Antibody-dependent enhancement and SARS-CoV-2 vaccines and therapies
Nature Microbiology volume 5, pages 1185–1191 (2020)
Abstract
Antibody-based drugs and vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are being expedited through preclinical and clinical development. Data from the study of SARS-CoV and other respiratory viruses suggest that anti-SARS-CoV-2 antibodies could exacerbate COVID-19 through antibody-dependent enhancement (ADE). Previous respiratory syncytial virus and dengue virus vaccine studies revealed human clinical safety risks related to ADE, resulting in failed vaccine trials. Here, we describe key ADE mechanisms and discuss mitigation strategies for SARS-CoV-2 vaccines and therapies in development. We also outline recently published data to evaluate the risks and opportunities for antibody-based protection against SARS-CoV-2
Contributing Opinion Writer
...{I}n May, when the court agreed to hear Mississippi’s appeal of a decision that struck down its ban on abortion at 15 weeks of pregnancy, it was perfectly obvious that if Mississippi’s Gestational Age Act were to be upheld, the two precedents would have to go. That’s because a fetus at 15 weeks is at least two months shy of viability, and both Roe and Casey give women an absolute right to terminate a pregnancy before the fetus is viable. The 1992 Casey decision authorized states to place an onerous and expensive obstacle course in a woman’s path, but nonetheless, the ultimate decision to terminate a pregnancy before fetal viability remained hers to make.
Permitting a state to ban abortion at 15 weeks — or at six, as in Texas, or at just about any old time, as in a new Arkansas law, temporarily blocked last week by a federal district judge, that purports to ban nearly all abortions — is inconsistent with nearly 50 years of Supreme Court jurisprudence.
In the Supreme Court petition Attorney General Fitch filed in June 2020 (that is not a typographical error; it took the justices 11 months simply to decide to hear the case), she was coy about what she was really asking. “To be clear,” she told the court, “the questions presented in this petition do not require the court to overturn Roe or Casey.” She did concede, but only in a footnote, that the case might prompt a more conclusive outcome: “If the court determines that it cannot reconcile Roe and Casey with other precedents or scientific advancements showing a compelling state interest in fetal life far earlier in pregnancy than those cases contemplate, the court should not retain erroneous precedent.”
The tone is completely different in the state’s brief on the merits, filed last week in advance of the argument the court will hold this fall. “Roe and Casey are egregiously wrong,” Ms. Fitch asserts. The case for overturning them is “overwhelming.” The two precedents have not only “proven hopelessly unworkable,” but “have damaged the democratic process, poisoned our national discourse, plagued the law — and, in doing so, harmed this court.”