The Possible of Immunotherapy for COVID-19: a Systematic Review
Identifieur interne : 001347 ( Pmc/Corpus ); précédent : 001346; suivant : 001348The Possible of Immunotherapy for COVID-19: a Systematic Review
Auteurs : Akram Aminjafari ; Sorayya GhasemiSource :
- International Immunopharmacology [ 1567-5769 ] ; 2020.
Abstract
The immunotherapy is an effective method for fighting against similar viral infections such as SARS-CoV, and MERS-CoV. These methods include several types of vaccines, monoclonal antibody candidates, and etc. This systematic review article was designed to evaluate the existing evidence and experience related to immunotherapy for 2019-nCoV. As a conclusion of these studies demonstrated that although no serious research has been done on this subject at the time of writing this article, similar studies on the coronaviruses showed notable results. So immunotherapy for COVID-19 virus can also be a suitable option.
Url:
DOI: 10.1016/j.intimp.2020.106455
PubMed: 32272396
PubMed Central: 7128194
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The Possible of Immunotherapy for COVID-19: a Systematic Review</title><author><name sortKey="Aminjafari, Akram" sort="Aminjafari, Akram" uniqKey="Aminjafari A" first="Akram" last="Aminjafari">Akram Aminjafari</name><affiliation><nlm:aff id="af005">Cellular and Molecular Research Center, School of Advanced Technologies, Shahrekord University of Medical Sciences, Shahrekord, Iran</nlm:aff></affiliation></author><author><name sortKey="Ghasemi, Sorayya" sort="Ghasemi, Sorayya" uniqKey="Ghasemi S" first="Sorayya" last="Ghasemi">Sorayya Ghasemi</name><affiliation><nlm:aff id="af010">Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran</nlm:aff></affiliation><affiliation><nlm:aff id="af015">Cancer Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">32272396</idno><idno type="pmc">7128194</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7128194</idno><idno type="RBID">PMC:7128194</idno><idno type="doi">10.1016/j.intimp.2020.106455</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">001347</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001347</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The Possible of Immunotherapy for COVID-19: a Systematic Review</title><author><name sortKey="Aminjafari, Akram" sort="Aminjafari, Akram" uniqKey="Aminjafari A" first="Akram" last="Aminjafari">Akram Aminjafari</name><affiliation><nlm:aff id="af005">Cellular and Molecular Research Center, School of Advanced Technologies, Shahrekord University of Medical Sciences, Shahrekord, Iran</nlm:aff></affiliation></author><author><name sortKey="Ghasemi, Sorayya" sort="Ghasemi, Sorayya" uniqKey="Ghasemi S" first="Sorayya" last="Ghasemi">Sorayya Ghasemi</name><affiliation><nlm:aff id="af010">Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran</nlm:aff></affiliation><affiliation><nlm:aff id="af015">Cancer Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran</nlm:aff></affiliation></author></analytic><series><title level="j">International Immunopharmacology</title><idno type="ISSN">1567-5769</idno><idno type="eISSN">1878-1705</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Highlights</title><p><list list-type="simple" id="l0005"><list-item id="o0005"><label>•</label><p id="p0005">The immunotherapy is an effective method for fighting against similar viral infections such as SARS-CoV, and MERS-CoV.</p></list-item><list-item id="o0010"><label>•</label><p id="p0010">These methods include several types of vaccines, monoclonal antibody candidates, and etc.</p></list-item><list-item id="o0015"><label>•</label><p id="p0015">This systematic review article was designed to evaluate the existing evidence and experience related to immunotherapy for 2019-nCoV.</p></list-item><list-item id="o0020"><label>•</label><p id="p0020">As a conclusion of these studies demonstrated that although no serious research has been done on this subject at the time of writing this article, similar studies on the coronaviruses showed notable results.</p></list-item><list-item id="o0025"><label>•</label><p id="p0025">So immunotherapy for COVID-19 virus can also be a suitable option.