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Convalescent serum lines up as first-choice treatment for coronavirus
Antibodies from blood donated by people who recovered from the illness and hyper-immunoglobulins are becoming treatments of choice for COVID-19, with recombinant polyclonal antibody approaches to follow.
A group of US academic researchers has sparked a nationwide effort to encourage people who have recovered from COVID-19 to donate plasma, which will be used to treat patients across the country. The convalescent plasma program was instigated by physicians and investigators from 40 institutions, including the Mayo Clinic, Johns Hopkins University, Washington University, Einstein Medical Center and the Icahn School of Medicine at Mount Sinai, among many others working closely with the US Food and Drug Administration (FDA) and industry partners. The UK’s National Health Service launched in April a program across its 23 main blood centers to collect convalescent plasma for testing in planned clinical trials. At the same time, a consortium of industry players — Takeda, CSL Behring, Biotest, Bio Products Laboratory, LFB, Octapharma and Microsoft — has come together to develop an unbranded polyclonal antibody product: hyperimmune globulin (H-Ig) purified from the pooled plasma of donors who have recovered from COVID-19. Elsewhere, convalescent plasma treatment is getting a twenty-first century facelift, with two efforts attempting to capture the entire human antibody repertoire against SARS-CoV-2 in recombinant platforms: a collaboration between SAb Biotherapeutics, CSL Behring and the US Biomedical Advanced Research and Development Authority (BARDA) working to introduce artificial chromosomes into cattle to produce human antibodies and an effort by GigaGen to introduce an antibody library against SARS-CoV-2 into a mammalian cell line. The goal is to scale up polyclonal antibody manufacturing to produce treatment cocktails directed against the betacoronavirus causing COVID-19. But, as with every other response to the pandemic, scaling these efforts to the point where they can have a meaningful and immediate impact presents a complex set of problems.