A perspective on potential antibody-dependent enhancement of SARS-CoV-2.
Animals
Antibodies, Neutralizing
/ adverse effects
Antibodies, Viral
/ adverse effects
Antibody-Dependent Enhancement
/ immunology
Betacoronavirus
/ immunology
COVID-19
COVID-19 Vaccines
Coronavirus Infections
/ immunology
Dengue Virus
/ immunology
Disease Models, Animal
HEK293 Cells
Humans
Immunoglobulin Fab Fragments
/ immunology
Immunoglobulin Fc Fragments
/ immunology
Immunoglobulin G
/ immunology
Macaca mulatta
Mice
Middle East Respiratory Syndrome Coronavirus
/ immunology
Orthomyxoviridae
/ immunology
Pandemics
Pneumonia, Viral
/ immunology
Rats
Severe acute respiratory syndrome-related coronavirus
/ immunology
SARS-CoV-2
Viral Vaccines
/ adverse effects
Journal
Nature
ISSN: 1476-4687
Titre abrégé: Nature
Pays: England
ID NLM: 0410462
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
15
05
2020
accepted:
06
07
2020
pubmed:
14
7
2020
medline:
28
8
2020
entrez:
14
7
2020
Statut:
ppublish
Résumé
Antibody-dependent enhancement (ADE) of disease is a general concern for the development of vaccines and antibody therapies because the mechanisms that underlie antibody protection against any virus have a theoretical potential to amplify the infection or trigger harmful immunopathology. This possibility requires careful consideration at this critical point in the pandemic of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here we review observations relevant to the risks of ADE of disease, and their potential implications for SARS-CoV-2 infection. At present, there are no known clinical findings, immunological assays or biomarkers that can differentiate any severe viral infection from immune-enhanced disease, whether by measuring antibodies, T cells or intrinsic host responses. In vitro systems and animal models do not predict the risk of ADE of disease, in part because protective and potentially detrimental antibody-mediated mechanisms are the same and designing animal models depends on understanding how antiviral host responses may become harmful in humans. The implications of our lack of knowledge are twofold. First, comprehensive studies are urgently needed to define clinical correlates of protective immunity against SARS-CoV-2. Second, because ADE of disease cannot be reliably predicted after either vaccination or treatment with antibodies-regardless of what virus is the causative agent-it will be essential to depend on careful analysis of safety in humans as immune interventions for COVID-19 move forward.
Identifiants
pubmed: 32659783
doi: 10.1038/s41586-020-2538-8
pii: 10.1038/s41586-020-2538-8
doi:
Substances chimiques
Antibodies, Neutralizing
0
Antibodies, Viral
0
COVID-19 Vaccines
0
Immunoglobulin Fab Fragments
0
Immunoglobulin Fc Fragments
0
Immunoglobulin G
0
Viral Vaccines
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
353-363Références
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