EBOLA disease: which is the only MONOCLONAL ANTIBODY that can diagnose it ?

Tested on an experimental basis since May 2018 in the Democratic Republic of the Congo, the mAb114 treatment against Ebola proves to be safe, well tolerated and easy to administer. With the Democratic Republic of Congo (DRC) experiencing its tenth Ebola epidemic since August 1970 since the 1970s, an encouraging study has just been published in The Lancet.

This concludes an early stage clinical trial which has proven effective on subjects who have received it on an experimental basis in the DRC.

Well tolerated and easy to administer treatment

Called mAb114, this new treatment was administered to 18 healthy adults in a Phase 1 clinical trial at the National Institutes of Health (NIH) clinical center in Bethesda, Maryland. It is now available to patients with Ebola virus disease in the Democratic Republic of the Congo as part of compassionate use and as part of a phase 2/3 clinical trial involving several experimental treatments.

The peculiarity of mAb114 is that it is a single monoclonal antibody, that is to say an antibody derived from a single strain of lymphocytes. A monoclonal antibody has a unique specificity for a single antigen, which binds to the main receptor for the surface protein of Zaire Ebayavirus: this action thus prevents the virus from infecting human cells. Scientists successfully isolated the antibody of a human survivor from the 1995 Ebola epidemic in Kikwit, DRC. Previous studies have shown that mAb114 can protect monkeys from the deadly disease caused by the Ebola virus when given up to five days after infection.

Particularity of mAb114 and its tests

Participants in the Phase 1 clinical trial received a single intravenous infusion of mAb114, administered over approximately 30 minutes. Three participants received a dose of 5 milligrams (mg) / kilogram (kg), 5 received a dose of 25 mg / kg and finally 10 participants received a dose of 50 mg / kg. All infusions were well tolerated. Four participants reported mild side effects, such as discomfort, muscle or joint pain, headache, nausea and chills, within three days of the infusion.

As expected by scientists, the levels of mAb114 in the blood increased with the increase in dosage. The researchers also observed relatively uniform levels of absorption, distribution and elimination of mAb114 among the participants.

For the authors of the study, the deployment of the mAb114 treatment in an epidemic situation has many advantages, among which the ease and speed of its administration, as well as its formulation in the form of lyophilized powder that does not require storage in the freezer. . The powder is reconstituted with sterile water and added to a saline solution for administration.

“Pharmaceutical tools alone are not enough to stop an Ebola epidemic”

For the moment, no date has been given for a possible provision of the mAb114 treatment to the Congolese population. In an interview with SciDev.Net, Annick Antierens, strategic medical advisor at Médecins Sans Frontières (MSF) believes that “pharmaceutical tools alone are not enough to stop an Ebola epidemic”.

We must also continue to raise awareness in the field with populations at risk, seek out sick people to avoid further contamination and provide support for regular health care other than that focused on Ebola.

A reserve shared by Jean-Jacques Muyembe, director of the National Institute of Biomedical Research (INRB) in Kinshasa and co-discoverer of the Ebola virus. “We will have won a battle, but not yet the war, which is on the horizon: convincing our peers and working together to improve this therapy against the Ebola virus.”