectious diseases.