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Myron Cohen, MD
Myron Cohen, MD

Serum therapy was used extensively before the development of antibiotics and vaccines, pioneered over a century ago in the fight against diphtheria. The discovery that serum made from the blood of immunized animals, mostly horses, could neutralize toxins and inhibit the growth of some bacteria provided an intervention — even if imperfect — for several deadly diseases. However, in the 1940s, the success of antibiotics and the development of many vaccines compromised the enthusiasm for research in the use of passive infusions of serum to prevent or treat infectious diseases.

Georges Köhler and César Milstein won the Nobel Prize in 1984 for the development of monoclonal antibodies. Subsequently, the idea of using these agents for the treatment of cancers and a plethora of immunologic diseases took off.

Still, the infectious diseases community demonstrated limited interest in this approach (see the figure, where to date no antimicrobials have surfaced in the forecast, a situation that I believe SARS-CoV-2 will remedy rapidly), instead focusing on the development of ever broader antibacterial agents, and a growing number of important antiviral agents, especially those that would control the progression and transmission of HIV. To some extent the breadth and magnitude of infectious diseases seems inconsistent with mAb treatment, especially given the greater degree of difficulty in making, transporting and delivering these agents. Notable exceptions include the development of mAbs to prevent respiratory syncytial virus in premature newborns, mAbs to prevent and treat HIV, and mAbs to neutralize C. difficile infections.

[Read more in the Infectious Diseases Society of America blog]