Could monoclonal antibodies prevent Lyme disease better than a vaccine?

Researchers say they have had “promising results” in developing a unique method to prevent people from becoming infected with Borrelia burgdorferi (Bb), the causative agent of Lyme disease. It does not involve a vaccine, but rather a process which stimulates the immune system to ward off infections.

 

by Daniel J. Cameron, MD MPH

In a recent article by NBC News, entitled Lyme Disease Treatment Would Prevent Infection, Researchers Say, Dr. Mark Klempner, of the University of Massachusetts’ nonprofit vaccine development arm, MassBiologics, describes a study where lab-developed monoclonal antibodies prevented Lyme disease in mice.

Klempner’s group presented their findings, claiming the monoclonal antibody could protect mice against the Borrelia bacteria, during a meeting with infectious disease experts in San Diego, California. [1] More details on the study should be available once it is published in a peer-reviewed journal.

Researchers say study brings "promising results" for new approach in preventing infections from Lyme disease agent.

Researchers say study brings “promising results” for new approach in preventing infections from Lyme disease agent.

Klempner explained the difference between monoclonal antibodies and vaccines to NBC News. “The way a vaccine works is that you give people pieces of the bacteria or the virus that you are interested in preventing and then the body mounts a big immune response.”

Monoclonal antibodies, however, are not vaccines “but an approach that builds on the gamma globulin shots that were once frequently used to try to prevent tuberculosis and hepatitis.” The monoclonal shot offers immediate immunity but must be injected every year.

The NBC News piece summarized concerns with the Lyme disease vaccine, “There once was a human Lyme disease vaccine on the market, but its maker, GlaxoSmithKline, stopped making it after rumors about its safety and multiple lawsuits filed by people claiming it made them sick. The company said it couldn’t sell enough doses to make it worthwhile.”

The Lyme disease vaccine was removed from the market in 2002. The CDC website warns, “Protection provided by this vaccine diminishes over time. Therefore, if you received the Lyme disease vaccine before 2002, you are probably no longer protected against Lyme disease.” [2]

Klempner finds the mouse study encouraging. He tells NBC News, “the company is laying the groundwork now to start testing its monoclonal antibody in people next year.”

The investigators at MassBiologics will need, however, to address several questions:

Will the monoclonal antibodies work for the growing number of strains of the infection?

Will the monoclonal antibodies work for new species, e.g. Borrelia miyamotoi, which is related to the bacteria causing tick-borne relapsing fever (TBRF) described by the CDC? [3]

Will there be monoclonal antibodies for other tick-borne illnesses, e.g. Babesia, Anaplasmosis?

Will there be any side effects in people not evident in the mice?

Will the monoclonal antibodies be affordable, as the NBC News article points out, “They are often very expensive, costing upwards of $100,000 a year.” Klempner says, “the university’s goal is to make it available cheaply.”

 

References:

  1. Lyme Disease Treatment Would Prevent Infection, Researchers Say, by Maggie Fox at NBCNews.com Available from: http://www.nbcnews.com/health/health-news/lyme-disease-treatment-would-prevent-infection-researchers-say-n441946. (Last accessed 10/11/15).
  2. Lyme disease vaccine, Centers for Disease Control and Prevention, Available from: http://www.cdc.gov/lyme/prev/vaccine.html. (Last accessed 10/11/15).
  3. What you need to know about Borrelia miyamotoi. Centers for Disease Control and Prevention (CDC) Available from: http://www.cdc.gov/ticks/miyamotoi.html. (Last accessed 10/11/15).


2 Replies to "Could monoclonal antibodies prevent Lyme disease better than a vaccine?"

  • plenzini
    05/30/2018 (2:22 pm)
    Reply

    The way I understand the whole monoclonal antibody thing is that you are essentially creating a bunch of clones of a particular immune cell that is trained (long and complicated genetics discussion) to identify a specific flag (e.g. antigen) on the borrelia species. In theory you could create a cocktail of monoclonal antibodies for all the different flags on the bugs in a tick bite. You could even create one that accounts for the fact that the borrelia changes it’s flags once it realizes they have become miniature GPS tracking devices, by preemptively adding antibodies to the shape-shifted flags on the bacteria.
    If this understanding is correct (albeit an oversimplified non-biologist’s understanding) then here are a few more questions to add to the list:
    1. How do you do this without proving that you know how to precisely identify the bacterial species actively expressing proteins in the body through PCR genotyping of 16s rRNA?
    2. If you have managed to hide the implication that the tools for better diagnostics are immediately available in #1, how do you convince anyone you’ve managed to select what is unique to the bacterial genome and isn’t going to trigger another auto-immune response?
    3. If you have managed to hand-wave on #1 and #2, how do you account for bacteria that have put up flags that are the same color as the flags on our normal immune system cells? Molecular mimicry will always be a tool in the arsenal of any b.b. species. As with bacterial evolution brought on by the onslaught of antibiotics, its only a matter of time before this tool is genetically transferred to the other co-infectious agents via shared plasmids. How do you talk about this inherent limitation (all drugs have their limits)?

    • Dr. Daniel Cameron
      05/30/2018 (3:42 pm)
      Reply

      Good questions.


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