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Sublingual Immunotherapy as an Alternative to Induce Protection Against Acute Respiratory Infections
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Respiratory delivery of passive immunotherapies for SARS-CoV-2 prophylaxis and therapy

Daniele Focosi1, Fabrizio Maggi2

  • 1North-Western Tuscany Blood Bank, Pisa University Hospital, Pisa, Italy.

Human Vaccines & Immunotherapeutics
|October 6, 2023
PubMed

Convalescent plasma has been extensively tested during the COVID-19 pandemic as a transfusion product. Similarly, monoclonal antibodies have been largely administered either intravenously or intramuscularly. Nevertheless, when used against a respiratory pathogen, respiratory delivery is preferable to maximize the amount of antibody that reaches the entry door in order to prevent sustained viral multiplication. In this narrative review, we review the different types of inhalation device and summarize evidence from animal models and early clinical trials supporting the respiratory delivery (for either prophylactic or therapeutic purposes) of convalescent plasma or monoclonal antibodies (either full antibodies, single-chain variable fragments, or camelid-derived monoclonal heavy-chain only antibodies). Preliminary evidences from animal models suggest similar safety and noninferior efficacy, but efficacy evaluation from clinical trials is still limited.

Keywords:
COVID-19Convalescent plasmaSARS-CoV-2Spikemonoclonal antibodiesnasal immunotherapiesneutralizing antibodiespassive immunotherapies

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