Monoclonal antibodies to treat COVID patients should always be used in pairs to minimise mutation formation: former ICMR DG

By Joymala Bagchi
New Delhi [India], May 31 : Monoclonal antibodies, recently introduced in India as an antibody therapy to treat COVID-positive patients, are being used to minimise mutation formation and should always be used in a pair, said Dr Nirmal K Ganguly, former Director-General of the Indian Council of Medical Research (ICMR) on Monday.
When a single one is used, it causes a lot of mutation in the virus, which is why a cocktail is used to minimise mutation formation and thus always used in pairs, Dr Ganguly told ANI, adding that it prevents the spike protein from attaching to s2 receptor and beta integrin receptor.
"Plasma therapy, which differs in quality and quantity, has been disapproved and monoclonal antibodies has been introduced, which is made in very high concentration and tested in neutralising access to see how efficient they are. Essentially, these monoclonal antibodies prevent spike proteins from attaching to s2 receptor and beta integrin receptor," he said.
Citing ineffectiveness in the number of new cases as per the guidelines of the ICMR, he supported dropping the use of convalescent plasma theory from the recommended treatment protocols for COVID-19.
The expert while speaking on how the antibody therapy works explained, "Monoclonal antibody works against the targeted epitope, against virus proteins that are in the spike region and against that particular domain only to know how specifically they are reacting."
The monoclonal antibodies which are available against the spike protein are IGGI which is very specific and homogeneous, says the expert.
These antibodies are lab-made and are specifically tailored to fight the disease they treat. The artificial process through which monoclonal antibodies are made is a fermentation process in which one produces a few vials.
"Monoclonal antibodies work as they're made against targeted epitope. There are six receptor-binding domain points that are important in spike protein, which undergo mutation/functional enhancement to create specific monoclonal antibody," said Dr Ganguly.
The monoclonal antibody therapy was recently given approval in India. The first person to be administered the antibody therapy was an 84-year old male Covid-positive patient in Gurgaon who went back to his home after treatment on May 27.
He has become the first person in India to be administered the COVID drug cocktail, which came into the limelight after it was administered to former US President Donald Trump when he tested positive for the virus last year.
This FDA-approved therapy demonstrated good efficacy in Phase 1/2 and Phase 3 studies by reducing COVID-19 related hospitalization and death by 70 per cent. Approved by the Drugs Controller General of India (DCGI), this single dose infusion-based treatment can be provided on an outpatient or daycare basis and marks a dramatic shift in coronavirus care in India.