</p></list-item></list></p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Shanmugaraj, B" uniqKey="Shanmugaraj B">B. Shanmugaraj</name></author><author><name sortKey="Malla, A" uniqKey="Malla A">A. Malla</name></author><author><name sortKey="Phoolcharoen, W" uniqKey="Phoolcharoen W">W. Phoolcharoen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Malik, Y S" uniqKey="Malik Y">Y.S. Malik</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shanmugaraj, B" uniqKey="Shanmugaraj B">B. Shanmugaraj</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Tian, X" uniqKey="Tian X">X. Tian</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Zhang, Q" uniqKey="Zhang Q">Q. Zhang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tai, W" uniqKey="Tai W">W. Tai</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Baruah, V" uniqKey="Baruah V">V. Baruah</name></author><author><name sortKey="Bose, S" uniqKey="Bose S">S. Bose</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Zhang, N" uniqKey="Zhang N">N. Zhang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ahmed, S F" uniqKey="Ahmed S">S.F. Ahmed</name></author><author><name sortKey="Quadeer, A A" uniqKey="Quadeer A">A.A. Quadeer</name></author><author><name sortKey="Mckay, M R" uniqKey="Mckay M">M.R. McKay</name></author></analytic></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="review-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int Immunopharmacol</journal-id><journal-id journal-id-type="iso-abbrev">Int. Immunopharmacol</journal-id><journal-title-group><journal-title>International Immunopharmacology</journal-title></journal-title-group><issn pub-type="ppub">1567-5769</issn><issn pub-type="epub">1878-1705</issn><publisher><publisher-name>Elsevier B.V.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">32272396</article-id><article-id pub-id-type="pmc">7128194</article-id><article-id pub-id-type="publisher-id">S1567-5769(20)30912-7</article-id><article-id pub-id-type="doi">10.1016/j.intimp.2020.106455</article-id><article-id pub-id-type="publisher-id">106455</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>The Possible of Immunotherapy for COVID-19: a Systematic Review</article-title></title-group><contrib-group><contrib contrib-type="author" id="au005"><name><surname>AminJafari</surname><given-names>Akram</given-names></name><xref rid="af005" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="au010"><name><surname>Ghasemi</surname><given-names>Sorayya</given-names></name><email>sorayya.ghasemi@gmail.com</email><xref rid="af010" ref-type="aff">b</xref><xref rid="af015" ref-type="aff">c</xref><xref rid="fn1" ref-type="fn">1</xref><xref rid="cor1" ref-type="corresp">⁎</xref></contrib></contrib-group><aff id="af005"><label>a</label>Cellular and Molecular Research Center, School of Advanced Technologies, Shahrekord University of Medical Sciences, Shahrekord, Iran</aff><aff id="af010"><label>b</label>Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran</aff><aff id="af015"><label>c</label>Cancer Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran</aff><author-notes><corresp id="cor1"><label>⁎</label>Corresponding Author: Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran <email>sorayya.ghasemi@gmail.com</email></corresp><fn id="fn1"><label>1</label><p id="np005">Postal address: Cellular-Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Postal code: 8813833435 Shahrekord, Rahmatiyeh, Iran.</p></fn></author-notes><pub-date pub-type="pmc-release"><day>2</day><month>4</month><year>2020</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="epub"><day>2</day><month>4</month><year>2020</year></pub-date><elocation-id>106455</elocation-id><history><date date-type="received"><day>25</day><month>3</month><year>2020</year></date><date date-type="accepted"><day>27</day><month>3</month><year>2020</year></date></history><permissions><copyright-statement>© 2020 Elsevier B.V. All rights reserved.</copyright-statement><copyright-year>2020</copyright-year><copyright-holder>Elsevier B.V.</copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract abstract-type="author-highlights" id="ab005"><title>Highlights</title><p><list list-type="simple" id="l0005"><list-item id="o0005"><label>•</label><p id="p0005">The immunotherapy is an effective method for fighting against similar viral infections such as SARS-CoV, and MERS-CoV.</p></list-item><list-item id="o0010"><label>•</label><p id="p0010">These methods include several types of vaccines, monoclonal antibody candidates, and etc.</p></list-item><list-item id="o0015"><label>•</label><p id="p0015">This systematic review article was designed to evaluate the existing evidence and experience related to immunotherapy for 2019-nCoV.