Therapeutic Role of Neutralizing Antibody for the Treatment against SARS-CoV-2 and Its Emerging Variants: A Clinical and Pre-Clinical Perspective

Abstract

Since early 2020, the entire world has been facing a disastrous outbreak of the SARS-CoV-2 virus, with massive reporting of death and infections per day. Medical practitioners adopted certain measures such as convalescent plasma therapy, antibody treatment, and injecting vaccines to eradicate the pandemic. In this review, we have primarily focused on the neutralizing antibodies presently under pre-clinical and clinical trials, focusing on their structures, binding affinity, mechanism of neutralization, and advantages over other therapeutics. We have also enlisted all the nAbs against SARS-CoV-2 and its emerging variants in different phases of clinical trials (phase-1, phase-II, and phase-III). The efficacy of administering antibody cocktails over the normal antibodies and their efficacy for the mutant variants of the SARS-CoV-2 virus in minimizing viral virulence is discussed. The potent neutralizing antibodies have eliminated many of the common problems posed by several other therapeutics. A common mechanism of the antibodies and their relevant sources have also been listed in this review.

A Detailed Overview of SARS-CoV-2 Omicron: Its Sub-Variants, Mutations and Pathophysiology, Clinical Characteristics, Immunological Landscape, Immune Escape, and Therapies

“…Scientists are facing a real challenge to finding therapeutic antibodies against the Omicron variant because the therapeutic antibody escapes their neutralization efficacy due to certain properties of the Omicron variant [ 120 , 136 ]. Due to this, several scientists have tried to evaluate therapeutic antibodies against the Omicron variant over time and assess their efficacy of naturalization ( Table 3 ).…”

Targeting SARS-CoV-2 and host cell receptor interactions

“…This Ab showed broad inhibition of SARS-CoV-2 wildtype and all VOCs, including Delta (B.1.617.2), Omicron BA.1, and BA.2. Readers are encouraged to refer to excellent reviews by Strohl et al (2022) , Zhang et al (2022) and Bhattacharya et al (2022) for deeper insights into the Ig isotope and epitope recognition sites of the different neutralizing antibodies with EUA or under clinical development.…”

Therapeutic applications of nanobodies against SARS-CoV-2 and other viral infections: Current update

“…The S-glycoprotein of the SARS-CoV-2 virus is believed to contain multiple epitopes, which are the major targets of the antibodies. The S-glycoprotein of the virus attaches to the surface of the host ACE2 receptor and other co-receptors and mediates the event of membrane fusion [15] . Due to the structural conformation, the receptor-binding domain (RBD) exists in two known conformations, namely “up” and “down”.…”