Effect of monoclonal antibody therapy on the endogenous SARS-CoV-2 antibody response

SARS-CoV-2 Anti-Spike IgG Antibody and ACE2 Receptor Binding Inhibition Levels among Breakthrough Stage Veteran Patients

“…As shown in Fig. 2B , anti-N IgG antibodies appeared with similar kinetics in both groups with most individuals positive after day 10, as we previously reported for a primary response to SARS-CoV-2 nucleocapsid antigen ( 8 ). Because there was no evidence of a secondary anamnestic anti-N response, it indicated that no previous occult infections had occurred.…”

“…However, a novel finding was our observation that previously infected subjects that had undergone SARS-CoV-2 anti-S monoclonal antibody (MAb) therapy did not display this augmentation. We previously reported that MAb treatment suppressed the endogenous anti-S antibody response in what appeared to be an epitope-specific manner because the anti-N antibody response was largely unaffected ( 8 ). Our current findings agree with this and suggest that, regarding the anti-S antibody response, MAb therapy keeps subjects in a naive state during infection and recovery, presumably by preventing expansion of memory B cells by either epitope blockade or reduction of antigen load or possibly both.…”

COVID-19 convalescent plasma boosts early antibody titer and does not influence the adaptive immune response

“…We hypothesized that receipt of CCP might have blunted the host anti-S antibody response, in part due to historical information such as the use of anti-D antibody to block Rh immunization ( 30 ). Two studies of mAb therapy suggest modest suppression of host anti-spike antibody responses, either through monitoring of antibodies targeting regions of spike that are not targeted by the mAb ( 31 ) or via measuring anti–spike IgM in patients versus controls treated with mAb therapy ( 32 ). In contrast, a study of CCP showed no difference in anti-spike antibody levels within days after therapy between those who did or did not receive CCP ( 14 ), consistent with our findings.…”

Endogenous antibody response to SARS-CoV-2 in patients who received monoclonal antibodies against COVID-19: A systematic review

“…In the study of Zhang et al [6] , when compared to placebo recipients, the antibody titres against spike-E484K, spike NTD and NCP and against spike NTD and NCP were reduced among patients treated with bamlanivimab and bamlanivimab + etesevimab, respectively. Similarly, Kim et al [5] identified a reduction of anti-S IgM among bamlanivimab and casirivimab + imdevimab treated subjects compared to the untreated group, which persisted up to 39 days after mAbs infusion. Anti-N IgG level were less significantly impacted with significant reductions of 50% only in the casirivimab + imdevimab treated group.…”