</p></list-item><list-item id="o0020"><label>•</label><p id="p0020">As a conclusion of these studies demonstrated that although no serious research has been done on this subject at the time of writing this article, similar studies on the coronaviruses showed notable results.</p></list-item><list-item id="o0025"><label>•</label><p id="p0025">So immunotherapy for COVID-19 virus can also be a suitable option.</p></list-item></list></p></abstract><abstract id="ab010"><p>The novel coronavirus (2019-nCoV) is an emerging pathogen that was first described in late December 2019 and causes a severe respiratory infection in humans. Since the outbreak of COVID-19, international attention has raised to develop treatment and control options such as types of immunotherapies.</p><p>The immunotherapy is an effective method for fighting against similar viral infections such as SARS-CoV, and MERS-CoV. These methods include several types of vaccines, monoclonal antibody candidates, and etc.</p><p>This systematic review article was designed to evaluate the existing evidence and experience related to immunotherapy for 2019-nCoV. Web of Science (ISI), PubMed, and Scopus databases were used to search for suitable keywords such as 2019-nCoV, novel coronavirus, Immunotherapy, interleukin, vaccine and the related words for relevant publications up to 24.3.2020. The present systematic review was performed based on PRISMA protocol. Data extraction and quality valuation of articles were performed by two reviewers. 51 articles were the results of the search and based on the inclusions and exclusions criteria, 7 articles were included in the final review.</p><p>As a conclusion of these studies demonstrated that although no serious research has been done on this subject at the time of writing this article, similar studies on the related viruses showed notable results. So immunotherapy for this virus can also be a suitable option.</p></abstract><kwd-group id="kg005"><title>Keywords</title><kwd>2019-nCoV</kwd><kwd>COVID-19</kwd><kwd>Immunotherapy</kwd><kwd>monoclonal antibody</kwd><kwd>vaccine</kwd><kwd>interleukin</kwd></kwd-group></article-meta></front><body><sec id="s0005"><label>1</label><title>Background</title><p id="p0030"><bold>2019-nCoV</bold> a large enveloped virus with a positive sense, single-stranded RNA genome, is the third known coronavirus after SARS-CoV and MERS-CoV that was first identified in late December 2019 and causes severe respiratory illness and pneumonia-like infection in humans<xref rid="b0005" ref-type="bibr">[1]</xref>, <xref rid="b0010" ref-type="bibr">[2]</xref>. WHO has declared the pandemic outbreak of novel coronavirus (2019-nCoV) as a global health emergency. Immunotherapy is an efficient therapeutic option intervention against viral infections. Most immunotherapy attempts have been successful to fight against similar COVID-19 viruses such as SARS-CoV and MERS-CoV. The main methods in this regard include several vaccines and monoclonal antibody candidates. Furthermore, according to existing evidence in fighting against viral infections such as Ebola, influenza, SARS, and MERS plasma exchange can likely reduce the viral load and disease mortality <xref rid="b0015" ref-type="bibr">[3]</xref>, <xref rid="b0020" ref-type="bibr">[4]</xref>.</p><p id="p0035">In both SARS-CoV and SARS-CoV-2 viruses entry into the host cells is mediated by interaction of the receptor-binding domain (RBD) in S protein on virus outer-membrane and angiotensin-converting enzyme 2 (ACE2) on cell. So, these proteins can be the major potential targets for immunotherapy <xref rid="b0005" ref-type="bibr">[1]</xref>, <xref rid="b0025" ref-type="bibr">[5]</xref>. The increasing knowledge of MERS-CoV and SARS-CoV immunotherapies in recent years might increase the opportunities to design effective same therapeutics for novel coronavirus<xref rid="b0015" ref-type="bibr">[3]</xref>.</p><p id="p0040">Despite the relatively high identity of RBD in 2019-nCoV and SARS-Co, it is necessary to develop novel monoclonal antibodies that could bind specifically to 2019-nCoV RBD since some of the most potent SARS-CoV-specific neutralizing antibodies (e.g. m396, CR3014) that target the ACE2 binding site of SARS-CoV failed to bind 2019-nCoV spike protein, implying that the difference in the RBD of SARS-CoV and 2019-nCoV<xref rid="b0025" ref-type="bibr">[5]</xref>.