Thread by @RajeevJayadevan

Early indications that certain monoclonal antibodies in current use might still be effective against omicron.

This lab study using pseudotyped viruses bearing some of the key mutations of omicron showed the effect wasn’t blunted.

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biorxiv.org/content/10.110…

The obvious theoretical question that comes with Omicron is that the extraordinary number of mutations in certain key areas could potentially alter the target of these antibodies to a point where the “missiles miss their target”.

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Particularly because these mutations occur in a part of the spike protein that binds to the ACE-2 receptor, called the RBD.

However, there are several parts of the spike protein that remain unchanged, which means that the ENTIRE TARGET cannot be changed by the virus.

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The makers of the monoclonal antibody (who did this study) say that they use a Spike RBD epitope at position S309, away from the RBM (receptor binding motif) which is less likely to be the focus of recurring mutations.This epitope is shared with the original SARS 2003 virus.

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This study was done on a partial set of mutations in the lab. Authors believe that the remaining mutations might not affect the final results.

That’s because those remaining mutations are located outside the target area of these monoclonal antibodies.

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Further studies (using the full set of mutations) will confirm whether these early findings will actually correlate with clinical results.

Lab studies are important, but they should not be confused with actual patient outcomes.

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