Coronavirus: What is the Antibody-rich Blood Plasma Therapy?

The Food and Drug Administration on Sunday (22nd) gave emergency approval for expanded use of antibody-rich blood plasma to help hospitalized coronavirus patients which was limited in the past. President Trump on Sunday described the treatment as “a powerful therapy” made possible “by marshaling the full power of the federal government.” And Trump has kept pressuring the agency to move faster to address the pandemic, to claim progress on the eve of the Republican convention.

On the one hand, President Trump and the FDA suddenly approved antibody plasma therapy to treat patients with COVID-19. On the other hand, the public is uncertain about the treatment method, worrying that this treatment method is similar to the Hydroxychloroquine drug strongly recommended by President Trump previously, and same to the disinfectant treatment which caused lots of death as a disaster. So, what is plasma therapy and is there any scientific basis?

What is Plasma Therapy?

Plasma Therapy is called convalescent plasma therapy also. This treatment method is used in the treatment of new coronavirus pneumonia, and was first used in China Wuhan COVID-19 outbreak, and now was approved by FDA after a long time after the first COVID-19 confirmed case was found in USA.

At present, antibodies are the exact and effective inhibitors to the new coronavirus, but they cannot be industrially produced. The core of the recovery period plasma therapy for COVID-19 patients is to use the antibodies contained in it to neutralize the virus, inhibit infection, and achieve recovery. Another way is vaccination, the machinism of vaccination is to make the body to generate antibody by itself to produce prevention of virus infection. But the COVID-19 vaccine still is developing over the world.

How is Antibody Produced?

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There are two ways the body can “autonomously produce” antibodies against a certain virus:

One is to be infected by the virus once, get sick, and then produce antibodies;

The second is to artificially “toss” the virus to death and weaken its pathogenicity, but retain the “characteristic appearance” of the virus, inject it into the body, and stimulate the body to produce (for the characteristic appearance of the virus) without the disease (decreasing the toxicity) ) Antibodies, this is known as the “vaccine”.

Simply talk about the principle of antibody production:

1. Virus or “vaccine” as a “foreign” invades our body, the monocytes in the blood (one of the white blood cell fighters) will burrow out of the blood vessels and reach the tissues and transform into macrophages;

2. Macrophages swallow these “unidentified foreign objects”, crush them to pieces, recognize the “characteristic appearance” of the virus, and report it to the superior T cells;

3. T cells (immune commanders, producing terrible cytokines, killing viruses externally, and internally injuring their own organs) inform B cells of the characteristics of the virus;

4. Part of the B cells grow into effector B cells (plasma cells), which specifically produce antibodies (start producing IgM after about 10 days, and reach the peak of IgG antibodies within 2 to 3 weeks) to catch the virus. Other B cells will grow into memory B cells, remembering the characteristics of the virus for a long time. If this virus invades/infects the body again, the “long memory” B cells will quickly and massively grow into effector B cells, producing a devastating amount of antibody IgG (within 3 to 5 days);

5. The high-affinity IgG will clear the virus quickly.

When you are not infected by the virus, actively inject “attenuated vaccines” to ensure that the process of stimulating the body’s production of antibodies without getting sick is the act of actively making antibodies, which is called “active immunity.”

The infusion of antibody-rich plasma from the recovered patient to deal with the virus in the body is called “passive immunity”, which is also the principle of plasma therapy for the recovered patient.

Limitations of plasma therapy

One of the main reasons hindering the large-scale application of plasma therapy is that there are still too few therapeutic materials that can be used. The virus content in critically ill patients is often relatively high. If antibodies are used for treatment, it is obvious that the concentration must be high enough to make sense. However, the levels of antibodies in the blood of recovered patients vary greatly, so plasma with a higher antibody concentration must be selected as the material, or the antibodies of several recovered patients will be enough to rescue a critically ill patient.

The virus content in critically ill patients is often relatively high. If antibodies are used for treatment, the concentration must be high enough to make sense.

Since there were no anti-infective drugs in the past, the main tool for humans to fight infectious diseases in the early days was the convalescent plasma. However, due to technical limitations, the convalescent plasma was a “crude” product with many side effects, and the application cost was high; With the emergence of monoclonal antibody technology, “high-level” products will better protect human health.

Conclusion

So far, the new crown epidemic has been developing around the world for more than half a year. Many patients have unfortunately died, and many patients have been cured. Therefore, in each country, especially the United States, a large number of cured patients have been accumulated, so there is a chance to collect a large number of patients. After scientific treatment, the serum rich in antibodies to the new coronavirus can be directly injected into other patients to increase the number of antibodies to the new coronavirus, thereby enhancing the patient’s resistance and increasing the probability of cure. From this perspective, the US FDA’s approval of plasma therapy at this time still has a certain positive significance, and it is believed that it will also receive a better effect.

However, this only enhances the probability of curing patients with new coronavirus infected, and does not fundamentally solve the spread of new coronavirus. It is still a very important task to prevent and control the spread of new coronavirus and a big challenge for each country government in the world.