</p><p id="p0045">Our purpose in this article is to review immunotherapeutic attempts against 2019-nCoV and to list current investigational immunotherapeutic strategies for 2019-nCoV.</p></sec><sec id="s0010"><label>2</label><title>Methods</title><p id="p0050">The present systematic review article was performed based on PRISMA protocol <xref rid="b0030" ref-type="bibr">[6]</xref>. (Table S1)</p><sec id="s0015"><label>2.1</label><title>Search strategy</title><p id="p0055">Web of Science (ISI), PubMed, and Scopus databases were used to search for the proper keywords such as: 2019-nCoV, novel coronavirus, Immunotherapy, interleukin, vaccine and the related words for publications published until 24.3.2020. The search strategies are available in the supplementary data (Table S2). Titles and abstracts were separately reviewed by two authors (A.AJ and S.GH) to detect potentially related articles. The full texts of articles that appeared confusing were evaluated to determine their appropriateness for inclusion.</p></sec><sec id="s0020"><label>2.2</label><title>Included studies</title><p id="p0060">The studies reviewed in this article were about the categories of immunotherapy (monoclonal antibody, interleukins, vaccines,…) for all three coronaviruses, but they must have been mentioned use of immunotherapy for treatment or control of 2019-nCoV.</p></sec><sec id="s0025"><label>2.3</label><title>Excluded studies</title><p id="p0065">The articles with only abstract were excluded from this review. Some articles were also excluded because they were only about SARS and MERS without any discussion or outlook on the 2019-nCoV.</p></sec><sec id="s0030"><label>2.4</label><title>Data extraction</title><p id="p0070">Data from articles were extracted independently by two reviewers to fill in table items.</p></sec><sec id="s0035"><label>2.5</label><title>Quality assessment</title><p id="p0075">Quality of each publication was evaluated by two independent reviewers (A.AJ and S.GH). This review addressed 7 domains: Type of immunotherapy, Dedicated or for other viruses, Treatment/ Interventions, Accompanied by another treatment, Number of patients treated (percent improved), Outcomes, results and clinical outcome.</p></sec><sec id="s0040"><label>2.6</label><title>Statistical analysis:</title><p id="p0080">It was not possible to conduct a meta-analysis because there was not enough proper research studies on this subject.</p></sec></sec><sec id="s0045"><label>3</label><title>Results</title><sec id="s0050"><label>3.1</label><title>Study selection</title><p id="p0085">We retrieved a total of 51 potentially eligible articles from initial database searches, 14 articles were excluded because of being duplicate. 30 articles were also excluded because they were review articles or addressed other virusess or their full text were not accessible.. Therefore, a total of 7 articles were included in final analysis (<xref rid="f0005" ref-type="fig">Figure.1</xref>).<fig id="f0005"><label>Fig. 1</label><caption><p>Flowchart of the articles selection</p></caption><graphic xlink:href="gr1_lrg"></graphic></fig></p></sec><sec id="s0055"><label>3.2</label><title>Study characteristics (Eligibility criteria)</title><p id="p0090">According to inclusion criteria stated in the protocol, articles were included in English language without any date restriction. We updated the search process in PubMed, WOS and Scopus up to 24.3.2020. Endnote library (version X6, Thomson Reuters) was used to import Citations from all databases and duplicate citations were removed. The title and abstract of the remainder of the search results were reviewed by both authors to exclude irrelevant studies. Full texts of the remainder of the citations were collected for further screening and data extraction. Included studies were original articles published until 24.3.2020 and most publications were related to 2020 with the aim to manage and control corona virus pandemic by several types of immunotherapy.</p></sec></sec><sec id="s0060"><label>4</label><title>Results:</title><p id="p0095">According to the extracted data in <xref rid="t0005" ref-type="table">Table 1</xref>, all immunotherapy attempts for 2019-nCoV until now include polyclonal antibody by Plasma therapy, Polypeptide hormone for maturation of T cells, immunoglubolins, ACE2 immunoadhesin and monoclonal antibody against the interleukin-6. other interventions such as viral-vectors, nanoparticles, inactivated whole virus and DNA as vaccines and monoclonal antibody have been used for SARS-CoV that holds the promise for using in 2019-nCoV.