Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 May:55:102768.
doi: 10.1016/j.ebiom.2020.102768. Epub 2020 Apr 16.

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

Ruklanthi de Alwis  1 , Shiwei Chen  2 , Esther S Gan  2 , Eng Eong Ooi  3
Affiliations
Review

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

Ruklanthi de Alwis et al. EBioMedicine. 2020 May.

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.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Mechanism of ADE and antibody mediated immunopathology. Left panel: For ADE, immune complex internalization is mediated by the engagement of activating Fc receptors on the cell surface. Co-ligation of inhibitory receptors then results in the inhibition of antiviral responses which leads to increased viral replication. Right panel: Antibodies can cause immunopathology by activating the complement pathway or antibody-dependent cellular cytotoxicity (ADCC). For both pathways, excessive immune activation results in the release of cytokines and chemokines, leading to enhanced disease pathology.
See this image and copyright information in PMC

References

    1. WHO . In: Coronavirus disease 2019 (COVID-19) situation report 72. WHO, editor. WHO; Geneva: 2020. editor. WHO.
    1. Guan W.J., Ni Z.Y., Hu Y. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020 Available from: https://www.nejm.org/doi/full/10.1056/NEJMoa2002032. - DOI - PMC - PubMed
    1. Mair-Jenkins J., Saavedra-Campos M., Baillie J.K. The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review and exploratory meta-analysis. J Infect Dis. 2015;211(1):80–90. - PMC - PubMed
    1. Hung I.F.N., To K.K.W., Lee C.K. Hyperimmune IV immunoglobulin treatment: a multicenter double-blind randomized controlled trial for patients with severe 2009 influenza A(H1N1) infection. Chest. 2013;144(2):464–473. - PubMed
    1. Cheng Y., Wong R., Soo Y.O. Use of convalescent plasma therapy in SARS patients in Hong Kong. Eur J Clin Microbiol Infect Dis. 2005;24(1):44–46. - PMC - PubMed

MeSH terms