Impact of immune enhancement on Covid-19 polyclonal hyperimmune globulin therapy and vaccine development

EBioMedicine. 2020 May:55:102768. doi: 10.1016/j.ebiom.2020.102768. Epub 2020 Apr 16.

Abstract

The pandemic spread of a novel coronavirus - SARS coronavirus-2 (SARS-CoV-2) as a cause of acute respiratory illness, named Covid-19, is placing the healthcare systems of many countries under unprecedented stress. Global economies are also spiraling towards a recession in fear of this new life-threatening disease. Vaccines that prevent SARS-CoV-2 infection and therapeutics that reduces the risk of severe Covid-19 are thus urgently needed. A rapid method to derive antiviral treatment for Covid-19 is the use of convalescent plasma derived hyperimmune globulin. However, both hyperimmune globulin and vaccine development face a common hurdle - the risk of antibody-mediated disease enhancement. The goal of this review is to examine the body of evidence supporting the hypothesis of immune enhancement that could be pertinent to Covid-19. We also discuss how this risk could be mitigated so that both hyperimmune globulin and vaccines could be rapidly translated to overcome the current global health crisis.

Keywords: COVID-19; Coronavirus; Polyclonal hyperimmune globulin; SARS-CoV-2; Vaccines.

Publication types

  • Review

MeSH terms

  • Animals
  • Antibodies, Viral / adverse effects*
  • Antibodies, Viral / immunology
  • COVID-19
  • COVID-19 Serotherapy
  • COVID-19 Vaccines
  • Clinical Trials, Phase I as Topic
  • Convalescence
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / immunology*
  • Coronavirus Infections / prevention & control
  • Coronavirus Infections / therapy
  • Dendritic Cells / virology
  • Global Health
  • Host Microbial Interactions / immunology
  • Humans
  • Immunization, Passive
  • Macrophages / virology
  • Models, Animal
  • Monocytes / virology
  • Pandemics* / prevention & control
  • Plasma
  • Plasmapheresis
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / immunology*
  • Pneumonia, Viral / prevention & control
  • Pneumonia, Viral / therapy
  • Receptors, Fc / immunology
  • Translational Research, Biomedical
  • Viral Vaccines / immunology*
  • Virus Internalization*

Substances

  • Antibodies, Viral
  • COVID-19 Vaccines
  • Receptors, Fc
  • Viral Vaccines