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Review
. 2023 Aug;19(2):2260040.
doi: 10.1080/21645515.2023.2260040. Epub 2023 Oct 6.

Respiratory delivery of passive immunotherapies for SARS-CoV-2 prophylaxis and therapy

Daniele Focosi  1 , Fabrizio Maggi  2
Affiliations
Review

Respiratory delivery of passive immunotherapies for SARS-CoV-2 prophylaxis and therapy

Daniele Focosi et al. Hum Vaccin Immunother. 2023 Aug.

Abstract

Convalescent plasma has been extensively tested during the COVID-19 pandemic as a transfusion product. Similarly, monoclonal antibodies have been largely administered either intravenously or intramuscularly. Nevertheless, when used against a respiratory pathogen, respiratory delivery is preferable to maximize the amount of antibody that reaches the entry door in order to prevent sustained viral multiplication. In this narrative review, we review the different types of inhalation device and summarize evidence from animal models and early clinical trials supporting the respiratory delivery (for either prophylactic or therapeutic purposes) of convalescent plasma or monoclonal antibodies (either full antibodies, single-chain variable fragments, or camelid-derived monoclonal heavy-chain only antibodies). Preliminary evidences from animal models suggest similar safety and noninferior efficacy, but efficacy evaluation from clinical trials is still limited.

Keywords: COVID-19; Convalescent plasma; SARS-CoV-2; Spike; monoclonal antibodies; nasal immunotherapies; neutralizing antibodies; passive immunotherapies.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Potential approaches for respiratory delivery of passive immunotherapeutics against COVID-19.
See this image and copyright information in PMC

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