<table-wrap position="float" id="t0005"><label>Table 1</label><caption><p>Main characteristics of included studies: Immunotherapy potentials</p></caption><table frame="hsides" rules="groups"><thead><tr><th><bold>Treatment by</bold></th><th><bold>Specific or for similar viruses</bold></th><th><bold>Type of immunotherapy (vaccine and…..)</bold></th><th><bold>Treatment/Interventions</bold></th><th><bold>Accompanied by another treatment</bold></th><th><bold>Number of patients treated (percent improved)</bold></th><th><bold>Outcomes, results and relationships</bold></th><th><bold>Ref</bold></th></tr></thead><tbody><tr><td>Plasma therapy(Convalescent plasma)</td><td>Specific (for COVID-19)</td><td>polyclonal antibody immune response(passive antibody)</td><td>-</td><td>Standard treatment</td><td>300 people in COVID-19 clinical trial</td><td>Clinical improvement</td><td><xref rid="b0035" ref-type="bibr">[7]</xref></td></tr><tr><td>Immunoglobulin</td><td>Specific (for COVID-19)</td><td>-</td><td>-</td><td>Standard treatment</td><td>80 people in COVID-19 clinical trial</td><td>Clinical improvement</td><td><xref rid="b0035" ref-type="bibr">[7]</xref></td></tr><tr><td>Thymosin</td><td>Specific (for COVID-19)</td><td>Polypeptide hormone for maturation of T cells</td><td>-</td><td>Camrelizumab(anti-PD-1 immune checkpoint inhibitor), conventional treatment</td><td>120 people in COVID-19 clinical trial</td><td>Lung injury score</td><td><xref rid="b0035" ref-type="bibr">[7]</xref></td></tr><tr><td>Tocilizumab</td><td>Specific (for COVID-19)</td><td>monoclonal antibody against the interleukin-6 receptor (IL-6R)</td><td>-</td><td>-</td><td>188 people in COVID-19 clinical trial</td><td>Cure rate</td><td><xref rid="b0035" ref-type="bibr">[7]</xref></td></tr><tr><td>SARS-CoV RBD-specific antibodies</td><td>SARS-CoV-2</td><td>Vaccine</td><td>cross-neutralize SARS-CoV-2</td><td>-</td><td>-</td><td>Experimental test</td><td><xref rid="b0040" ref-type="bibr">[8]</xref></td></tr><tr><td>cytotoxic T lymphocyte (CTL) and B cell epitopes</td><td>Specific (for COVID-19)</td><td>Vaccine</td><td>-</td><td>-</td><td>-</td><td>untested</td><td><xref rid="b0045" ref-type="bibr">[9]</xref></td></tr><tr><td>Immunoglobulin Fc domain</td><td>Specific (for COVID-19)</td><td>ACE2 immunoadhesin</td><td>-</td><td>-</td><td>-</td><td>untested</td><td><xref rid="b0050" ref-type="bibr">[10]</xref></td></tr><tr><td>Viral-vector</td><td></td><td>Vaccine</td><td>rAd5 encoding S or S1 protein</td><td></td><td></td><td></td><td><xref rid="b0055" ref-type="bibr">[11]</xref></td></tr><tr><td>Viral-vector andNanoparticle</td><td></td><td>Vaccine</td><td>MERS-CoV SNanoparticle</td><td></td><td></td><td></td><td><xref rid="b0055" ref-type="bibr">[11]</xref></td></tr><tr><td>DNA</td><td>MERS</td><td>Vaccine</td><td>DNA encoding S or S1Protein</td><td>-</td><td>-</td><td>Un-tested</td><td><xref rid="b0055" ref-type="bibr">[11]</xref></td></tr><tr><td>Inactivated whole-virus</td><td>MERS-CoV</td><td>vaccine</td><td></td><td></td><td></td><td></td><td><xref rid="b0055" ref-type="bibr">[11]</xref></td></tr><tr><td>Nanoparticle</td><td></td><td></td><td></td><td></td><td></td><td></td><td><xref rid="b0055" ref-type="bibr">[11]</xref></td></tr><tr><td></td><td></td><td>monoclonal antibody</td><td></td><td></td><td></td><td></td><td><xref rid="b0055" ref-type="bibr">[11]</xref></td></tr><tr><td>CR3022</td><td>SARS-CoV</td><td>monoclonal antibody</td><td>cross-reactive antibodies</td><td>alone or in combination with other neutralizing antibodies(e.g. m396, CR3014)</td><td>-</td><td>Un-tested</td><td><xref rid="b0025" ref-type="bibr">[5]</xref></td></tr><tr><td>Based T cell epitope</td><td>SARS-CoV-2 proteins</td><td>vaccine</td><td>-</td><td>-</td><td>-</td><td>Only about SARS</td><td><xref rid="b0060" ref-type="bibr">[12]</xref></td></tr></tbody></table></table-wrap></p><p id="p0100">Plasma therapy and immunoglobulin intervention on 2019-nCoV infected patients could improve clinical outcome. The vaccines and ACE2 immunoadhesin have not been tested yet. As the preferred immunotherapy method, monoclonal antibody has performed only for SARS; however, this method has not yet been tested. Most articles in this field are review articles recommending immunotherapy for 2019-nCoV with reasons and evidence of previous studies on two other coronaviruses SARS-CoV and MERS-CoV.