Monoclonal Antibodies to Prevent Lyme Disease
Updated: April 8, 2021
Could monoclonal antibodies prevent Lyme disease? Researchers have begun enrolling volunteers in the first human clinical trial of Lyme PrEP, a seasonal shot designed to prevent Lyme disease. The study is evaluating the safety and pharmacology of the treatment. [1]
“Lyme PrEP prevents infection by delivering a single human anti-Lyme antibody directly to a person rather than triggering the body to produce its own antibodies, as vaccines do,” the researchers explained.
READ MORE: Preventative Shot for Lyme Disease Enters Clinical Trial
Studies conducted by MassBiologics demonstrated that Lyme PrEP provides immediate protection after injection.
“We identified the single antibody responsible for immunity and tested it in animals, where it proved 100 percent effective,” explained Dr. Mark Klempner.
The Phase I clinical trial aims to evaluate the safety of Lyme PrEP and determine how long the antibody remains active in the bloodstream.
A key question remains: Will monoclonal antibody prevention for Lyme disease be affordable? A 2015 NBC News article noted that monoclonal antibody therapies can be extremely expensive, sometimes costing more than $100,000 per year.
Klempner explained that the university’s goal is to make the treatment affordable if it proves successful.
Early Research on Monoclonal Antibodies for Lyme Disease
The potential for monoclonal antibodies to prevent Lyme disease was discussed earlier in an NBC News report titled Lyme Disease Treatment Would Prevent Infection, Researchers Say.
In that study, researchers demonstrated that laboratory-developed monoclonal antibodies were able to prevent Lyme disease in mice.
Klempner’s team presented findings showing that the antibody protected mice against infection with Borrelia burgdorferi, the bacteria responsible for Lyme disease. [2]
Further details were expected once the results were published in a peer-reviewed journal.
Monoclonal Antibodies vs. Vaccines
Researchers report promising results for monoclonal antibodies as a potential approach to preventing Lyme disease.
Klempner explained the difference between vaccines and monoclonal antibodies.
“With a vaccine, people receive pieces of the bacteria or virus so the body mounts an immune response and produces antibodies,” he said.
Monoclonal antibodies work differently. Instead of stimulating the body to produce antibodies, the treatment directly delivers a protective antibody.
This approach builds on earlier preventive strategies similar to gamma globulin injections used historically to prevent infections such as hepatitis and tuberculosis.
The monoclonal antibody provides immediate protection but may need to be administered yearly.
The Lyme Disease Vaccine History
An earlier Lyme disease vaccine was once available for humans. However, its manufacturer, GlaxoSmithKline, discontinued production after concerns about safety and multiple lawsuits from individuals who claimed the vaccine caused illness.
The company ultimately reported that demand for the vaccine was insufficient to justify continued production.
The vaccine was removed from the market in 2002.
The CDC notes that protection from the vaccine diminished over time and that individuals who received the vaccine before 2002 are unlikely to remain protected today. [3]
Important Questions About Monoclonal Antibody Prevention
Researchers at MassBiologics still need to address several important questions before monoclonal antibody prevention becomes widely available:
- Will monoclonal antibodies protect against the growing number of Lyme disease strains?
- Will the treatment work against related species such as Borrelia miyamotoi, which causes tick-borne relapsing fever? [4]
- Could monoclonal antibodies be developed to prevent other tick-borne illnesses such as Babesia or Anaplasmosis?
- Will side effects occur in humans that were not observed in animal studies?
- Will the treatment be affordable if it reaches the market?
Clinical Takeaway
Monoclonal antibodies represent a promising approach to preventing Lyme disease. Unlike vaccines, which rely on the body to produce its own immune response, monoclonal antibodies deliver immediate protection. Ongoing clinical trials will determine whether this strategy is safe, effective, and practical for widespread use.
Related Articles:
Lyme disease vaccine for humans: would you trust it?
Researchers race to develop a Lyme disease vaccine
Questions linger on the efficacy of the Lyme disease vaccine
References:
- UMass Medical School. Preventative shot for Lyme disease developed at UMass Medical School enters clinical trial. Feb 24, 2021.
- Fox M. Lyme Disease Treatment Would Prevent Infection, Researchers Say. NBC News.
- Centers for Disease Control and Prevention. Lyme disease vaccine.
- CDC. What you need to know about Borrelia miyamotoi.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
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)?