Effect of monoclonal antibody therapy on the endogenous SARS-CoV-2 antibody response
Monoclonal antibody treatment of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has been widely implemented. Effects of treatment on the endogenous primary humoral response to the virus are unknown. A retrospective cohort study performed at a Veterans Health Administration me...
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| Published in | Clinical immunology (Orlando, Fla.) Vol. 236; p. 108959 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
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United States
Elsevier Inc
01.03.2022
Academic Press |
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| Abstract | Monoclonal antibody treatment of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has been widely implemented. Effects of treatment on the endogenous primary humoral response to the virus are unknown. A retrospective cohort study performed at a Veterans Health Administration medical center compared serologic responses of treated and untreated COVID-19 patients at high risk for severe outcomes. Three anti-viral spike protein IgG monoclonal treatments were used during the study period, 1) bamlanivimab, 2) casirivimab with imdevimab, and 3) bamlanivimab with etesevimab. Data were analyzed at acute (0–9 days), seroconversion (10–19 days), and maximum antibody (20–39 days) stages. SARS-Cov-2 infection induced a dynamic primary humoral response with anti-spike IgM and anti-nucleocapsid IgG seroconversion occurring after 9 days with maximum serologic indices achieved by 20–39 days. All monoclonal antibody treatments suppressed the endogenous anti-spike IgM response by 85–90% with minor effect on the anti-nucleocapsid response. Thus, passive immunization therapy may cause immunologic interference.
•Acute stage SARS-CoV-2 infection can be confirmed by combined laboratory testing modalities•Anti-SARS-CoV-2 monoclonal antibodies administered in the acute stage suppresses the endogenous anti-viral primary IgM humoral response•While clinically beneficial, anti-SARS-CoV-2 monoclonal antibody therapy should be followed with vaccination after antibody clearance |
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| AbstractList | Monoclonal antibody treatment of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has been widely implemented. Effects of treatment on the endogenous primary humoral response to the virus are unknown. A retrospective cohort study performed at a Veterans Health Administration medical center compared serologic responses of treated and untreated COVID-19 patients at high risk for severe outcomes. Three anti-viral spike protein IgG monoclonal treatments were used during the study period, 1) bamlanivimab, 2) casirivimab with imdevimab, and 3) bamlanivimab with etesevimab. Data were analyzed at acute (0-9 days), seroconversion (10-19 days), and maximum antibody (20-39 days) stages. SARS-Cov-2 infection induced a dynamic primary humoral response with anti-spike IgM and anti-nucleocapsid IgG seroconversion occurring after 9 days with maximum serologic indices achieved by 20-39 days. All monoclonal antibody treatments suppressed the endogenous anti-spike IgM response by 85-90% with minor effect on the anti-nucleocapsid response. Thus, passive immunization therapy may cause immunologic interference. Monoclonal antibody treatment of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has been widely implemented. Effects of treatment on the endogenous primary humoral response to the virus are unknown. A retrospective cohort study performed at a Veterans Health Administration medical center compared serologic responses of treated and untreated COVID-19 patients at high risk for severe outcomes. Three anti-viral spike protein IgG monoclonal treatments were used during the study period, 1) bamlanivimab, 2) casirivimab with imdevimab, and 3) bamlanivimab with etesevimab. Data were analyzed at acute (0-9 days), seroconversion (10-19 days), and maximum antibody (20-39 days) stages. SARS-Cov-2 infection induced a dynamic primary humoral response with anti-spike IgM and anti-nucleocapsid IgG seroconversion occurring after 9 days with maximum serologic indices achieved by 20-39 days. All monoclonal antibody treatments suppressed the endogenous anti-spike IgM response by 85-90% with minor effect on the anti-nucleocapsid response. Thus, passive immunization therapy may cause immunologic