Monoclonal Antibodies for Emerging Infectious Diseases — Borrowing from History

Abstract

Although antibodies play pivotal roles in the immune response to infection, they have seen limited use as therapeutic agents for infectious diseases. Yet there is a long history of plasma-derived treatments for several pathogens. Emil Adolf von Behring, for example, won the Nobel Prize in Physiology or Medicine in 1901 for the application of animal-derived serum therapies, principally against diphtheria.¹ Since then, plasma-based therapy has been attempted for infectious disease outbreaks ranging from the 1918 influenza pandemic to Ebola outbreaks from 1976 onward. Despite this history and the rapidly accelerating development of monoclonal antibodies (mAbs) for noncommunicable diseases such as cancer and autoimmune conditions, only a handful of antibody therapies have been licensed for infectious diseases (e.g., palivizumab for prophylaxis against respiratory syncytial virus in at-risk infants). Recent conceptual and technological advances in mAb development could have an enormous impact on the field of infectious diseases, particularly in the context of emerging infectious disease (EID) outbreaks, in which the process of vaccine development for new pathogens may be difficult and prolonged. The rapid development and strategic deployment of effective, highly specific preventive and therapeutic interventions have the potential to alter the course of an epidemic.