Coronavirus may dodge some treatments, study suggests

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Various types of monoclonal antibodies are now in clinical trials. If all goes well, such concoctions could not only treat coronavirus infections but also prevent them. That could help millions of people, especially as the world waits for a vaccine, said Akiko Iwasaki, an immunologist at Yale University who was not involved in the study.

Studies like these could help researchers identify ideal antibody targets in the beak, Dr. Taylor said. Some parts of the protein, for example, will never successfully mutate because they are essential for the virus’s ability to penetrate cells. That makes them easy prey for the immune system.

But the new findings also suggest that single-antibody formulations “may not be as successful,” Dr. Taylor said, at least in the long term. Developing a cocktail that contains a diverse mix of antibodies could be a safer bet.

Such mixtures would also more closely mimic the body’s natural response to the coronavirus. In the study, viruses rinsed with convalescent plasma samples (blood fractions donated by people who recovered from Covid-19) struggled to infect cells.

Some scientists, including those at the American biotech company Regeneron, are already trying this combined approach, mixing two powerful types of monoclonal antibodies in a single treatment.

But Dr. Iwasaki noted that antibody cocktails could be more difficult to bring to market. “Every time you make a drug, you get approval for each component separately,” he said. Still, the data so far indicates that “it doesn’t take hundreds of monoclonal ones” to master this virus, he added. Two could be enough.

The diversity lesson could be even more powerful for vaccines, which can elicit a multifaceted immune response. Some immune cells and molecules will adapt to the spike, while others may prefer other parts of the virus. Vaccines that present the body with many pieces of the coronavirus, rather than the spike alone, may have a better chance of activating a set of these defenses, said Dr. Taia Wang, an immunologist at Stanford University who was not involved in the study.