</p><p id="p0105">There is only one clinical trial study in the field that mentions some of these methods on 2019-nCoV<xref rid="b0035" ref-type="bibr">[7]</xref>.</p></sec><sec id="s0065"><label>5</label><title>Discussion</title><p id="p0110">As both SARS-CoV and SARS-CoV-2 (2019-nCoV) have the same receptor for virus entry, potential biotherapeutics to prevent SARS entry could be extrapolated to use for SARS-CoV-2. Among immunotherapy approaches to block the virus attachment or entry, monoclonal antibodies are preferred due to their specificity, purity, low risk of blood-borne pathogen contamination and safety compared to serum therapy and intravenous immunoglobulins preparations<xref rid="b0015" ref-type="bibr">[3]</xref>.</p><p id="p0115">The promising results in targeting spike protein in SARS-CoV and MERS-CoV by monoclonal antibodies encourages researchers to use them in fighting against 2019-nCoV. Monoclonal antibody cocktail or the combination of different monoclonal antibodies that recognizes different epitopes on the viral surface may increase the effectiveness of virus neutralizing<xref rid="b0015" ref-type="bibr">[3]</xref>.</p><p id="p0120">Other targets in immunotherapy for COVID-19 that seem to be Promising are cytokines. Among cytokines, specificity of IL-6 in COVID-19 comes from that Elevated IL-6 is correlated with inflammatory cytokine storm severity. therefore targeting IL-6 and its receptor (IL6R) by Siltuximab and tocilizumab monoclonal antibodies (mAb) Could mitigate cytokine storm-related symptoms in severe COVID-19 patients <xref rid="b0065" ref-type="bibr">[13]</xref>.</p><p id="p0125">Despite major progress in the development of monoclonal antibody-based passive immunotherapy for coronavirus infection, there is no marketed monoclonal antibody. What limits the use of antibodies is that large-scale production of monoclonal antibodies for clinical application is laborious, expensive and time-consuming. So designing and developing advanced protein production platforms and expression systems is urgent to provide efficient monoclonal antibodies at the affordable cost in a short time<xref rid="b0015" ref-type="bibr">[3]</xref>.</p><p id="p0130">Although no research has been tested, and there is no approved vaccines or anti-viral therapeutic agents to treat COVID-19 until now, the vaccines can be successful due to the specific structure of the virus. Furthermore, existing evidence on immunotherapy for SARS-CoV and MERS-CoV holds the promise for using in 2019-nCoV.</p></sec><sec id="s0070"><label>6</label><title>Conclusion</title><p id="p0135">As is evident from this systematic review, immunotherapy is an efficient therapeutic option intervention against COVID-19 and the main methods in this regard such as using immunoglobulins and plasma therapy have improved clinical outcomes in COVID-19 infected patients.</p></sec></body><back><ref-list id="bi005"><title>References</title><ref id="b0005"><label>1</label><element-citation publication-type="journal" id="h0005"><person-group person-group-type="author"><name><surname>Shanmugaraj</surname><given-names>B.</given-names></name><name><surname>Malla</surname><given-names>A.</given-names></name><name><surname>Phoolcharoen</surname><given-names>W.</given-names></name></person-group><article-title>Emergence of Novel Coronavirus 2019-nCoV: Need for Rapid Vaccine and</article-title><source>Biologics Development. 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Available at SSRN 3548761, 2020.</mixed-citation></ref></ref-list><ack id="ak005"><sec id="s0075"><title>Acknowledgments</title><p id="p0140">The authors would like to thank the Shahrekord University of Medical Sciences.</p><p id="p0145">Conflict of interest</p><p id="p0150">There is no potential conflict of interest for authors to disclose.</p><p id="p0155">Authors’ contributions</p><p id="p0160">A.AJ and S.GH contributed to conception, literature search, screening, and data extraction and revised the draft; they provided the first draft of the article. Both authors contributed to statistical analysis and data interpretation and critically revised the article. Both authors contributed to the review design and article drafting.</p><p id="p0165"><bold>Funding source:</bold> This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</p></sec></ack></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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