Antibody-dependent enhancement and SARS-CoV-2 vaccines and therapies
Open accessAbstract
Antibody-based drugs and vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are being expedited through preclinical and clinical development. Data from the study of SARS-CoV and other respiratory viruses suggest that anti-SARS-CoV-2 antibodies could exacerbate COVID-19 through antibody-dependent enhancement (ADE). Previous respiratory syncytial virus and dengue virus vaccine studies revealed human clinical safety risks related to ADE, resulting in failed vaccine trials. Here, we describe key ADE mechanisms and discuss mitigation strategies for SARS-CoV-2 vaccines and therapies in development. We also outline recently published data to evaluate the risks and opportunities for antibody-based protection against SARS-CoV-2.
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“The relevance for antibody-dependent enhancement of disease (ADE) in the context of a range of different viral infections, including SARS-CoV and SARS-CoV-2, is reviewed elsewhere (Arvin et al., 2020; Bournazos et al., 2020b; Lee et al., 2020).”
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- Authors
- Lee, W. S., Wheatley, A. K., Kent, S. J., & DeKosky, B. J.
- Affiliations
- The University of Melbourne (AU)
- University of Kansas (US)
- Corresponding author
- Kent, Stephen J.
- DeKosky, Brandon J.
- Venue
- Nature Microbiology
- Published
- 2020-09-09
- Volume
- 5
- Issue
- 10
- Pages
- 1185-1191
- ISSN
- 2058-5276 (ISSN-L)
- PMC
- PMC12103240
- OpenAlex
- W3083773456
- Cited by
- 676
- References
- 104
- Citations by year
- 2026: 21 · 2025: 41 · 2024: 45 · 2023: 88 · 2022: 160 · 2021: 282 · 2020: 39
- FWCI
- 6.72
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Nature Microbiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Fast Grants
- State Government of Victoria
- National Institutes of Health (DP5OD023118, COVID-19)
- Medical Research Council (COVID-19)
- National Health and Medical Research Council (1149990, 1162760)
- National Institute of Allergy and Infectious Diseases (R21AI143407)
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Animal Virus Infections Studies
- Keywords
- antibody-dependent enhancement, SARS-CoV-2, COVID-19 vaccines, antibody-based therapy, vaccine safety, respiratory syncytial virus, dengue virus, SARS-CoV, neutralizing antibodies
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, COVID-19 Vaccines, COVID-19 Drug Treatment, COVID-19 Serotherapy, Animals, Antibodies, Monoclonal, Antibodies, Viral, Humans, Immunization, Passive, Pneumonia, Viral, Respiratory Tract Diseases, Risk Factors, Safety, Viral Vaccines, Coronavirus Infections, Models, Immunological, Antibody-Dependent Enhancement, Antibodies, Neutralizing, Pandemics, In Vitro Techniques
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