interference.Monoclonal antibody treatment of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has been widely implemented. Effects of treatment on the endogenous primary humoral response to the virus are unknown. A retrospective cohort study performed at a Veterans Health Administration medical center compared serologic responses of treated and untreated COVID-19 patients at high risk for severe outcomes. Three anti-viral spike protein IgG monoclonal treatments were used during the study period, 1) bamlanivimab, 2) casirivimab with imdevimab, and 3) bamlanivimab with etesevimab. Data were analyzed at acute (0-9 days), seroconversion (10-19 days), and maximum antibody (20-39 days) stages. SARS-Cov-2 infection induced a dynamic primary humoral response with anti-spike IgM and anti-nucleocapsid IgG seroconversion occurring after 9 days with maximum serologic indices achieved by 20-39 days. All monoclonal antibody treatments suppressed the endogenous anti-spike IgM response by 85-90% with minor effect on the anti-nucleocapsid response. Thus, passive immunization therapy may cause immunologic interference. Monoclonal antibody treatment of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has been widely implemented. Effects of treatment on the endogenous primary humoral response to the virus are unknown. A retrospective cohort study performed at a Veterans Health Administration medical center compared serologic responses of treated and untreated COVID-19 patients at high risk for severe outcomes. Three anti-viral spike protein IgG monoclonal treatments were used during the study period, 1) bamlanivimab, 2) casirivimab with imdevimab, and 3) bamlanivimab with etesevimab. Data were analyzed at acute (0–9 days), seroconversion (10–19 days), and maximum antibody (20–39 days) stages. SARS-Cov-2 infection induced a dynamic primary humoral response with anti-spike IgM and anti-nucleocapsid IgG seroconversion occurring after 9 days with maximum serologic indices achieved by 20–39 days. All monoclonal antibody treatments suppressed the endogenous anti-spike IgM response by 85–90% with minor effect on the anti-nucleocapsid response. Thus, passive immunization therapy may cause immunologic interference. •Acute stage SARS-CoV-2 infection can be confirmed by combined laboratory testing modalities•Anti-SARS-CoV-2 monoclonal antibodies administered in the acute stage suppresses the endogenous anti-viral primary IgM humoral response•While clinically beneficial, anti-SARS-CoV-2 monoclonal antibody therapy should be followed with vaccination after antibody clearance |
| ArticleNumber | 108959 |
| Author | Kim, Paul S. Dimcheff, Derek E. Chensue, Stephen W. Siler, Andrew Schildhouse, Richard J. |
| Author_xml | – sequence: 1 givenname: Paul S. surname: Kim fullname: Kim, Paul S. organization: Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA – sequence: 2 givenname: Derek E. surname: Dimcheff fullname: Dimcheff, Derek E. organization: Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA – sequence: 3 givenname: Andrew surname: Siler fullname: Siler, Andrew organization: Pharmacy Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA – sequence: 4 givenname: Richard J. surname: Schildhouse fullname: Schildhouse, Richard J. organization: Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA – sequence: 5 givenname: Stephen W. surname: Chensue fullname: Chensue, Stephen W. email: stephen.chensue@va.gov, schensue@med.umich.edu organization: Pathology and Laboratory Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35218964$$D View this record in MEDLINE/PubMed |
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| Keywords | eGFR IMD anti-S FDA CDC anti-N Monoclonal antibody BAM VHA mAb COVID-19 EUA ACE2 SARS-CoV-2 CAS ETE Passive immunization Humoral immunity BMI |
| Language | English |
| License | This is an open access article under the CC BY-NC-ND license. Published by Elsevier Inc. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
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| SubjectTerms | Antibodies, Monoclonal - therapeutic use Antibodies, Monoclonal, Humanized Antibodies, Neutralizing Antibodies, Viral Antibody Formation COVID-19 Humans Humoral immunity Monoclonal antibody Passive immunization Retrospective Studies SARS-CoV-2 |
| Title | Effect of monoclonal antibody therapy on the endogenous SARS-CoV-2 antibody response |
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