使用针对 COVID-19 的免疫球蛋白和单克隆抗体

Elena E. Popadyuk, T. E. Sizikova, A. L. Khmelev, M. A. Timofeev, V. N. Lebedev, S. Borisevich
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摘要

导言。当一种新的疾病发生时,最经济实惠的疗法之一就是含有针对这种传染病病原体的特异性抗体的药物。使用这类药物的目的是减少大生物体中的病原体数量,从而减轻疾病症状的严重程度或使疾病痊愈。本综述旨在分析大流行期间使用免疫球蛋白和单克隆抗体治疗 COVID-19 患者的经验。结果和结论。从康复者血浆中提取的药物(免疫球蛋白)和人类单克隆抗体是阻断 SARS-CoV-2 病毒侵入容许细胞的两大类医疗保护剂。治疗 COVID-19 的第一类药物包括康复者血浆,可成功用于紧急预防。使用康复者血浆的主要缺点是,由于献血者体内特异性抗体的含量不同,很难实现标准化。另一个缺点是血浆注射后会对接受者产生不良副作用。COVID-19 疗法的另一种方法是使用针对 SARS-CoV-2 病毒某些表位的人源化和基因工程人类单克隆抗体。例如,针对 S 蛋白受体结合域的单克隆抗体可阻止病毒进入许可细胞并阻断感染的发展。这类药物的优点是安全、特异性强、可实现标准化。然而,由于其生产的复杂性和高昂的成本,在实际医疗中无法大规模使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The use of immunoglobulins and monoclonal antibodies against COVID-19
Introduction. When a new disease occurs, one of the most affordable remedies is drugs containing specific antibodies to this infectious agent. The use of such drugs is aimed at reducing the amount of the pathogen in the macroorganism and the associated reduction in the severity of the symptoms of the disease or recovery. The purpose of this review is to analyze the experience of using immunoglobulins and monoclonal antibodies in the treatment of COVID-19 patients during the pandemic. Results and conclusion. The two main groups of medical protective agents that block the penetration of the SARS-CoV-2 virus into permissive cells are drugs obtained from blood plasma of convalescents (immunoglobulin) and human monoclonal antibodies. The first group of drugs in the treatment of COVID-19 includes blood plasma of convalescents, which can be successfully used for emergency prevention. The main disadvantage of using blood plasma convalescents is the difficulty of standardization due to the different content of specific antibodies in donors. Another disadvantage is the undesirable side effects in recipients that occur after plasma administration. An alternative approach to COVID-19 therapy is the use of humanized and genetically engineered human monoclonal antibodies against certain epitopes of the SARS-CoV-2 virus. For example, monoclonal antibodies against receptor-binding domain of the S-protein, which prevents the virus from entering permissive cells and interrupts the development of infection. The advantages of these drugs are their safety, high specific activity, and the possibility of standardization. However, the complexity of their production and high cost make them inaccessible for mass use in practical medicine.
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