Drug Design, Development and Therapy (Jul 2020)
Plasmapheresis, Anti-ACE2 and Anti-FcγRII Monoclonal Antibodies: A Possible Treatment for Severe Cases of COVID-19
Abstract
Amin Sedokani,1 Sadegh Feizollahzadeh2 1Cardiology Department, Medical Faculty, Urmia University of Medical Sciences, Urmia, Iran; 2Medical Immunology, Laboratory Sciences, School of Allied Medical Sciences, Urmia University of Medical Sciences, Urmia, IranCorrespondence: Amin SedokaniCardiology Department, Medical Faculty, Urmia University of Medical Sciences, 17 Sharivar St., Urmia 571478334, IranTel +98 443237 5907Fax +98 443 237 2917Email [email protected]: In March 2020, the WHO declared the COVID-19 disease as a pandemic disease. There have been studies on the COVID-19 to find a certain treatment, but yet, there is no certain cure. In this article, we present a possible way to treat severe cases of COVID-19. Based on the previous studies, there are similarities between the spike antigens of SARS-CoV and SARS-CoV-2 viruses. It is expected that these similarities (structural and affinity to the receptor of ACE2) can lead to the same pathophysiological activity of the virus by the use of ACE2 and FcγRII (the antibody-dependent enhancement mechanism). Therefore, we propose a way of washing out (by plasmapheresis) the possible antibodies against the spike protein of the virus out of patients’ plasma to stop the antibody-dependent enhancement (ADE)-mediated infection of the immune system cells at the first phase of the treatment and simultaneous use of the anti-ACE2 with anti-FcγRII monoclonal antibodies at the second phase. We propose these procedures for the patients that have no significant response for typical anti-viral, ARDS and conservative therapies, and the disease persists or progresses despite sufficient therapies.Keywords: COVID-19, SARS-CoV-2, antibody-dependent enhancement, plasmapheresis, monoclonal antibodies
