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Covid, the Spike Protein, & Monoclonal Antibody Treatments
Bottom Line: The monoclonal antibodies are for non-hospitalized patients. One in every 20 people who get Eli Lilly Monoclonal Antibody and one in every 50 people who get Regeneron, may avoid a hospitalization.
Spike is a protein found on the outside of the Sars-CoV-2 viral particle. The Spike protein, also known as S-protein, is the key that unlocks the door to the human cells and allows the virus to gain access. Once inside the cell, the virus that causes Covid can take over genetic machinery and begin replicating. The door on the cell wall is a receptor named ACE2. There is a common class of medications called ACE-Inhibitors that help lower blood pressure (the “prils” like Lisinopril) and there was some thought early on in the pandemic that these medications might lower viral transmission (by keeping the door closed so that the virus couldn’t enter the cell). Unfortunately, lots of people on ACE-Inhibitors also became sick with Covid and targeting ACE2 didn’t pan out as a treatment option. That leaves the S-protein. Take away the key and you can’t open the door.
Spike is the target of both monoclonal antibody (Ab) therapy as well as developing vaccinations against Sars-CoV-2. Monoclonal Ab therapies are produced by cloning cell lines of identical antibody molecules. Monoclonal antibody drug names end in “-mab”. For example, Eli-Lilly’s drug LY-CoV555 is bamlanivimab and the two antibodies in the Regeneron ‘cocktail’ infusion treatment are casirivimab and imdevimab. You might not be able to pronounce their names but that mab ending tells you what they do. Specifically, these are IgG antibodies. IgG antibodies have two places to bind antigens and are the most common type of antibody in humans. When you have Covid-19, your body produces IgG antibody and, after about 10 days, most people will have their own detectable IgG antibody in their blood to fight future Covid infections.
While there has been a lot of scientific discussion about whether those antibody levels stay high, the reality is that it doesn’t matter very much because the instruction booklet is also left and the body can more easily mount an attack on future attempts of Sars-CoV-2 to infect the body, at least likely lessening the symptoms. As of this writing, there are only about 26 people who have been infected…
