When U.S. President Donald Trump tested positive for COVID-19, his treatment included a drug that is still in its experimental stages. The cocktail of drugs involved in his treatment included a mixture of two monoclonal antibodies. Monoclonal antibodies have been used clinically since the 1980s and are already being used to treat many diseases including cancer.

The treatment is intended to give the immune system an immediate boost to fight off COVID-19. When COVID-19 infects the body, antibodies attach to the spikes of the virus, blocking it from entering the cells – a response of our body's immune system.

The body produces many different antibodies, especially neutralizing ones, and scientists have been going through them to determine which best sticks to the spike of the virus. The selected antibody is multiplied in the lab and produced in huge quantities so that patients who receive or produce antibodies, immediately boost their immune response.

Antibody therapeutics

The monoclonal antibodies are manufactured in a laboratory to imitate the natural antibodies produced by the body. Specific germs are recognized by the antibodies, in this case, SARS-CoV-2, which is the virus that causes COVID-19. Although antibody therapy is in its early stages, it is considered by experts to be the most promising treatment so far.

The treatment is still in its clinical trial stage and is being studied as a potential treatment for people who have been exposed to the virus. Regeneron Pharmaceuticals, the American drug company that is producing the antibody treatment states that the early trials suggest that the treatment is effective for mild to moderate illness caused by COVID-19.

Regeneron Pharmaceuticals has already produced several monoclonal antibodies since it was founded in 1988. These include Praluent for high cholesterol, Libtayo for cancer and Dupixent for severe eczema. They also used the same technology in 2014 to develop an effective treatment for Ebola. In February, a genetic code fragment of COVID-19 arrived at Regeneron laboratories from China. Regeneron used this genetic code fragment to produce hundreds of virus-neutralizing antibodies, using genetically engineered mice, accompanied by blood taken from COVID-19 survivors.

The trial conducted by Regeneron Pharmaceuticals tests a mixture of two monoclonal antibodies, which both attach to the spike of the virus at slightly different places. To make sure the virus mutates and the structure changes, at least one should work, as many scientists have feared a major mutation that would cause all vaccine trials to fail for good.

There are several pharmaceutical companies in a race to roll out the first antibody treatment. GlaxoSmithKline has made a $250,000 investment in the U.S.-based pharmaceutical firm Vir Biotechnology to support its development of antibody treatment. Takeda, the Japanese drug producer, has partnered up with CSL Behring in the U.S. to scale its efforts and pool their resources to develop an antibody treatment. Other pharmaceutical companies in the race include BioSolutions (U.S.) and AstraZeneca (U.K.).

What are the similarities?

Vaccines and antibody therapies are two of the most promising treatments to treat COVID-19. Although there is a clear overlap between the two treatments, there are some key differences that should be noted. An antibody is a molecule that is produced naturally by the body in response to an infection. The body is able to make a diverse range of antibodies that are able to recognize many types of viruses or bacteria. These molecules are then able to stick to viruses and therefore prevent them from infecting healthy cells.

In antibody therapy, blood is taken from a person who has already survived COVID-19 from which antibody-producing B cells are extracted and used in sequencing technology to make new and more antibodies. If we can work out the type of antibody that neutralizes SARS-CoV2 in the laboratory, we can then produce massive quantities of the antibody that can be injected into patients experiencing COVID-19, helping them fight the infection.

Vaccines on the other hand provide "active immunity" and can be made up of either a piece of the virus, an inactivated virus or an active virus that no longer has the ability to cause disease. Once the vaccine is injected into the body, the immune system launches an attack as if the person actually has COVID-19.

The injected person does not get sick and with the help of the vaccine develops "immune memory" that protects the immune system from future infections as the body has already learned how to respond to the virus. In the majority of cases, this immunity lasts a lifetime.

The advantage of using vaccines is that they are safe and can prevent people from catching COVID-19, but conversely, the disadvantage is that they cannot treat those already sick from the virus.

An antibody treatment can successfully treat a patient with an existing COVID-19 infection, a vaccine, on the other hand, can only train the immune system to fight future infections. A vaccine needs to be developed to provide the general population with immunity but there must be an antibody therapy to go alongside it to treat those who have already become infected as well as others with medical conditions preventing them from being vaccinated such as the elderly or those with immune deficiencies. Having both of these radical treatments ready will ensure that the majority of the general population is protected from the serious effects of COVID-19.

A lot of people believe that antibody treatments could be the bridge to overcoming COVID-19 before a vaccine is found. Monoclonal antibodies are the No. 1 selling drug on the market today, with a lot of hope resting on this antibody treatment to fight COVID-19, perhaps more than a vaccine could promise us.