Antibody tests have been heralded as a crucial weapon in the battle against the Covid-19 pandemic. This has been a significant focus of the UK Government, which ordered 3.5m home tests at the end of March. The US has recently jumped on the bandwagon, with the FDA calling on manufacturers to submit emergency use authorisation applications for antibody tests, while the US National Institutes of Health will evaluate the tests’ performance.
Despite early struggles to find and buy tests that were sufficiently reliable and accurate, two large, experienced medical device and diagnostics companies – Abbott and Roche – have now developed antibody tests and are hoping to roll them out in the next month or so.
Why are antibody tests important?
These are serological tests that determine whether a person has had Covid-19 and then recovered; they differ from diagnostic tests that simply show whether a person is infected at the time of testing.
They do this by searching for proteins called antibodies in the blood stream. Antibodies are produced by the immune system’s B cells when they are activated due the presence of a particular foreign pathogen’s antigen; antibodies specifically target certain antigens on the pathogen.
Having antibodies against the SARS-CoV-2 virus, which causes Covid-19, means that a person’s immune system will, in theory, be able to identify, target and fight off the infection if the person is re-infected. The precise strength of the immunity these antibodies confer to infected people is still unknown; remember, we need different seasonal influenza vaccines every year because of how significantly the virus mutates.
Not only will antibody tests enable governments around the world to understand how many people have immunity against the novel coronavirus, and therefore decide when to bring their populations safely out of lockdown, they also improve epidemiological understanding of the virus’s lethality, and how it has spread globally.
The precise antibodies developed against Covid-19 are also invaluable in discovering therapies to treat patients.
Treating Covid-19 with antibodies
Although vaccines are essential for conferring future immunity and protection against Covid-19 by safely encouraging the body to develop the correct antibody against the coronavirus, it is going to take a while to get to that point. “It’s a 2021 thing”, says Berkeley Lights CEO Eric Hobbs.
However, he argues that “in the meantime, there is something that will help [tackle Covid-19]: antibody therapeutics.” It is possible antibody therapeutics will be available by the end of the summer, noted SynBioBeta founder and CEO John Cumbers, during a Covid-19 and antibody webinar.
“Monoclonal antibodies are the way to go” against Covid-19, Hobbs notes. If they can neutralise the SARS-CoV-2 virus, then they can treat and prevent disease progression in infected patients. The challenge is in finding the antibodies, and that is where Berkeley Lights and its Beacon system come in.
Hobbs says Berkeley Lights has “the fastest path for finding antibody therapeutics” through the use of its technology. The Beacon system can find B cells that are secreting the right antibody against a disease in less than 10 hours, and it focuses on finding neutralising antibodies, as well as the binders and blockers. Although Berkeley Lights initially did this from transgenic mice, the company now runs patient blood through the system to screen “the plasma B cells in an acute patient or the memory cells” to use as a basis for therapeutics.
Berkeley Lights’ approach is to support academic and industry partners in antibody identification for anti-Covid-19 drugs. “Collaborations are probably one of the most fantastic things about what’s happening in the world today,” Hobbs notes.
The company’s international partners include Vanderbilt University Medical Center and GenScript China.
Within three weeks of working with Professor James Crowe’s lab at Vanderbilt University, the Beacon system was able to find 500 antibodies from patient blood; the antibodies were then moved into downstream testing. While GenScript ProBio used the platform to screen antibodies in just 24 hours; now the company is working on moving into mass production and development of antibody drugs.
Preparing for a future pandemic
Another priority of Berkeley Lights, and other actors in the antibody space, is how this antibody work can improve the ability of the pharma world to respond better and quicker to future pandemics.
To this end, Berkeley Lights has launched the Global Emerging Pathogen Antibody Discovery Consortium (GEPAD). Founding members include Dr. James Crowe and Dr. Robert Carnahan at Vanderbilt University Medical Center, Dr. Erica Ollman Saphire at La Jolla Institute for Immunology and Dr. Frances Eun-Hyung Lee at Emory University.
The new team is calling on anyone working in viral neutralisation to collaborate with the consortium, and to leverage the Beacon system against emerging pathogens.
During the SynBioBeta webinar, Distributed Bio CEO and star of Netflix documentary Pandemic Jake Glanville noted that his company’s approach to tackling Covid-19 is to create generally applicable antibody drugs that target “broadly neutralising sites that do not mutate on viruses; we know these exist on flu and HIV, and now we have them on coronaviruses”.
Having broadly neutralising antibodies against classes of viruses would mean when a pandemic breaks out, there is only the need to do efficacy testing. “Then we win the battle against pathogens; outbreaks are never as bad as they could be as we have an off-the-shelf therapy to react quickly,” said Glanville. The key is to find a virus class’s Achilles heel in advance.
Unfortunately, this has not been done previously due to a lack of political or financial will, Vanderbilt University’s Professor James Crowe added during the webinar discussion. However, responding to this pandemic has generated billions, if not trillions, of dollars of funding, as well as significantly damaging the world economy, so there’s a good chance Covid-19 will transform attitudes tofuture pandemic preparedness.