Antibody-dependent enhancement and SARS-CoV-2 vaccines and therapies

Wen Shi Lee, Adam K. Wheatley, Stephen J. Kent, Brandon J. DeKosky

Research output: Contribution to journalReview ArticleResearchpeer-review

433 Citations (Scopus)


Antibody-based drugs and vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are being expedited through preclinical and clinical development. Data from the study of SARS-CoV and other respiratory viruses suggest that anti-SARS-CoV-2 antibodies could exacerbate COVID-19 through antibody-dependent enhancement (ADE). Previous respiratory syncytial virus and dengue virus vaccine studies revealed human clinical safety risks related to ADE, resulting in failed vaccine trials. Here, we describe key ADE mechanisms and discuss mitigation strategies for SARS-CoV-2 vaccines and therapies in development. We also outline recently published data to evaluate the risks and opportunities for antibody-based protection against SARS-CoV-2.

Original languageEnglish
Pages (from-to)1185- 1191
Number of pages7
JournalNature Microbiology
Issue number10
Publication statusPublished - Oct 2020

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